I have always had pain in this arm, but for the past five or so years, I have had numbness in my hand that is getting worse. Within the past year, I’ve had sharp pains in my forearm, almost like someone is splitting the bone in two. I’m concerned that if I mention this to my PCP, he will just want to prescribe me a painkiller and send me on my way, possibly labeling me a drug seeker.

What kind of treatment is available for something like this? I don’t want painkillers.

DEAR READER: I’m not sure why you didn’t have a pin in your arm if you broke it in multiple places, but I’m sure that your orthopedist had his or her reasons for simply casting it. Without reviewing the X-rays, there is no way of telling how severe the fractures were.

You appear to be levelheaded. I cannot believe that if you present the facts as you did to me in your brief letter that painkillers would be prescribed. While you may experience pain and would like relief, the prime concern is to determine why you have the numbness. You should be followed by an orthopedic specialist to avoid further progression of whatever is going on. An X-ray can determine bone alignment and see whether there is nerve impingement. Only then can your doctor plan an appropriate course of action. Good luck.

I do have numbness in my hand during the day, but it is not as intense. It occurs when I apply my makeup, style my hair, write, drive and a few times it has happened while playing tennis. Is there anything short of surgery that can be done?

DEAR READER: Carpal tunnel syndrome (CTS) is a common condition of the hands and wrist. It is commonly thought to be caused by using a computer keyboard for extended periods of time, repeatedly; however, it actually has many causes.

The condition involves the median nerve that runs though the carpal tunnel. This tunnel protects the nerve and the nine tendons that allow us to move our fingers. Problems arise when the nerve becomes compressed, causing tingling or numbness of the fingers (excluding the little finger) or hand, a sense of weakness causing a tendency to drop objects, and pain extending from the wrist up the arm into the shoulder — typically on the palm side of the forearm, or from the wrist down into the fingers.

The nerve itself is known as a mixed nerve because it provides both sensory and motor functions. The sensory portion of the nerve is responsible for providing sensation to the thumb, index and middle fingers and the middle-finger side of the ring finger.

Causes of pressure on the medial nerve include specific health conditions such as rheumatoid arthritis, diabetes, pregnancy-related fluid retention, thyroid disorders and menopause, repetitive flexing and extending of the hand and wrist tendons, wrist injuries that cause swelling, and having a narrower-than-average carpal tunnel. Risk factors include overuse or strain from certain tasks such as from the use of power tools or heavy assembly-line work, having a family history of CTS, having certain health conditions and being female, because women are three times more likely to develop the condition. While computer work is commonly considered a cause and risk factor, scientific evidence is not definitive on this point.

Those with mild symptoms may need only to take frequent breaks to rest their hands and/or apply cold packs to reduce occasional swelling. As symptoms increase or if these techniques fail to provide relief, wrist splinting such as you have used is an appropriate next step. Nonsteroidal anti-inflammatory drugs (NSAIDs) may offer relief by reducing swelling and pain. A final option is corticosteroid injections directly into the wrist to decrease inflammation. If the CTS is caused by an underlying health condition, treating that condition may result in lessened CTS symptoms.

The last resort is surgery, which does not work for everyone; however, about 70 percent of those who have undergone the carpal-tunnel-release procedure say they are completely or very satisfied with their results. Some may experience residual pain, numbness or weakness.

Speak with your physician regarding further treatment options, or request a referral to a specialist who can better help you.