Ask the Doctor: Carpal tunnel syndrome, arthritis, and swollen calves

Doctor Rob Riley joins us from Memorial Family Medicine every week to answer viewer questions.

Here are the questions he addressed on November 17, 2015:

Jenn: I had carpal tunnel surgery a few years ago. All seemed fine until a few weeks ago. Is it possible to need to have the procedure done again?

Dr. Riley: Carpal tunnel syndrome occurs when one of the nerves that goes to the hand gets compressed as it passes through the wrist. People notice numbness and tingling and sometimes weakness in the hand. The surgery involves cutting through the band of tissue that goes across the base of the wrist, and that leaves more room for the nerve and typically things get better and they stay better. But occasionally that band can scar down and cause pressure again. A repeat of the procedure has a good chance of success.

Suzann: Osteoarthritis or rheumatoid arthritis: how can you tell them apart? And what professional should I see?

Dr. Riley: Osteoarthritis is the wear and tear kind of arthritis. People most commonly complain of pain in their knees and hips with activity. We see this more commonly as people get older, particularly in those who carry extra weight. Rheumatoid arthritis is much less common and is caused by a problem with the immune system. People are more likely to complain of pain in their fingers and hands rather than those large weight-bearing joints. In rheumatoid arthritis, the joints also become red, hot, and swollen. So, a combination of the story, the exam, blood tests, and x-rays help to make the right diagnosis. People with joint symptoms should see their primary care doctors first and then decide if others should be involved.

April: About once or twice a month for a few days at a time my calves swell up and are sore. What is this and why is it happening?

Dr. Riley: The most common reason for having swelling in both legs that comes and goes is a condition called venous stasis. This just means that the veins in the legs are not as good at pushing the blood back up into the body against gravity as they should be. We see this more commonly in women than men. Other risk factors include obesity, pregnancy, and a past history of blood clots in the legs. Symptoms often get worse after standing for a long time. Medications are not generally helpful, so we start by emphasizing elevating the legs whenever possible and applying compression to the legs, starting with simple things like wearing support hose. I'd advise the viewer to check with her doctor to see if maybe this is what's going on.

If you have medical questions, you can call the health professionals at Memorial Hospital at 574-647-6800 or 800-999-8890.