Questions Your Doctor May Ask - and Why!
During a consultation, your doctor will use various techniques in his assesment of the symptom: Finger paresthesia.
These may include a physical examination or other medical tests.
Your doctor may ask several questions when assessing
your condition. It is important to remember that your consultation is a two-way process and any extra information
you can share with your doctor may help them with their diagnosis.
Some of the questions your doctor may ask are listed below:
- How long have you noticed paresthesia in your finger?
Why: to establish if acute or chronic.
- Which finger or fingers are affected?
- Are there other parts of the upper extremity that are affected by paresthesia?
Why: e.g. hand, forearm, elbow, shoulder - can help determine which nerves are affected.
- Are both upper extremities affected and is it symmetrical?- helps determine which nerves are affected e.g. peripheral neuropathy is symmetrical compared with individual nerve or nerve root disease which should be suspected if sensory loss is asymmetrical or confined to one limb
- Is there a time of day when finger paresthesia is worse?
Why: can help determine the cause of arm numbness e.g. carpal tunnel syndrome is usually worse at night.
- Relieving factors?
Why: helps determine the cause of finger paresthesia e.g. carpal tunnel syndrome symptoms may be relieved by dangling the arm over the side of the bed.
- Recent viral infection?
Why: may suggest Guillain-Barre syndrome (usually follows 1-3 weeks after a viral illness that is often trivial).
- History of trauma?
Why: e.g. whiplash injury, Brachial plexus injury, finger fracture may cause finger paresthesia.
- History of exposure to extreme cold conditions?
Why: may suggest frostbite.
- Past medical history?
Why: diabetes and chronic renal failure can be a cause of peripheral neuropathy; Raynaud's phenomenon may be caused by rheumatoid arthritis, lupus erythematosus, systemic sclerosis, polyarteritis nodosa, Buerger's disease, polycythaemia, leukemia, polymyositis , dermatomyositis.
- Dietary history?
Why: e.g. Vitamin B12 deficiency can be a cause of peripheral neuropathy.
- Medications?
Why: some medications can cause peripheral neuropathy e.g. amiodarone , phenytoin, nitrofurantoin; beta-blocker blood pressure medications and ergotamine can cause Raynaud's phenomenon.
- Occupational history?
Why: certain occupations requiring repetitive motions are at risk of causing work-induced overuse disorders (e.g. process and meat workers are at risk of carpal tunnel syndrome due to rapid finger and wrist movement); vibrating machinery workers are at risk of Raynaud's phenomenon.
- Sexually transmitted disease history?
Why: Tabes dorsalis of syphilis may be the cause.
- Cigarette smoking?
Why: aggravates Raynaud's phenomenon and peripheral vascular disease.
- Alcohol history?
Why: can be a cause of peripheral neuropathy.
Questions your doctor may ask about related symptoms:
Sometimes, other symptoms may be present and may help your doctor analyse
your condition. These may include:
- Arm pain?
Why: if also pain in the involved extremity this usually suggests herniated cervical disc , spinal cord tumor or cervical spondylosis. Other conditions to consider are brachial plexus neuropathy, thoracic outlet syndrome, cervical rib, Pancoast's tumor, Raynaud's disease, sympathetic dystrophy or various entrapment syndromes such as carpal tunnel syndrome and ulnar nerve entrapment at the elbow.
- Arm weakness?
- Neck pain?
Why: may indicate cervical spondylosis, herniated cervical disc, spinal cord tumor.
- Are there any other areas of the body which have paresthesia?
Why: e.g. paresthesia of the face would suggest a diagnosis of cerebrovascular disease, a mass in the brain, migraine or multiple sclerosis.
- Symptoms of multiple sclerosis?
Why: e.g. impaired vision, limb weakness, limb numbness or tingling, tremor of hands, dizziness.
- Symptoms of Raynaud's phenomenon?
Why: e.g. sequential discoloration of the digits from pallor to blueness to redness upon exposure to cold. When fingers become red they are painful.
- Symptoms of panic attacks?
Why: e.g. sudden, unexpected, short-lived episodes of intense anxiety, shortness of breath, dizziness, palpitations, trembling, sweating, choking, nausea and fear of dying. Can get tingling or paresthesia, but usually associated with many other symptoms.
- Symptoms of Guillain-Barre syndrome?
Why: e.g. weakness of distal limb muscles or distal numbness which ascends over several days or weeks.
» Next page: Types of Finger paresthesia
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