Dear doctor

MS fears

Q: For six months, I've had tingling and slight numbness in the fingers of both hands. I also feel tired walking up stairs and seem more forgetful. My GP referred me to a neurologist because I was worried I might have multiple sclerosis but he laughed and seemed convinced it wasn't. I'm in my twenties and generally well. What could be wrong?

A: Pins and needles and numbness are alarming and I think we all tend to assume the worst. But the commonest cause is that nerves to the hands are trapped - either in the neck if you have slept awkwardly, or are tensing your neck muscles while working or because you are stressed. The nerves can also be trapped at the wrist, so-called carpal tunnel syndrome, which affects thumb, index and middle fingers only. This often happens in pregnancy or other times excess fluid is retained, as before a period. You could try osteopathy to the neck. If symptoms persist, ask to be re-referred to the neurologist.

Is dementia inherited?

Q: I have a family history of multi-infarct dementia. What can I do to avoid it myself, a thought that terrifies me?

A: Multi-infarct dementia (MID), caused by a series of mini-strokes which restrict the blood supply to the brain, is not known to be inherited in any predictable way. However, you can minimise your risk of developing it, or related diseases such as heart attack and stroke. The best prevention is not to smoke. Get your blood pressure, cholesterol and blood sugar levels checked and make sure all are kept within normal range, if necessary with medication. Ask the GP to check your pulse rate and listen to your heart because irregular beats can throw off small blood clots which may contribute to MID.

Chest pains

Q: I've been suffering from a tight chest pain, mostly on the left, especially when I play rugby. I gave up smoking more than two years ago and go to the gym several times a week, as well as rugby. My GP gave me a peak flow meter to blow into which apparently shows that it's not asthma. So am I mad, or a hypochondriac, as my partner suggests?

A: I don't think you are mad or a hypochondriac. It's quite possible that the pain is muscular and due to the odd positions you get into when playing rugby. But as it comes on during exercise, it would be useful to know that it's not due to early heart disease causing narrowing of the vessels round the heart (angina). You may want to ask your doctor about an exercise ECG in which you use a treadmill while wired up to an ECG machine which records the electrical activity of your heart. This can show signs of exercise-induced angina; if normal, you will be reassured.

Nasty little rash

Q: Four weeks ago I returned from my gap year inter-railing all around Europe. I have developed an unbearably itchy rash of tiny spots in my armpits, round my belly button and on my bottom and thighs. I can't face going back to my old family doctor but, equally, I can't bear another night of this terrible itching.

A: It's hard to say without seeing the rash but it sounds like scabies. You could easily have caught this mite from infested mattresses, even if they looked quite clean at the time. Permethrin dermal cream (Lyclear) can be bought over the counter and is effective and easy to use. Apply it to your whole body, excluding head and neck, and wash off between eight and 12 hours later. You can also take Piriton antihistamine tablets orally for the itching, also available from the chemist. See your GP first to confirm the diagnosis.

• If you have a question for Dr Robinson, email her at or write c/o the Health Editor, The Guardian, 119 Farringdon Road, London EC1R 3ER. She regrets she cannot enter into personal correspondence.

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