<s>[INST] i am a 58 year old female who has worked as a computer accountant for 20+ years. Have two years ago been diagnosed with arthritis. I have had mild to severe hand pain for several years that comes and goes. I take a lot of Aleve, which upsets my stomach. For the last few months I have been experiencing shooting pains in my left arm and tingling and numbness in my left hand. Stabbing pain that feel like my hand is being crushed in a vice. Wakes me up in the middle of the night, for months. I recently, about six weeks ago went through a workmans comp doctor who thought I had Carpal Tunnel. I have been through 6 weeks of therapy, which does bring some immediate relief. When i go back to the job, pain returns. Had a nerve study last week. Results were radiculpathy involving C-8 distribution. Workmans comp dropped me, as they said not work related . I now have an appointment to go back to primary doctor tomorrow for follow up. The pain level and numbness is the same as when I started. Now i am experiencing some tremors in the left hand.And since the nerve study and 20 holes poked in my neck, my neck hurts. Cant hardly turn my head. What does all this mean? [/INST] Hello, It could be be due to neuropathic causes like carpel tunnel syndrome. As of now you can consult a neurologist and plan for an MRI scan for further assessment. As of now you can take analgesics like Tramadol or Aceclofenac for pain. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Shinas Hussain, General & Family Physician </s>