<s>[INST] my fience says he has carpel tunnel and is pretty sure he has arthritis, but he has this intense throbbing that he says it feels like its pulling his index finger and thumb together and it sends shooting pains up his fore arm!!! what can i do to help him ease the pain cuz it makes it really hard for him to work and he is constantly dropping stuff and i really hate seeing him hurt like that? [/INST] Hi, thank-you for providing the brief history. A thorough neuromuscular assessment is advised. As the pain is in the index finger and thumb which is pulling in nature and radiates to the forearm. It can be due to two factors. Either a nerve pathology or a muscle pathology. Also, for clearing the doubt in RA and Carpal tunnel two test can be performed. For RA - laboratory test for RA factor and For CTS - Nerve conduction velocity study. Also, if both reposts come normal or such then an MRI of cervical spine is advised. As the pain is radiating in nature. Now, for all the CTS, RA and Cervical disc pathology - physical therapy is recommended to improve the physical abilities and strength. RegardsJay In Chat Doctor.  </s>