Dear Dr. Gott: About 13 years ago, I fractured my humerus in multiple places. The fracture was cast only and did not heal properly. If you run your finger up my arm, you can feel where the bones are misaligned.

I have always had pain in this arm, but for the past five or so years, I have had numbness in my hand that is getting worse. Within the past year, I've had sharp pains in my forearm, almost like someone is splitting the bone in two. I'm concerned that if I mention this to my PCP, he will just want to prescribe me a painkiller and send me on my way, possibly labelling me a drug seeker.

What kind of treatment is available for something like this? I don't want painkillers.

Reply: I'm not sure why you didn't have a pin in your arm if you broke it in multiple places, but I'm sure that your orthopaedist had his or her reasons for simply casting it. Without reviewing the X-rays, there is no way of telling how severe the fractures were.

You appear to be levelheaded. I cannot believe that if you present the facts as you did to me in your brief letter that painkillers would be prescribed. While you may experience pain and would like relief, the prime concern is to determine why you have the numbness. You should be followed by an orthopaedic specialist to avoid further progression of whatever is going on. An X-ray can determine bone alignment and see whether there is nerve impingement. Only then can your doctor plan an appropriate course of action. Good luck.

Dear Dr. Gott: I have been plagued for years by an incurable skin condition I am told is called prurigo nodularis. Nothing has helped in clearing it up, and it has been active for more than two years. I have tried a sunlight box and a tanning bed, as well as cortisone injections, medical cortisone tape and creams – both over-the-counter and prescription. All seem to help only a little.

Do you have any idea as to how I can get rid of this or at least keep it under control? I eat healthy and take vitamins.

I am 22 years past breast cancer diagnosed at the age of 32. I had nine rounds of chemotherapy and took tamoxifen for ten years. I was divorced in 2006 after a lengthy marriage of much discord. I'm now stressed, as I was a homemaker and never worked. I face a mortgage and a pile of bills and am trying to find a job. I haven't worked in two years, my unemployment ran out several months ago, and I have a pile of bills and no health insurance. It's difficult to maintain my sanity under all the stress.

Reply: Prurigo nodularis resembles multiple soybean-sized nodules on the skin, particularly the legs and thighs of women. While the urge to scratch is overwhelming, repetitive touching results in plaque buildup and hyperkeratosis (thickening of the skin). Therefore, covering, wrapping or avoiding touching the nodules is extremely important. Anxiety exacerbates the symptoms.

Current available treatments only provide mild to moderate improvement of the condition. Capasicin cream applied four to six times a day, vitamin D3, antihistamines, dapsone, gabapentin, cryotherapy and topical anaesthetics might be options. Thalidomide appears the drug of choice at this stage, but it was a horror drug in the 1960s that can cause peripheral neuropathy, and I can't endorse it without further research. Chinese herbs have been reported to help, but I am unfamiliar with the remedies recommended and, again, cannot endorse these, either. Share my suggestions with your physician for his or her consideration.

Dr. Peter H. Gott is a retired physician and the author of several books, including 'Live Longer, Live Better', 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook', which are available at most bookstores or online. His website is www.AskDrGottMD.com. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.