Dear Dr. Gott: I am writing in regards to your answer to the 74-year-old woman with carpal tunnel. Please don't discount occupational therapy as a valid treatment option. Therapists are educated and trained in the treatment of the upper extremities as well as management of pain and restoration of function for daily tasks. We would have provided this woman with modalities, stretches, custom splints and effective home programmes. Each patient gets a custom-designed plan of care. Please let your readers know about occupational therapists.

Reply: Not everyone is aware of what an occupational therapist (OT) actually does, so I will explain. OTs work with a variety of people of all ages with mental, physical, emotional or developmental disorders. Their goal is to help patients improve their ability to perform tasks associated with living and working environments. The techniques used are designed to develop, recover and/or maintain the daily skills of their patients.

Some OTs work with patients in a specific age bracket or with those who have a particular disability. Others work within a certain field, such as mental health (including mental illness, developmental or emotional challenges), school systems, nursing homes or other elderly-care facilities. As you stated in your brief note, each person receives a customised treatment/care plan. Those with temporary conditions, such as those recovering from an injury, may require only minimal aid and limited therapy to regain skills, while others with permanent disabilities may benefit from long-term or lifelong treatment to develop and maintain those skills.

Occupational therapists are medical professionals, educated, tested and qualified through a number of accredited schools. They must pass a national examination as well as any state-required licensing or specific qualifications. Typically, a master's degree or higher in OT is the minimal educational requirement. Students must also attend an academic programme accredited to the Accreditation Council for Occupational Therapy Education before they can take the national certifying exam (at which they earn the title Occupational Therapist Registered, or OTR). Every state requires licensing, and only those who have graduated from an accredited programme and have passed the national exam become licensed. Some states have additional requirements that must be met should the OT choose to work in a school or early-intervention programme.

Following licensing, therapists are mandated (as are nurses, doctors and many other healthcare professionals) to participate in continuing-education courses and workshops. Such programmes aid the therapist in keeping up-to-date on current therapies, procedures and a great deal more.

Many states require these programmes in order to maintain licensure.

I suggest that anyone interested in learning more about what occupational therapists do or what requirements there are to become one visit the American Occupational Therapy Association Inc. website at www.AOTA.org.

The Bureau of Labor Statistics also has information about types of employment, possible estimated earnings/wages and more.

Dear Dr. Gott: Keep up your excellent work and honest reporting; it is much appreciated. I also want to thank you for not using our e-mail addresses for any other purpose. And, lastly, I want to mention that providing an e-mail address, telephone number or even a last name should be optional unless the correspondent wishes to do so.

I know many people will use you in the worst sense of the word for "free" medical advice outside your column's parameters. It's just human nature, I guess.

Reply: Although my website does not specify that last name, e-mail address or telephone are required or optional, they are, in fact, optional. I even tested this myself by simply putting in my first name, typing a message, and clicking the submit button. I did receive my own message.

Thank you for the compliments.

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.