looking for some advice about work.

Jabd
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Hi,

Probably best I start with a bit about my CTS...

Its a pretty new new diagnosis, I saw my Doctor on Friday. He said he is referring me to a consultant to 'Get to the bottom of things'.... he also urged me to go and see a physiotherapist first thing Monday morning (thats today). The physiotherapist made his assessment, he said he is referring me to the consultant as an 'urgent' case and that there is nothing that physiotherapy can do for me.

So I am 27 years old, I have been having the usual symptoms for a few months... numbness, pins and needles, and swollen feeling. I first put it down to the activities involved in my new job. I just assumed the symptoms would go eventually. things have escalated now. three fingers on my left hand lock up over night, and two on my right. I have constant pain in my wrists that at times goes right up to my elbow. I can feel my grip getting worse pretty much day by day.

the physiotherapist recommended I wear splints at night and also alluded to me going back to work fairly soon.... but is this a good idea?

I work as an assistant brewer which involves amongst other things, constantly lifting heavy barrels, using machinery and intensively cleaning the kit. Right now even pushing a sweeping brush hurts pretty bad!

There was a time when the symptoms weren't so bad when I was working. in fact, it was better when I was keeping busy. now just everything hurts all the time.

my dilemma is am I doing the right thing by staying away from work? If I go back am I making things worse? Is this just how it is now and I just need to suck it up and get on with it?

It would be great if anyone had any answers to this...... and PLEASE someone tell me I'm not alone!

Thanks for letting me rant!

jeremydpbland
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I'm sorry but no-one really knows the answers to this - though there are plenty of people who will be prepared to tell you that they do. The scientific community can't even agree amongst themselves how much of a role use of the hands has in causing CTS in the first place. The only thing you can say with reasonable certainty is that most people with CTS do seem to feel that using their hands more, more strenuously, and more repetitively, tends to exacerbate symptoms - but that is not necessarily the same thing as making the nerve damage worse. Conversely the majority of patients feel that resting the hands helps - but generally speaking, not using your hands for anything leads to a pretty unfulfilling life!

In the absence of any good evidence from well designed experiments my best guess, and it is a guess, is that it is generally advisable to lay off doing things which clearly make your symptoms worse.

As usual, the first thing you need is an accurate diagnosis. Your symptoms sound initially plausible for CTS but it is uncommon in your age group and your symptom score on here is fairly modest (it will have been marked down considerably on grounds of age by the algorithm I think), so I would want some definite evidence in favour of the diagnosis before just accepting that it is CTS.

I would then want an objective measure of how bad it is. With all due respect, the physiotherapists clinical assessment of the severity of nerve damge is likely to be inaccurate unless you have end-stage CTS - the only degree of severity which can be reliably spotted by examining the hand. You can get both of these things from a set of nerve conduction studies. Then you have a more objective measure on which to base some rational decision making about how to proceed. JB

Jabd
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Thank you for getting back to me.

I really appreciate you taking the time to give me your views. I feel I've had so much information thrown at me over the last few days I don't really know whats going on.

Hopefully I will get some more information over the coming weeks with witch I can make an informed decision on my next step.

Thank you again.

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