Before i proceed with surgery

Nstkins53
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13 months ago i had to stop working after persistent numbness, pins and needs, pain on the top side of my hands (feels like when you push a bad bruise) sharp stabbing like pains, cramp like spasms from my fingers to my shoulders ( highly repetitive work in a fish market) initially i was told it was likely CTS by a GP and we proceeded to seek treatment from a Physio Therapist and resedt for 5-6 months until i was sent to seek advice from a surgeon who told me he greatly thinks i have CTS due to my describes symptoms ( he recommended i get CTS release surgery asap) Seeking a second opinion i went for Nerve Conduction Studies where my results came back negative for any signs of CTS. I went for a MRI scan which also came back negative for signs of CTS. I was very weak to the point where i had the grip strength of a 70 year old women using her non dominate hand ( Physio's words) I returned to work many months later and within a week my symptoms came back almost as bad as the initial flare up with most the pain focused on my lower arms to finger tips, again rested, physio, returned to work with the same result. I'm at a point where surgery seems like the only option available to help myself, but without any proof of CTS other then a surgeons opinion after 5 minutes of conversation should i proceed with surgery in hope that it will help? What else can i do? I'm only 27 years of age. Thanks.

jeremydpbland
Online

If you start off by running through the diagnostic questionnaire here we can then get a fairly objective indicator of how likely it is that the problem is CTS. You are much younger than the typical CTS patient, and if, by the 'top side' of the hand you mean what I would call the back of the hand then that is not a typical site for CTS symptom either. JB

Nstkins53
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I have taken the diagnostics questionnaire and it appears i have a low 4% chance of CTS? I'm going to assume i should avoid surgery at this stage, even though the surgeon assures me it can't be anything else causing the symptoms. I've been f work for almost 2 years now because of this issue.

jeremydpbland
Online

The surgeons will just have to accept that I think they are a little biassed in wanting to operate on the carpal tunnel of anyone whose symptoms might just be CTS. Your presentation is clearly not typical for CTS and I would be inclined to go and see a rheumatologist of neurologist for a second opinion - or even just a different hand surgeon if you can find one with a good reputation - before embarking on surgery. It's also a good idea to experment with local corticosteroid injection first before embarking on surgery. If there is a marked response to injection that helps to provide evidence of CTS, is a predictor of succssful surgery, and in any case sometimes solves the problem anyway. Are you in the UK or US or elsewhere?

Nstkins53
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I will take your advice and seek a second opinion from a hand surgeon and a neurologist. Definitely not proceeding with surgery at this stage. I've been recommended to under go steroid injection, i think i will proceed with that option. Is there any risks with the injections i should be made aware of? I'm locate in Australia. Thanks for you detailed response.

jeremydpbland
Online

Steroid injection is very low risk if carried out by someone competent. Look for someone who does lots of CTS injections and make sure they tell you what they are injecting. it probably needs a dose of 40mg triamcinolone or equivalent and there is little point in adding a local anaesthetic to the injection so we don't do it, but many people do, I suspect because one of the popularly available steroid preparations comes with a local anaesthetic already added. JB

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