Diagnosed with Carpal Tunnel and being told I need surgery but not convinced??
Hi I have been diagnosed last year by my GP with Carpal Tunnel and he also thought that I may have De Quervain's tenosynovitis. I have had 2 shots of Cortosone steroid injections. The first one was great last October as it took all the pain away but by christmas it started creeping back and then I was in a lot of pain again so I had another shot of it in the wrist again in January but this time it didn't work. It has taken some of the wrist pain away but am still in a lot of pain with my thumb and palm.
A little info about me - 36 year old female. Mother to young children and self employed working full time hours.
To back track I had symptoms for around 2 years which first started with a pins and needles sensation in the tip of my thumb. Gradually I got pain all in thumb joint, wrist, slightly up the arm and the worst pain was pinching my fingers together to grasp an object.
Before the symptoms I had an aggravated shoulder which I needed physio for, I think this was caused by using crutches after a bunion op.
I then had to have another op on my foot a year later so had to use crutches for another 6 weeks or so.
I am waiting to see a rheumatology consultant (appt in June) as several drs and physio have told me I have hypermobility syndrome (my daughter also has it). I have recently seen a specialist at hospital (carpel tunnel specialist) who said I need surgery for carpal tunnel. This is the part where I am concerned it may not be carpal tunnel. Its not typical of everything I read online about Carpal Tunnel as it comes and goes. Its like I have waves of it, I will have a good few days where the pain is bearable and it doesn't stop me doing anything then I seem to have an overwhelming tiredness hit me then several days of terrible pain. On the first day of the terrible pain my whole body hurts (all joints such as back, neck, feet, hands), they all seem to subside to a level that I feel ok to deal with but the right hand (the carpal tunnel hand) is absolute agony.
I am now on day 5 of the bad pain and the hand is wearing off (still hurts a lot but not as bad as day 1,2 and 3). After a week or so of this pain it seems to ease again then the tiredness hits again and the pain comes back.
I have been wearing a splint on a night for quite a few months now and when I can during the day.
At the moment the only thing visible looks like tendons or veins sticking up from my palm between index finger and thumb. It looks very different to my left hand and what ever it is sticking out is very tight.
Does this sound familiar to anyone with carpal tunnel? There is also a few reasons I want to be sure I would be doing the right thing with surgery: I have had further surgery to my foot after bunion op pain and looking back now I believe this was all to do with hypermobility and I am beginning to regret it as it has restricted me a lot over the past year since I had it. Also I am self employed and a mum to 2 young children so I am needed in top condition for my children and my business!!
I have done the symptom checker and not sure what the results mean but this is what I got :
You overall probability score(ANN): 4%
You overall probability score(LRP): 9%
Hi thank you for your help. Both injections were given typically for CT so were on left side of my right wrist if that makes sense. I'm not sure on dosage but I know that I cannot be given any more now. The de Quervains wasn't mentioned by the recent CT specialist so perhaps this was just a guess from my GP.
I am going to speak to the CT specialist about having a nerve conductive test. Due to being self employed and a mum I am very hesitant about going ahead with the surgery, especially as I have regrets over my last foot surgery as now looking back I wonder if the problems were caused by having hypermobility.
It's really hard to describe the injection site isn't it. There is an illustration of a carpal tunnel injection here on the site - does it look familiar? There isn't really an evidence based limit on the number of injection that can be given for CTS - if someone has said no more than two then that is justtheir personal opinion. We often carry on to 3 or 4. Good luck with getting NCS performed. JB
You for sure have been a Trooper... Aside from getting your hand check for carpal tunnel have you visited another type of physician? You might have a sensory nerve damage..
Thank you for your replies. Just wanted to update on this. I have seen the CT specialist today and he confirmed that he doesn't think all the pain is down to CT and to go ahead with the surgery may cause me further problems as it is not all related to CT.
He thinks that I may possibly have rheumatoid arthritis and also a chance of gout. I have been advised that the next time I have another flare up to get a blood test asap so that they can check if the markers are there for rheumatoid arthritis. I have had tests done before for this which were clear but this was when it wasn't flared up.
My hand is also hypermobile too - I will be seeing the rheumatoid specialist this year and will probably have the hypermobility officially diagnosed too.
Thanks for the update. Interesting that the CTS person (a surgeon presumably) is starting to backtrack a bit. I would still like to see some nerve conduction studies now that the issue of CTS has been raised. It will also be interesting to see what the rheumatologist thinks. JB
Those scores suggest that your symptoms are, as you suspected, not very typical of CTS so heading straight for surgery may not be a great idea to begin with. You should definitely get some nerve conduction studies done before allowing someone to take a knife to your wrist in this situation (that's a bit complex as normally I would suggest not bothering to test someone with a score that low because the results will probably be normal, but if they are going to operate on it anyway I would like to see that normality documented first in case of problems after operation).
Where were the injections given? Usually the one for de Quervains is on the side of the wrist - if you think of the wrist as having 4 'faces' one on the same side as the palm one on the back and two 'sides' then we are talking about the 'side' where the thumb is - 2-5 cm up the forearm. The CTS injection on the other hand is usually given into the palmar face of the wrist, again a few centimetres up though techniques do vary. The other thing to be aware of is that the dose and steroid used can vary a lot and it's worth knowing exactly what was injected - they might have used a tiny dose for the second one.
I'm sorry about the difficulty directing you here from patient.co.uk - it's really hard to post a simple link in that forum. JB