advice for cts please read my long painful story

montek
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Hello everyone-- I am experiencing some pretty annoying CTS symptoms- especially in my left hand. To give you guys a little background- I had major surgery in February 2015 in my abdominal cavity-- I had sepsis and abdominal compartment syndrome-( you can google it on the web)- I was the strongest and healthiest guy right before that occurred but following a cortisone shot I acquired sepsis and that was all she wrote. I almost expired- but due to my extremely healthy condition as per the doctor - I survived that massive operation. Now fast forward to today- I was doing physical therapy quite frequently especially at home . I am an exercise freak. Well I started doing miles of walking but many times I held weights in my hands nd tyhat is what I believe caused my present CTS. I went to a hand surgeon who sent me for an EMG and the results came positive for moderate damage in the left hand and mild in the right. I am a Pharmacist and type all day- I have been doing this for over 30 years and NEVER had a problem until this overuse I believe with walking with hand weights?? I love to exercise with weights - am no Schwarzenegger by any stretch of the imagination BUT I love to feel good and keeo in shape. I used to do farmer walks with 60 lpound dumbbells in each hands for my grip strength and that never affected me.! So why now am I getting all these CTS symptoms. It is making me lose sleep and I am getting very depressed that I am told not to do any weights for who knows how long? I am melting away. I started to do yoga and even am going to a physical therapist for LASER therapy and stretching. What scares me is that while in the waiting room of the hand surgeon- we spke with some patients who said that surgery was the best thing they ever decided to do.That all the PT they did for their hands was temprary relief and a waste of time and money??? This thought lingers in my brain now that I have CTS symptoms going on 6 weeks. I have now just fread about the C-TRAC device and am thinking seriously about trying it??? As for surgery mhy wife is quite against it since my last major surgery was just months ago and I was put in a 18 day medically induced coma to survive that operation. But I am the one living with this horrible condition right now- and if surgery is the way to stop this discomfort then so be it. My only other option is my wife is making an appointment for me to a neurologist and maybe he will prescribe some GABAPENTIN- for this nerve pain?? Has anyone known anyone who uses this medicine with any luck??? As you can see I really concerned,worried ,scared and unsure of what to do. You people seem to have a good pulse on what is going on. I would appreciate a reply regarding the Physical therapy I am getting(LASER) etc etc an also about the C-TRAC device and lastly about medicines like gabapentin? Thank you so much and sorry for the long story -BUT I had to tell you how I got where am I am.

jeremydpbland
Online

Why would you need a 'cortisone shot' at the start of that story if you were perfectly fit and healthy? Where was the injection and was it thought to be related to the abdominal catastrophe?

So far as the CTS is concerned, 6 weeks is quite a short history so the condition has not become fully established and might respond to conservative measures. Wear a neutral angle wrist splint at night for 4 weeks and give up the hand weights. There is no need to abandon all exercise and you can stay perfectly fit without doing things which increase your carpal tunnel pressure - power grip and marked flexion or extension of the wrist are the things to avoid, typing is fine.

Laser, all forms of physiotherapy/exercises and C-trac are of unproven benefit in CTS. In the only independent study of C-trac it performed no better than an ordinary splint. If you do decide to try it make sure that the vendor is still offering their money back guarantee and get your money back if you are not cured within the specified period - it's relatively expensive. I would also appreciate more reports on here from users of C-trac, whether or not it is found to be useful. We have had a few, with rather mixed results so far.

Gabapentin has been looked at in two decent quality trials and was found to be no better than placebo. 

The only interventions which are known to be effective for CTS are splints, steroids and surgery and I would want to know a bit more about your previous illness before suggesting steroid injection. If you have a copy of your NCS results we can also try to work out exactly what they mean by 'mild' and 'moderate'. JB

montek
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Thank you for replying. As for the back shot-- I had slightly injured my back using weightts years ago- Had some chiro treatments and was fine- Every now and then it would flare up. I had the cortiisone shot in mid to late January to relieve some tightness. After a large snowfall and much shoveling I again went back for another shot due to reaggravating my back- I had the second shot the first week of February- the shot was not given in the lower back as requested but much higher in the mid back fr some reason- make a long story short- I acquired sepsis- either from the shot or who knows what and it traveled into my abdominal cavity. That is that story.
I am wearing a cock-up-splint on both hands at night- is that what you are calling a neutral angle splint??
As for the treatments for my carpal tunnel- do you think Laser therapy is a waste of time or might it work?? And again sorry to press you- but if the neurologist recommends gabapentin- is that worth a try??? I might be one of the lucky ones???As you say I am early on in my problems so you did say conservative measures may help??
As for wearing the splint should I be wearing it during the day while I work- I feel that I am becoming dependent on it which I do not want to do???Please explain - about this aspect for me.
Also how about lidocaine patches on my wrists?? Any help there- and is the use of a TENS machine on the wrists any help as well?Sorry for all the questions- BUT I need to help myself as much as I can with your help if you can.
As you say I am early in my fight with CTS-- BUT again- how long does one wait before deciding to be aggresive?? As you mentioned surgery?? And what scares me is reading the forum posts on this site - not all stories are successes- I hear a lot of people complaining that surgery did not help??
Lastly I have scanned my NCS results for you BUT I do not know how to attach it here so that you can read them. Please inform me how to do this in my next reply.
P.S.-- I have been doing stretching exercises for my hands as I learned about from you tube channels- hopefully that will help??? I do some form of yoga exercises also for my hands? Again hopefully this will help. As you can tell I am obsessed with getting rid of this condition as quickly as possible.
as mentioned earlier are there any upper body exercises I can do with this condition or do you not recommend it- and if you do know of any please inform me. :)

jeremydpbland
Online

Interesting back injection story - I wonder how long a needle they were using - as you say it may or may not have been anything to with the infection.

Splints are illustrated on the splinting page of the site here and need to be adjusted to the right angle. 'Cock-up' splints which hold the wrist in extension probably make CTS worse.

All the alternative treatments of no proven benefit are listed on this page along with some brief details. Most of them are at least fairly harmless so can reasonably be experimented with but I would be wary of spending much money on any of them. Nerve and tendon gliding exercises are 'self-help' and harmless but have not clearly been shown to help.

It's worth remembering that people with poor outcomes from treatment, who are actually the minority, have more incentive to get out there on the web looking for solutions and telling their stories so they are disproportionately represented in web forums etc.

Just email the NCS results to me (Jeremy [dot] Bland [at] nhs [dot] net) and I'll take a look. JB

Thankyou for the NCS - looks like grade 1 right and grade 3 left, I've replied by email too JB

montek
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hello to all--- just wanted to give you guys an update--
I am happy to say that I am 100% again-- I must say that physical; therapy and cold laser treatments worked wonders- I was very very very diligent about doing the exercises and stretches-- and wearing the night braces. I have zero tingling in my hands and I am working out again doing Dumbbell curls and the like and working at my profession as a pharmacist typing many labels- again with no problems.. I am a very proactive and active person and I thank my lucky stars that I have recovered so well with nothing more than a little effort and hard work. I also have been using hand grippers- with quite a bit of tension and my grip is quite strong as well. Just wanted to let you know - that so far I am a success story. Thanks for all your concern and help. Stay well - all!

jeremydpbland
Online

Thanks for taking the trouble to come back with an update. I would probably put that down as a success for not doing anything very aggressive - it seems to have needed little more than splinting, possibly some exercise and a bit of time. Of course in that mixed bag of minor interventions it's impossible to know the relative contribution of each to the outcome but as long as you are better we don't really care, in the individual case, what made the difference. JB

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