Damage potential through continuing work through pain

Kdeco
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Hi
What is presumed to be Carpal Tunnel increased in severity whilst starting work as a decorator. It was so severe that at its worst I couldn't close my hand and was suffering severe pain and also pins and needles and deadening. I've taken a week out but as my waiting time to be seen by a consultant will be at least 12 weeks would I be doing further harm if I continued the work when possibly helped by pain killers?

jeremydpbland
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I would not assume automatically that that is carpal tunnel syndrome but regardless of what is the correct diagnosis, on general principles I would say if an activity immediately results in increased pain in the hands it is likely that the pain is indicating some damage to something or increasing inflammation so I would not generally recommend 'working through' hand pain until the diagnosis has been explored. There are probems where it seems that rest does not help, for example there is evidence that back pain sufferers who remain active do better in the long run than those who take to their beds - but it would be unwise to assume that is true in other disorders. 12 weeks is a longish wait - where are you? JB

Moni
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Hi Kdeco, I also would not recommend to work through pain. I did it initially when all my problems with the hands started. I got told at that time that I had overworked my hands and consequently I should rest for three weeks and then continue with my work again. I did so and after a week I was unable to move my left thumb and had much more pain. The pain is normally a sign of your body that something is wrong and need to be taken seriously to avoid further damage. Not feeling the pain when taking pain killers does not mean the pain is not there. Pain killers only "numb" the pain. And there is also the risk - you do not feel the pain and work more until it hurts again, i.e. the alarm bells of your body go off later and you may cause more damage to your body. Please, do not work through the pain, only till it start to hurt and stop then. I saw a hand therapist last year and I asked her the very same question because I was really frustrated to wait about three months (from beginning of May till beginning of August) until I would be able to see the orthopaedic surgeon. She highly discouraged me to do so. In the 15 years of her practice she never saw a good outcome of "working through the pain", but only delayed recovering time.
There is another question popping up in my mind. As decorator you put also a lot of stress on your back, don't you? Have you asked your doctor to check your back? I know of some people who were supposed to have carpal tunnel release surgery and there actually problem was in the neck. During the waiting time to see the consultant, you could try to see an osteopath to get your neck checked and to get some acupuncture and massages. Massages and acupuncture are probably not a permanent solution but it could give you some relaxation and your consultant a hint where to look for. Hope that helps, Moni

jaynealex
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hi Dr Bland

I'm currently sat on my sofa , its 4 O'clock in the morning , I took Ibrofuren at about 11pm and was able to drop off to sleep , I then woke up and went through the "hanging my arm out of the bed routine" but difficult when in a double bed and both hands / arms numb , tingling and painful ! I had to get up at about 2am..I find getting up and walking around relieves the symptoms a bit

I'm taking Ibrofuren 3 times a day 400g , so can't take any more till the morning

I started getting CT symptoms a couple of years ago when riding my bike ....say for an hour ...about halfway through the ride my hands / wrist would start to tingle / go numb....I also had symptoms when doing gardening....using a spade or secateurs...but only when doing an excessive amount of work in one go . The symptoms disappeared when the activity ceased

I'm currently in Spain in Cadiz province, and I'm covered by private medical insurance

My symptoms went balistic in line with me undertaking the creation of a drainage system at the house...basically I'm digging trenches....can't get a micro digger into garden where needed due to access issues. I don't have any problems doing the work( I can work through symptoms) , but when I stop the symptoms return....but they go balistic at night when I go to bed

I went to see my doctor last week and she gave me the anti inflamatories, and mentioned possible surgery if symptoms persist

My problem is that I've got to complete this project , which I should do over the next 3 days....obviously I can't expect the symptoms to go away while I'm doing the project. My doctor has given me the anti inflamatories to help me through the project and then has suggested we see how the symptoms go when I get back to normality.....

ie retired life , cycling , gardening and fishing being the main hand activities i do ( oh and using the internet)

Am I putting anything at risk by continuing the work ....Obviously I'm accentuating the current symptoms by continuing and the pain is that bad I can't sleep or even remain in bed during the night...standing or sitting up and especially walking around alleviates the symptoms...lieing down seems to be a problem...suggesting maybe a circulation issue ?

Thanks

jeremydpbland
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I doubt if three days is very likely to cause severe deterioration in what does sound very like CTS from your description - but it is not impossible. I have seen a normal wrist develop very severe nerve impairment within days of a weekend of unaccustomed heavy manual work so it is possible to cause an acute problem. You should try to get some neutral angle wrist splints and wear those at night - likely to be more help than ibuprofen.There is a description of what you need in these pages under treatment - you should be able to just go out and buy them. You may even find that they help somewhat during the day. I do not generally recommend daytime use but I have known patients do the gardening in their splints. Most importantly get some nerve conduction studies done and find out how bad it is. I would be much happier about continuing activity if I knew that the nerve damage was not already very severe. Provided it was not too advanced one might also then consider local steroid injection to get you over the current period of hard labour JB

jaynealex
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Thanks Dr Bland

blackwolf0578
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The above reply helped me :~D

(Maybe a thanks button like i've seen elsewhere)

Anyway my symptoms very similar to janealex ie worse at night or lying down then after an hour of being up i'd be fine. Until today, excruciating when just waking to the point where nearly had to shout the wife to come and dress me (erbs palsy in left arm) because i couldn't close hand ,then numbness/pain all day so off i went to walk in center 2.5 hrs wait then "diagnosed" CTS and given splint and printout which had this address so here i am, all i need now is for it to go away as quick as it came :~)

edit Been 7-10 days since first started

jeremydpbland
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It's interesting that someone has put the web address on a printout. We have links from places like NHS choices and PatientUK so quite a lot of people find us that way. I doubt if you will ever see this site top of a google search for CTS however. So far as symptoms are concerned I would wonder what caused the sudden exacerbation - any unusual activity, injury, change at work, other intercurrent illness? It's the kind of slightly atypical history where I would generally try to do both NCS and ultrasound imaging. They don't always reveal anything interesting but you can complete both tests in about 10-15 minutes.

A thanks button is an interesting idea - or at least a 'did you find this site useful' button but I'm quite happy with the unsolicited comments we get at present - what I would really like to see is a few more suggestions for things I can do better. JB

blackwolf0578
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Walk in used patient uk (spotted it while she went out of room for printout)

The only change in my circumstances around the same time was a deepish (1- 1.5mm) scratch on wrist while working on my car but "CTS" pain was about a day or so later

"Did you find useful ?" a better idea

as for what you can do better ............ nothing site answered ALL my questions, Thanx :~)

jeremydpbland
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If that scratch drew blood and was in a relatively dirty environment then I suppose there is always the possibility of local infection aggravating a pre-existing CTS and the day or two later would be about right for that - however there would, in most cases, be some local redness, swelling or tenderness around the injury to give the game away. Hope it improves soon anyway. JB

blackwolf0578
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but-------THANX-----ton

:~)

will let you know in about a week Dave aka blackwolf

blackwolf0578
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UPDATE

wore splint for approx 18 days, been splint free for a week now and my only "problem" is a slight numbness (like when you have a burn) on the inside tip of my ring finger.
i) will this go in time?
ii) should I be concerned?

jeremydpbland
Online

i) your crystal ball is as good as mine :-) - sorry but I'm afraid it's completely unpredictable - CTS can do anything, even without treatment - get worse, get better, relapse and remit, stay the same - and it is pretty much impossible to predict in the individual case what it will do.

ii) No I would not be too concerned. The patient's subjective impression of whether the problem is getting worse or better overall is generally a very reliable indicator of whether the underlying nerve damage is progressing or not - so as long as you feel that it is not getting worse there is very little risk of any serious and irreversible nerve damage occurring.

Thanks for the update! JB

blackwolf0578
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*** THANX *** for the informative speedy reply . Any more problems I'll know where to come (or send someone for that matter)

again thanx :~D

@@@@@@@@@@@@@@@@@@
@ @
@ ~~~ This Site Helped Me ~~~ @
@ @
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blackwolf0578
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*** THANX *** for the informative speedy reply . Any more problems I'll know where to come (or send someone for that matter)

again thanx :~D

@@@@@@@@@@@@@@@@@@
@ @
@ ~~~ This Site Helped Me ~~~ @
@ @
@@@@@@@@@@@@@@@@@@

:~( Aw it didn't work .... But you get the idea.

jeremydpbland
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Well it was a valiant effort anyway. Thankyou very much. JB

painNdHand
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When I sleep I use 2 pillows to help. I prop one up then rest my hand against it, the hand is up, the elbow is down, and the 2nd pillow is over my upper arm. This works my arem does not fall asleep this way.I sleep the entire night this way it works for me

jeremydpbland
Online

Sounds like the kind of thing that needs an illustration :-) JB 

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