Recently Diagnosed CTS

That's not a usual report from splinting. Some people fasten them too tightly - remember we are only trying to stop your wrist flexing at night, not cut off the circulation to your hand. Other splints need a bit of further adjustment to shape to be comfortable - especially if you have an unusually shaped wrist and forearm. A few people just don't tolerate splints and cannot wear them at night but it's worth persevering for a few nights as most people do get used to them. JB

Thank you, I tried loosening them off, pain in bearable now although pins and needles etc still happening. Also noticed reduced strength in my right hand.

Sorry it's taken me a few days to reply to that last one - I needed to look at your records and every time I read the website it seems to have been the wrong moment to access them for one reason or another. Your right CTS is grade 4 so is very likely to need more than just a splint. I'm sure Emma told you that our basic policy on grade 4 is that surgery is probably the best bet but we would still offer the option of injection if you don't fancy the operation. If you are completely undecided you could also join the INDICATE trial which would make the decision randomly for you. JB

I am not undecided, I believe after a year of pain etc, I would opt for the surgery, just unsure how to get this underway. SJ

We will organise it for you. It's a bit late tinight to deal with it now sp we'll sort it out tmorrow. Jb

I don't know if this is normal either. I got used to my splints after about 2 weeks and have been wearing them now for 4 weeks. They have eventually helped me to sleep a little better but not after going to the doctors again and asking for pain killers (amatripoline were prescribed) or time off work because I couldn't cope with the pain. Pins and needles still wake me up with them on and my wrists and forearms seem much weaker on a morning.
I'm very confused at the moment. I had the tests done in my left hand and arm where CT was confirmed but my physiotherapist thinks the diagnosis is in his words is a "red herring". I didn't know there was a points system and I don't know what my score was but he said it was slight. Hope this might help a little. Could anyone help me with the points system?
Thanks!

The neurophysiological grading system is explained here on the site. If you have a copy of your results we can try to work out what grade it is. If they only tested one side I think that is a bad sign (or you are in the USA). jB

I'm in co Durham. I explained that I had the symptoms in both hands but the only tested the left! I don't have any copy of results or anything like that. I'm back to my G.P. on Wednesday to see what he makes of it all.
I don't know if this is worth mentioning but I'm under a different physiotherapist for my left side lower back and hip as I had pains around that area as well. I've been told it's a hamstring problem and I've been given stretches to do to relieve that. I have to see him again on Tuesday because my C.T. physiotherapist thinks the pains in my shoulder may be coming from my neck or upper back!!! I fail to see how this I going to help with my wrists? The tingling and numbness and sleepless nights are still a problem.
Thank you JB.

In the UK it is a little odd to only test one side if the patient has symptoms in both hands. Were these tests done by a neurophysiologist or by some other professional (some are done by physiotherapists, GPs, surgeons etc with variable levels of training). What did the machine look like - a largish floor standing unit or a handheld unit, possibly connected to a laptop? Physiotherapists frequently think that arm symptoms are originating in the neck and shoulder, sometimes they are right but not always. If you run through the questionnaire on the site here I can take a look at the symptom pattern and see what I make of it. The lower limb problems are probably unrelated. JB

Did the questionnaire but I must say that I had injections in my left elbow five years ago because my little finger and ring finger used to go numb and white. Also, my pain severity may change daily depending on what I'm doing at work I.e. Laying bricks, kerbs, flagstones, block paving, concrete and digging and cutting masonary. I have pain in left elbow as well which I was sent for X-rays because it was thought that the nerves were being compressed in my elbow. I broke my left arm when I was 15 but X-Ray's are ok. Tests were done at Darlington memorial hospital. Don't know his title but I had the conduction test where he held something on my arm and sent electricity through it. I had something round my fingers at this time and he worked his way up my arm. Started of with low pulses then it got quite uncomfortable ....nearly 200 volts if I'm not mistaken.

OK there's about a 50/50 chance that is CTS on the basis of the symptoms. X-rays for the nerve at the elbow are pretty useless as you can't see the nerves on x-ray and all the X-rays can tell you is whether you have an arthritic/damaged elbow joint. This tells you nothing about the state of the nerve (the ulnar nerve) at the elbow. It's a bit sad that someone can carry out electrical tests on your nerves without you knowing who they are or what their qualifications are. I believe the neurophysiologist in that area is Chis Fisher - does that ring any bells? There are usually two parts to standard nerve conduction testing of the median nerve, one in which ring electrodes are placed on a finger and you feel the shocks in those, and a second part in which the stimulus is delivered directly to the nerve at the wrist and sometimes the elbow. For this second part the recording electrodes are on the thumb and you get twitches in the hand muscles - does any of that sound familiar? JB

Yep I think it was Chris but I don't have my appointment letter so couldn't be %100 sure. He was very professional and did most likely tell me his name and title but I just couldn't remember exactly. Everything you have described there rings very true. Thanks.

Still a bit odd to test only one hand if both have symptoms. Ask for a copy of the report. JB