Puzzling Symptoms
Hi, I'm 13 years old and have been experiencing carpal tunnel like symptoms.
I play piano, and for awhile I have experienced tingling while playing some pieces. At the beginning of April, I began to experience severe pain in my right hand, which is dominant. A few days later, I got pain in my left wrist too. The pain is from my fingers to my elbow, and I have tingling/numbness in all of my fingers.
About a week after I experienced the pain, I went to a doctor. He diagnosed my with De Quervain's Tenosynovitis and Carpal Tunnel Syndrome. I was told to rest, and get splints made.
The OT that made my splints thought the pain could be coming from my lower back or cervical spine. I had x-rays on both, and they came back normal. I also had blood tests, and all my levels were normal, including my CRP (inflammation) levels.
After a few weeks of complete rest, I had no relief so I decided to look for another opinion. The second Doctor thought I could possibly have carpal tunnel, but ruled de quervains out. She found my symptoms very puzzling. I had x-rays on bothe my arms, which were normal. She also referred me for an EMG test, and MRI. I'm still waiting to have the EMG test.
The MRI results came back normal besides mild flattening of the median nerve and mild T2 hyperintensity of the median nerve. This didn't seem to explain all the pain I was in.
I went to a physiotherapist whom diagnosed me with Thoracic Outlet Syndrome. This didn't make sense to me as I have no neck or shoulder pain. I saw another physiotherapist who ruled out Thoracic Outlet Syndrome, but once again seemed confused by my symptoms.
I have also been seeing an acupuncturist and massage therapist.
At sometimes the pain in my wrists is almost unbearable.
I also have tinnitus, and some people think these symptoms might all be linked.
I'm looking to see if anyone has had similar symptoms or any advice: I have now pain resting for over 2 months, and I'll have no relief.
Symptoms:
Pain in both wrists, up to elbows.
Tingling/numbness in all fingers
Thanks!
I play the piano very often: 2-3 hours a day. I also play other instruments such as violin, guitar and saxophone. Thanks for the advice!
And yes, playing piano aggravates the symptoms. Typing, writing, throwing, shooting a basketball, grasping objects, etc. also aggravate it.
Definitely worth seeing a neurologist and getting the NCS done. There is also an organisation devoted to this sort of problem in musicians - the British Association for Performing Arts Medicine - there's a link in the links page. JB
Well for a start carpal tunnel syndrome is extremely rare at your age unless there is either a very strong family history or an obvious cause such as a poorly set wrist fracture. I think you can throw out the idea that hand symptoms originate in the low back and although cervical spine problems can give hand symptoms this is again rare in your age group unless you have a congenital malformation of some kind which should have been easily picked up on imaging. De Quervain's is always a possibility in someone using their hands intensively but should be easy to diagnose on examining the hand. Neurogenic thoracic outlet syndrome is seen in your age group and you don't have to have neck or shoulder pain with it. That diagnosis should be made on the basis of nerve conduction studies, plain neck x-rays, and possibly MRI - I don't think the MRI commments on the median nerve mean much. Another possibility which no-one seems to have mentioned so far would be a task specific dystonia - how much do you play piano and does this activity in particular aggravate the symptoms?
Overall I would think you might be best served by seeing a neurologist and getting the nerve conduction studies done. JB