Pain in new locations Post Cortisone Injection
Hi
I had re-constructive surgery when I was 17 on my right thumb do to a rare form of tendinitis where the tendon is too large for the joint in my wrist. I am currently 34 and have had no serious issues with it since.
I had a child in July of 2016 and I noticed pins and needles in both my right and left pinkie, ring and middle finger in September 2016. I also had burning sensations while sleeping regularly. There was no pain just swelling and pins and needles during the day. Please note I had no symptoms while pregnant and there were no complications from the emergency C-Section.
I went to my GP and was sent to have tests done that came back as severe carpal tunnel.
I had cortisone injections one in each wrist 3 weeks ago. Following the injections I had severe pain in both hands. The left was worse than the right to the point that my left hand was completely unusable. This lasted for 48 hours. Once the severe pain subsided I have now found the following:
1. My fingers are still numb
2. *NEW* pain in both thumbs to the point that they become unusable
3. *NEW* pain in my lower palm and soreness to the touch
4. *NEW* weakness in my wrists and an inability to support any real weight
5. *NEW* inability to pick up a filled coffee cup with one hand
6. *NEW* sharp pain when turning either wrist
7. *NEW* shooting pains across my wrists when moving even slightly left or right.
8. *NEW* numbness in the palms of my hands
All of these symptoms persist even while taking 30/500 codeine and Naproxen.
My questions are:
Is this normal?
Can there be another problem other than CTS wrong with my hands?
Will a surgeon know what is wrong?
Is there anything other than splints and wrapping my hands to restrict movement that can be done while I wait to see a surgeon?
I ask because the assessor who gave me the shots is under the impression I just don't want to go back to work. Even though I told him I am working and wish to find ways to help me continue to work but I am struggling do to the pain I am in.
Can anyone help?
The injections were painful I both hands. I said ow several times but the assessor said discomfort was normal. There was pain immediately after. My left hand worse than my right. I could barely lift my 25lb son or put him in his push chair. Whereas prior to the shots I had no trouble lifting him. He did the injections in my right first, then my left. No I was not told what he was giving me other than it was a cortisone shot. And no I was not provided the results from the conduction test. The woman who did the test told me she had to turn it all the way up to get any response from my hands. I will call my GP on Monday and see if she can get me either information.
From that description there is a possibility that the steroid was injected directly into the nerve - which is not the intention and which could cause most of the symptoms which you are describing afterwards. Where was this done and is the person who did it experienced in carpal tunnel injection? They should generally not be very painful - roughly comparable to having a blood sample taken would be about average. Depending on the timescale it might be useful to repeat the NCS to see if there has been a deterioration after injection and if the injections are very recent then ultrasound imaging of the nerve may be useful, though there are not many people in the UK competent to do it in this situation. JB
Dr. Bland
I have contacted my GP who has told me that I must ask the doctor who performed the injections for both the injection information and the test results. She has also informed me that until the recommendation for a surgeon is completed and I meet with them she cannot advise me any further as she is not a specialist. She said that the surgeon will have to request any more tests to be done.
The tests were performed at Peterborough Hospital. The injections were performed at Dynamic Health Service, Musculoskeletal and Physiotherapy Services in Peterborough. The doctor who administered the shots, I assume knows what he was doing as he was training a nurse while giving me the shots. I did a quick google search and he doesn't have anything I can find quickly, unlike yourself that classifies him as a specialist. That being said I don't really want to blame him as although I felt he didn't really spend a lot of time understanding my issues (I was in there for only 10 minutes total both times I saw him), he was pleasant and efficient.
The tests were done the 1st week of December 2015 and the shots were done on the 10th of January.
When I had the cortisone shots almost 20 years ago for the problems with my right thumb, there was extreme pain when the injection was done but the pain was gone almost instantly. The surgeon found that the reason I was in so much pain was there were cysts above and below my tendon and when the injection was done the first time he burst both of them. The only reason I brought this up is the injections this time were nowhere close to that painful but they were about 6 times more painful while the fluid was being injected than a blood test.
I have written a letter to the doctor who performed the tests and hopefully he will send me my information back.
Again thank you for your time and help!
10th January to 13th Feb is getting to be a bit late for immediately examining the injection site with ultrasound unfortunately but it would still be worth repeating the NCS. The Peterborough service I do not know but it sounds like an intermediate care provider - there are quite a few of these organsiations, staffed usually by a mixture of doctors and physiotherapists, which sit in-between primary care and the hospital hand surgeons. I would hope that they would take an interest in the problem themselves and arrange further investigations as necessary. Lets see how they reply. JB
That's an unusually severe reaction to injection so no it's not 'normal'. Yes it is entirely possible that there is another problem as well as CTS and seeing a surgeon may help - at least they can see the hand. Were the injections very painful at the time - ie while the steroid was being injected - and do we know exactly which steroid/dose/added local anaesthetic was used? If the tests were nerve conduction studies then unfortunately 'severe' does not really mean much - do we have the actual results to review? JB