Update
As requested this is an update following the injections I received in both wrists on the 26th January. I immediately felt some relief and the pins and needles went altogether, the pain in my left shoulder was greatly reduced, although I still felt some discomfort. It has now been 2 weeks and I have noticed that I am again starting to feel pins and needles both wrists, although not as painful as previously the shoulder is also still uncomfortable but not still not as painful as previously.
I am happy to have the surgery on both wrists or could we do the surgery on the right side(as it appears to affect my shoulder on that side) and try another dose of steroids on the left?
If you come in this coming week sometime for re-injection of one side we will find a surgery date for the other one at the same visit. Tuesday afternoon would probably be good but I'll have to check that Emma is available.
Hi, Unfortunately I can't do Tuesday (I'm on court duty) but can do Wed or Thurs am or anytime Friday. Thanks
I'v just checked and Emma is available Wednesday am (15th Feb). Probably best to come early if you can before the clinic gets busy (9:00am). JB
Hi Dr Bland. Following the second injection to my right hand the pain was greatly reduced. However after being assessed it was agreed that they would operate on my left hand and then my right hand two weeks later. I think this was because there was a reduction in the muscles. Hope this update helps. Thanks.
I presume that's St Stephens. Personally I wouldn't make a decision about operating on the second hand until I had experienced surgery on the first one :-). Apart from anything else - the other side sometimes improves when you do the first one. JB
So there was quite a marked reduction in all the symptoms following injection, which tends to support the idea that the CTS really is causing a significant part of the overall problem, even on the left. At this point I think there are three options.
1) we could proceed to surgery - this is likely to produce similar efects to injection but to be longer lasting, but, as we discussed, carries a small risk
2) we could add another dose of steroids now (well Monday realistically). This approach was tried in a Spanish trial which achieved remarkably good results from injection but no attempt has been made to suplicate this in studies elsewhere so it remains just an odd observation
3) we could sit tight until our normal 6 week review after injection and re-assess the situation then. Some patients do improve between 2 and 6 weeks, some deteriorate. If uncertain how to proceed at that point we might repeat the NCS to see how much change there has been.
I think I would be equally happy with any of the three courses of action. A lot depends on how much of a nuisance to you the symptoms are now I think. JB
PS - I'll move this into the Canterbury patients forum in a few days, this is the general one.