Confusing diagnosis, symptoms improving
I wanted to start by saying this is a great site/outlet for me (and I think anyone with CTS). I went to the specialist 2 weeks ago and was diagnosed with CTS based on nerve conduction tests being moderate in RH. They gave me a shot of cortisone at the same time (using the ultrasound for needle placement), this gave me pain relief for about 1 week only. My symptoms are in both hands, but the left is mild, compared to the right, again, being moderate. I was working as a crane/boom operator up until the day of the appointment (I quit just after the appt realizing my profession was doing the damage); having to constantly depress my thumb onto the button of a remote for the crane, was generally the cause of this all. I've been using the rest, splinting, B vitamins, ice (and hot water) treatments, and I think the symptoms are improving. Third week off of work, I'm giving my hands a break.... The numbness is only mild and intermittent, even at night. I still do have pain esp in the right wrist though, albeit intermittent ranging from mild to moderate, sometimes having painful flareups in the AM (about the time I wake up). I have been to the rheumatologist aswell and she thinks that I may have spondylitis based on one of the markers being positive in the bloodworks (although all the xrays and other bloodworks were negative for everything else), I wonder if this ties in somehow with CTS or is the CTS and nerve impingement in my wrist causing these other symptoms. I'm sched for an MRI later on this month (spine and stomach)... Some of the additional symptoms I'm having outside of the afore mentioned are intermittent pain in the flexor/extensor muscles (generally right side), sometimes a moderate amount in the front of my shoulder blade(s), rotator cuff area. I have a modest amount of pain and stiffness in the vertebrae-neck/spine aprrox location C5 (cervical) through T3 (thoracic nerves). However, the detailed diagnosis here on Carpel.net here showed that I only have a 9% of having 'CTS', LH severity 1.82, RH 2.55. Functional impairment LH 1.12, RH 1.88. As it stands, I'm booked in to get a CT release surgery done in the nest 4-6 months.
My questions to the moderators, and the community are 1) do you think I generally have CTS, or are my issues possibly related to something else; now? 2) what are my chances of recovery if I abstain from the aggravating movements, or is it the case of damage is done, absolutely won't heal no matter what? 3) The numbness having subsided is this a sign of actual healing? 4) If my symptoms eventually disappear, what are the chances they will return (given I'm not doing something to aggravate)?
PS
Realistically I'm quite scared to get the surgery done as it really seems only 50% of people have success (in terms of the symptoms after being significantly better, and not have any other complications as a result of the surgery, including recurrence of CTS)
I would try any method to have it heal on it's own, to avoid surgery.
Thank so much for your time, attention and responses (in advance). Have a great one; good luck, and god bless.
Cecil
Very astute answer, thanks for being concise and addressing my queries. I'm glad a got someone positive, and with some good industry experience to reply. I ordered Artrhur Doerksen's Auto Zap 5 and FreeCoil 8 SuperZappicator, to see if it can help with some on my issues. I think I do have double crush on the median nerve, and if I stimulate, let it heal, and then strengthen that I can overcome this rotten bullshit. I wonder what they injected me with, maybe it was just saline water, will try to get the nerve conduction results for you to decipher. Thanks, god bless.
I have obtained the results of the nerve conduction tests and the injection, can I PM the results to you somehow, I don't see how to do that on the website (or email the pdf) to you? Thanks
Thanks for the NCS results. I have replied by email too but basically those are grade 3 in the right hand and grade 1 on the left. The dose of steroid they used was fairly small (20mg methyprednisolone). 40mg would be better and is used by most people. There is a little evidence of possibly better results still with 80 but that is based on a single study. JB
In favour of CTS you have the right distribution of the symptoms and the temporary response to corticosteroid injection but you do not really have a lot of risk factors for CTS and you are missing some of the classic symptoms such as night waking with numb/tingling hands as a prominent feature - hence the low score on the diagnostic questionnaire.
I think a significant possibility here would be that you do in fact have fairly mild CTS secondary to some other problem - for example inflammation of the flexor tendons secondary to over-use leading to increased pressure in the carpal tunnel and CTS as a secondary effect. If you have the actual nerve conduction results we can try to see what 'moderate' means - plain English terms for severity of CTS are notoriously inconsistent in usage.
if it feels as though it is improving then it probably is and may well continue to do so. CTS is by no means always relentlessly progressive so yes there is a possibility that this will resolve without surgery. One might also wonder about the dose of steroid they used if you have a record of that - some doctors use very small and probably less effective doses.
Finally - you are being a bit pessimistic about surgery. The success rate is much better than 50% - in well selected cases it can be 95-99% but to get that kind of result you need to be very sure both that CTS is the main cause of symptoms and that it has not advanced too far. JB