Carpal tunnel treatments

Mrs Mook
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I first had CTS at 27 when pregnant with my son. Strangely, not with my daughter 20 months later. I admit to putting on more weight the first time, but the night time hand numbness has been intermittent these past 26 years even after losing weight.
Now 3 years into full menopause, these past 4 weeks have been very severe. GP gave me ibuprofen, which I shouldn't take having a past stomach issue some 20+ years ago, but they didn't help. I have a self purchased splint (curved at wrist for palm) which has helped a little, especially at night. Stiffness in hand does not start to release until late afternoon, but I still get the random shooting pains, nettle-sting feeling, tingling, numbness in finger tips and burning at knuckles which makes me cry!
I have thrown everything at this...magnesium supplements, arnica cream, massage etc and had a consultation with a chiropractor. Having had all my joints checked out with the chiropractor for arthritis, spine (for any connection) and neck (also for any connection) I was told to pay for a private MRI and probably get some physio privately as it did appear, as I had thought, to be CTS.
Reluctant to pay out for MRI and dubious of any physio (this is not an 'injury') I decided to try my own ultrasound tool. I bought this some time ago for a frozen shoulder that would not respond to any treatment, but within 5 days I was almost back to normal. So, after 6 days of using it on my hand for 5 minutes twice a day I now have a hand seemingly returning to normal...much less daytime pain, more flexible, no night pain and much less numbness in my fingertips. I am still struggling to write, but at least type this! I guess this could be coincidental as it may have passed on its own, but would welcome anyone elses experiences with ultrasound. My 'very newly qualified' GP was clueless when I had asked him about using it and didn't appear to know much about the effects of use for any reason.
I now also have a 'hand therapy' appointment with NHS for a mere week's time! (Thought I would have to wait months!)
Watch this space!

jeremydpbland
Online

It is of course hard to draw any concrete conclusions from a single case in a condition which is known to spontaneously relapse and remit for obscure reasons in some people. However there is some literature on therapeutic ultrasound use in CTS which suggests that the topic is at least worthy of further investigation and we do in fact have a trial of ultrasound therapy in progress at present and we should have the result later this year. Almost all of the other things which you tried - magnesium, arnica, chiropractic, ibuprofen, massage - have not been clearly shown to provide any benefit in CTS and only a splint, which you did find helped somewhat, actually has any evidence behind it.

The one somewhat strange element of that story is stiffness of the hand persisting into the afternoon. This is not a common feature of CTS. Nerve conduction studies would be a much better initial investment than MRI if one has to carry out investigations but it sounds as though you are improving anyway, for whatever reason, so there may be good grounds for holding off with any new intervention for a while. JB

Mrs Mook
Offline

Many thanks for reply. I am puzzled that you find hand stiffness 'into the afternoon' uncommon. It was prevalent during my pregnancy and I carried on working driving 80 miles a day and working as a milliner at the time of my pregnancy, probably exacerbating the problem (hands raised driving + sewing/drawing). It seems at least 5 out of the 7 other ladies (menopausal) I have spoken to recently have suffered had similar experiences of afternoon stiffness. All of these women have continued to 'work' during painful days, splinted.
This particular episode (now) has been excruciating at times and has never given me fully functional right hand in all this time even though I have experienced days of only the occasional twinge.
I had 2 days of much lesser pain and tingling/numbness and (on a whoopee-doo moment) decided to 'do' as much as I could in housework. Big mistake! Next day back to painful and useless hand. Similarly, after my one and only consultation with the chiropractor pulling me around (fingers pulled, hand bent back and forth) I was in agony. I admit to being more than a little afraid of allowing the 'hand therapist' at the hospital physio department to touch me at all.
Is the stiffness related to nerve 'damage' ? Although it 'feels' like swelling preventing the movement, the fingers are not swollen. I still have slight numbness constantly in my finger tips (although not in my little finger) and am concerned about any long lasting effects as I had 'Bell's Palsy' severely at 17. This has never fully recovered.
With grateful thanks again for your time and valued experience!
Mrs Mook

jeremydpbland
Online

I suppose the first thing is to try and clarify communication a little - if we mean different things by 'stiffness' we have a bit of a problem. Stiffness to me means mechanical resistance to bending and could in theory be measured by using a spring balance gauge or some such to measure how much force was actually required to bend a finger. If you are describing a subjective sensation of the fingers being swollen as 'stiffness' then we are describing different things. My kind of stiffness is not a common feature of CTS, as I said, though it is a common feature of other disorders such as rheumatoid arthritis (that's not the only one - don't panic!). It is not usually a feature of common nerve injuries either, though some forms of neurological disease can result in apparent joint stiffness.

Not every case of CTS presents with exactly the same combination of symptoms but some things are relatively common, occurring in the majority of people with CTS. The most suggestive symptoms are tingling and pins and needles in the thumb, index, ring and middle fingers (or some subset of those) occurring in the middle of the night - but not everyone gets that. It is because every patient is a little bit different that there is no absolute way to be completely sure who has CTS and who does not. In less typical cases tests can help but they do not absolutely define the diagnosis either. JB

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