Report on splint use
I have been wearing the splints nearly every night since I saw you at the start of December.
The right hand seems a lot better, only occasional very slight tingling.
But the left hand is still tingling quite a lot, and still occasional numbness and shooting pains.
Ok O will read about the injections. Keep on with the splints and await a retest at the end of February.
I do take oral steroi (prenisolone) quite reguarly for chronic bronchial asthma
You are unlikely to be taking enough steroids overall for asthma to make an impact on CTS though it is possible that if you have short high dose courses from time to time they might have an effect on the hand. There is one small trial (referenced here as Chang 1998) which showed an effect of oral steroids on CTS and the dose used in that was 20mg daily of prednisolone for 2 weeks followed by10mg daily for 2 weeks. They assessed symptoms using a score which could range from 0 (no symptoms) to 50 and over the course of the 4 weeks treatment their steroid group's mean score reduced from 28 to 10 so it was quite a marked effect but that is 210mg of prednisolone over 4 weeks whereas we would inject only 40mg for usual treatment of CTS. JB
I take 8 x 5mg daily (40 mg) until my peak flow increases - then I decrease one tabley per day.
So you might expect a short course like that to have some impact on your CTS - but when did you last take such a course of steroids for an exacerbation? JB
December. Right wrist doing well, left wrist improved, but still troublesome - mainly tingling.
I think we should try a steroid injection in that left wrist. You can give the SIPC office a call to book one - number in the contacts page here, as it will take a week or two to arrange I think. You may need to tell them you have been discussing it with me on the website so that they can read this conversation. JB
So it's the dominant hand, which was the one with marginally worse symptoms which is being more persistent. The fact that there seems to have been some response to splinting provides a bit of support for the idea that this might be CTS but I do not think it amounts to conclusive proof by any means. If the left hand is enough of a nuisance that you want to try something else it would not be unreasonable to give it one steroid injection. Read through the information on injection on here first, and if you want to try it I will arrange it for you. I don't think surgery is a good bet at this point so it comes down to a choice between injection and further waiting/splinting. Either way I think we will plan to test you again about the end of February which will be a three month interval since the original tests - enough time for the results perhaps to have changed. JB