Sudden Onset of Severe Pain
I was last at the clinic in December 2016. My hand/finger pain symptoms have been coming and going since and for the past several months I have been experiencing pins/needles and pain in my right arm overnight. Three days ago I suddenly felt pain/weakness in my right forearm and radiating down with an increased level of pain/stiffness in the fingers. The pain continues unabated and is very hard to bear - it feels all the time as if I have just suffered a very severe sprain. Paracetamol has no effect, but using a cold pack on the wrist took the edge off the pain in the early hours this morning (the pain had woken me). I can hardly do anything with my right hand - weakness as well as pain. Any suggestions please!
Thank you Jeremy for your very swift reply.
I have been trying to get an early GP appointment, but without success, so I'd really value the opportunity to attend on Friday - could you kindly suggest a time please?
Many thanks.
David
Sorry for this duplication - it looked on my browser as if this message hadn't actually sent.
Thank you Jeremy for your very swift reply.
I have been trying to get an early GP appointment, but without success, so I'd really value the opportunity to attend on Friday - could you kindly suggest a time please?
Many thanks.
David
Around 10 am would probably be a good bet. You may have to hang around a bit depending on just what I happen to be doing when you arrive JB
Thank you Jeremy for such a helpful and considerate consultation this morning.
Regarding the steroid injection, I now see that I have to be at my GP's early Tuesday for a B12 injection, so could I please come to your clinic for the steroid at 10.30 instead of 10.00?
Many thanks.
With kind regards.
David
Sure we can be very flexible with timing that day as there are three of us in the clinic.JB
Thanks again for such prompt and considerate care Jeremy and Emma.
Following the steroid injection 10-07-18:
Week 1: No - or only slight - pins/needles, stiffness, numbness, aching in right arm, wrist and hand. Some pain (3) in middle finger.
Week 2: General return - though only relatively slight (3 - 4) - of right arm/wrist/hand pins/needles, stiffness, numbness, aching.
Week 3: Further increase (to 4 - 6) - of right arm/wrist/hand pins/needles, stiffness, numbness, aching.
27-07-18 - After 2 days of gradually worsening pain/stiffness, right hand middle finger has become very swollen and extremely painful (9)
28-07-18 - Pain continues unabated and there's very little I can do with my right hand currently. (Left hand has slight pain, especially in thumb shank and middle finger.)
This is like an episode I experienced a couple of years ago which was diagnosed as gout. Paracetamol and cold compress don't do much to alleviate and I think from that past experience I have to put up with it for 2 - 3 days (?)
Gout is pretty good bet for a single obviously swollen painful joint, though it's not the only possibility, infected joints look very similar - watch out for ay systemic symptoms that might indicate it is infectious - fever, sweating etc (yes I know in this weather it's hard to tell!). If it's visibly swollen you can photograph it and send it to us or you can drop in to the clinic on Monday for me to take a quick look. Has anyone ever checked your blood urinc acid levels (for gout)? JB
Thanks for your reply Jeremy.
I've been wondering about your mention of calcium-related 'gout' - I am being treated for osteoporosis and take Adcal-D3 (Calcium carbonate and Vit D3).
I believe I had blood tests relative to gout previously and that these did not confirm uric acid problem.
Pic shows the swelling, but I can't see how to attach here (?) Pain is at it worst right in the knuckle joint, but affects the entire finger.
Is there an e-mail address I could send the pic to please?
Regards.
David
My email address is in the contacts section but in any case it's jeremy [dot] bland [at] nhs [dot] net - simplest way to send me a picture. I don't think I said anything about calcium related gout - traditional gout is uric acid related while 'pseudogout', if I remember correctly is pyrophosphate crystals. JB
Thanks for picture - it is quite impressively swollen isn't it. My first thoughts would be gout/pseudogout, an infected joint, or an acute exacerbation of an inflammatory arthritis but I'm not a rheumatologist of course. I gather it's going down now so hopefully it will keep going that way. I'm pretty sure it's not connected with the CTS. JB
Thank you Jeremy - I'm grateful for your interest and comments as I appreciate that the particular condition is separate from (but certainly interacts with) my CTS troubles.
With kind regards.
David
Hard to tell for sure from a text description but it's quite possible that that is nothing to do with the CTS as it is a rather different symptom pattern. I think I therefore have to say "see a doctor" about that. If you can get to your GP quicky then that is one option. You can drop in to my clinic on Friday morning so that I can think about it in more detail or, in extremis, you could try A&E if the pain is 10/10 but I'm reluctant to overload A&E as they are already very stretched and it seems you have stuck with it for three days already without becoming an obvious 'casualty'. Possibilities include acute exacerbation of CTS, a genuine injury such as the sprain you have mentioned, disc problems in the neck, brachial neuritis, problems with the circulation in the arm, gout and pseudogout and other acute rheumatological problems and probably other things I have not thought of quickly. JB