Welcome side effects

I wonder what they injected into your back and how much. I would not generally expect modest doses injected to a remote location to have any effect on CTS but you never know. I will move this thread to the Canterbury patients forum once you have had a chance to see this reply, and we will see you at the new appointment. JB

I have now had my steroid injection for CTS. It was completely pain free. Less even than blood taking. A couple of hours later I was able to hit a few golf balls with no alteration of feeling than before. The tip of my middle finger still has a little paresthesia, but I have had that all the while I have had CTS. I have a feeling that this is permanent. We shall see.

I have now been given a follow up appt. with Dr Bill Warrilow. Unfortunately the injection has, up until now, had no diminution of symptoms. It looks, Dr Bland, that you were right and that, as a grade 4 I will probable need surgery. I will let you know what Dr Bill says.

Well it was worth a try. We will see what it is like at the review and then you can post me a further message on here - it usually takes about a week for the review appointment paperwork to reach me here. JB

I have now had a follow up appointment with Dr Warrilow. He found that there was no muscle wastage and that grip strength was good. As my symptoms are minimal we thought that it might be worth waiting to see if they return before resorting to cutting the carpal ligament. I am quite happy to do this if you think that the nerve will not deteriorate to a serious extent. I would imagine that the steroids will have reduced any swelling in the carpal-tunnel region, so this will not be the case. Please let me know what you think.

I'm generally a great believer in not operating on patients who don't feel they need surgery - at least when the main purpose of surgery is to relieve the symptoms. As long as it does not seem to be deteriorating then doing nothing is a perfectly viable option and the nerve is not likely to degenerate irreversibly without you noticing the change (except in diabetic patients in whom CTS can behave in odd ways). I would like to see how your symptom score has changed if you would not mind adding a new one from the 'MyCTS' pages and you are of course welcome to contact me through this site for advice whenever you feel that the symptoms are actually changing - if you are lucky they might even go away. JB

I have now completed a new symptom score. I am virtually back to normal. Thank you for giving me the option of contacting you again if things change. I have been a lucky person all my life so my symptoms will probably go away completely.(touch wood)
Thanks once again for your attention.

It is indeed pretty much asymptomatic now isn't it. If that was due to the injection then it seems to have been a slower response than normal but as long as it got better one way or another we are not going to worry about it.  Lets see how long it stays that way - typically it will be 6-12 months but it can be shorter.... or much longer. JB

I am still symptom free, however I was wondering if, to stay that way, I should exercise the hand (ie stress balls) or use it as little as possible. Perhaps you can let me know the perceived wisdom. Brigham

I'm afraid there is no perceived wisdom. My own feeling is that one should simply use the hand as normal. The purpose of treating CTS, so far as I am concerned, is to allow the patient to be able to do what they want to with their hands. JB

I know that this is a long time since my last bout of CTS, but it has returned. I wonder if it would be possible to have another steroid injection from Dr. Bill Warrilow. I'm 82 now so I would expect, if the injection works, that it would see me out.

Certainly possible to inject it again but I would greatly appreciate it if we could test it again to see how much it has changed in objective terms after all this time. We could also inject it for you at the same visit now to kill two birds with one stone. JB

I have done another severity test, and have been given an appointment. (not looking forward to the conduction test) Thank you for your attention.

It's quite a bit worse in the left hand isn't it (looking at the set of scores). See you shortly. JB

Yes, the other night I woke up with quite severe pain which is a symptom I had not had before. I also think my grip strength is quite poor.

It is about 6 weeks since my injection in my left wrist. I'm afraid that it hasn't worked this time. I have done another diagnostic test. My left hand is quite bad, but I'm not sure about the right. The tingling and numbness there seems,to me, to be possibly, caused by the numbness that can occur when blood supply is reduced by pressure on the arm when lying awkwardly, as it rapidly goes when the position is changed.

Sounds as though we might be heading for surgery this time. I think you are quite right about many tingling/numb symptoms being related to cutting off the blood supply to a nerve - both in CTS and in sitting awkwardly! How do you feel about surgery? JB

Much as I am loath to have hand surgery, I don't see any other alternative. Has the operation got a name. I would like to get all the details to know all the ins and outs of the procedure. As an injection helped my right hand for a long time, would you consider a top up injection here would be appropriate? In case the symptoms are due to CTS starting up again.

The operation is known as carpal tunnel release (or decompression) and you can read all about it on the treatment section of this website which gives you the best available local data on outcomes as well as a description of what is involved. There is also a bit more infomration in the 'Information for Kent patients' section. You can read lots about it on the web but most internet sources are biassed one way or the other, either by surgeons strongly advocating surgery, or by patients with poor outcomes having much more motivation to go on patient forums looking for help than those with successful outcomes - thus distorting the apparent results of surgery that can be judged from internet patient stories. The data on this site is as objective as I can make it. 

The other option would be to try a second dose of steroids. The pros and cons of this are perhaps a bit too complex to cover fully in the forum so if you want to consider that I think we should test you again and discuss it at some length in person. JB

I've looked up the actual procedure on "you tube", and this has set my mind at rest. It appears that the anaesthetic injections are the worst part, and the whole thing lasts for less than half an hour. This is a small price to pay for relief of the symptoms. Should I make an appointment with your secretary, for an appointment to discuss it all?

It's even quicker than that normally, the average operating time is about 6-10 minutes. I can probably get this done for you in Ashford at St Stephen's health centre. Do you have any other major medical issues which might have a bearing on it such as being on anticoagulants? JB

I'm on candesartan, felodipine, and atorvastatin. ( controlled hypertension) So no problems there. I await your decision.

Should be no problems with those. I'll get the team who run that operating list to contact you and arrange surgery. JB

Many thanks Dr. Bland.