complication after carpel tunnel steriod injection
Hello i need some advice on what i should do. i had the injections in both wrist on the 30th july 2012, i hardly had any problems in the right hand before the injection it was mainly the left. since having the injections though my left hand is feeling lots better within 24 hours i started to notice the difference. but with the right hand instantly it didnt feel right, i told the doctor that did them that my hand felt very heavy straight after and it hurt when he injected it. but ever since the 30th my right wrist has been in alot of pain, if i move it it hurts more but even keeping it still hurts. my thumb has been numb since the 4th august.and all round the bottom of the thumb is painful to. it hurts to much to open the hand fully and to close it. im getting tingling in the ends of my fingers. but the main pain is in the wrist where he injected it. the pain doesnt go its there all day and night. i have been to my doctors on 3-4 occasions i also attended the ashford hospital on monday 6th after my doctor told me to go there. the hospital told me there was nothing they could do an that my doctor should not have told me to go there. i went back to the doctor who then prescribed me Meptazinol as my Tramadol havent helped, and still nothing is even touching the pain. i have had it up in a sling since monday because it was swollen and bruised. the doctor i saw on wednesday said he was going to send you a fax but i assume they havent heard back as i phoned them this afternoon and they said they hadnt recieved anything. please can you help me. many thanks
Yes i can come on Monday, thank you very much. It was Dr Beach, i saw him at Sandgate rd surgery. I thought it was just the left hand that was being done. But he said he had it down for both. Even my own doctor an the hospital said it was a bit odd having them both done at the same time. they said normally its done seperately. Thank you again.
In fact we do often inject both sides when both have symptoms, though when it comes to surgery we only operate on one at a time. The odd thing here is that you had no symptoms on the right side and I would not generally treat anyone for CTS purely on the basis of the lab results. See you Monday. JB
hello just an update. Had really bad night sleep, i am getting stronger pain round the wrist an the base of the hand. Also im getting pain Up my arm upto the elbow the pain comes like lines of pain if that makes sense. and if i lean on the elbow i get really sharp pains shooting up the arm to the wrist. also the finger next to the thumb is painful but not numb or tingley. Also the palm of the hand feels stiff an heavy if i try and open or close hand its still hurts but feels stiff to move.
hello Dr Bland another update am currently recieving the hand thearpy the sensitivity has reduced to just the base of hand and wrist now. but it is still very painful especially in the wrist spreading up the palm constantly. and still painful to move it. movement is still very limited, numbness in fingers and thumb, also still keeping me awake. the left hand is now starting to get the symptoms back, numbness, pins & needles, weak grip, its been just over 5weeks since injections.
I suspect we're going to have to operate on the CTS. Does anyone in hand therapy have any thoughts on what the new pain after injection is casued by - I haven't had a letter back from them yet. JB
hi JB sorry operate on which hand? sorry other than the thoughts that you had they havent really said whats causing the pain or problems in the right hand but they started straight after having the injections if you remember i never had problems with the right hand before. they said last week about possible doing some ultrasound therapy on it but said something about not being able to until the sensitivity reduces. K
Sorry the symptomatic CTS side when it becomes a problem - I don't think we would want to try injecting again after an episode like this. I'll see you again myself in a few weeks if you don't mind, to catch up with the current situation. JB
ok thank you. yeah that will be fine. just let me know when and i will be there. many thanks k
hello have started get really severe constant pain in the right arm from elbow downwards, started about 2 nights ago. have struggled to even fall asleep. been to GP today they have given me more Tramadol and they have also given me Amitriptyline.
seeing hand therapy again on thursday.
This is a very odd story and I'm not at all sure we know what we are dealing with in that right arm. if you are free to drop in tomorrow morning I will take a look but I'm not promising any easy answers I'm afraid. JB
very sorry only just seen the message. im coming on thursday at 11.30 for hand therapy if you are there i could pop in if thats ok. the Amitriptyline did help last night only woke up 3 times was nice to get abit of sleep. i had a feeling there was no easy answers. k
We will be doing the usual Thursday morning CTS clinic at the K+C so Nick and I will be there from 9:00 am until 1:00 if you are passing by. It is of course the usual Thursday morrning mayhem with patients with CTS everywhere you look but I'm sure we can find a few minutes for an update on your rather odd arm problem. JB
i will probably be there about 11ish as my hand therapy app is 11.30 after that i will wait about to see you.
thank you very much for seeing me today. just to let you know mike in hand therapy started the ultrasound treatment today he has booked me in for another 2 sessions over the next 2 weeks. he said if after another 2 sessions its still no better then hes not sure what they do next. k
I'm not sure either I'm afraid though we may seek assistance from the pain clinic or the hand surgeons. We will also undoubtedly check the nerve conduction studies and ultrasound again. I'm still hoping it will start to improve though. JB
ok thank you. so am i it just feels like it hasnt improved other than the sensitivity the pain feels just as bad and up the arm aswel. do you have any rough idea how long it could take or how long it should normally take. sorry i know im proberly a pain in keep asking questions.
As I've never seen anything like this in 4583 injections arranged so far from this clinic I don't think there is any 'normally' to refer to I'm afraid. If I knew exactly what was causing the pain then I might have some answers but at the moment there are no real clues as to what it is. JB
Depends on whether I can find anything significant on repeat nerve conduction studies and imaging and whether any new signs appear to give us diagnostic clues - could ne hand surgery, pain clinic or neurology. JB
I need to see you. Can you come in to my office on Monday please about 13:30 so that I can see it and we will probably take a look at it with the ultrasound scanner. I'm not sure we intended to inject the right hand as when I saw you that one was pretty much asymptomatic - who did the injections? JB