carpal tunnel syndrome and hormones
Hi, great information on this site, glad to have found it.
I am booked in for release surgery in my right hand in about 1 month, in a private hospital, courtesy of the NHS. I had almost exactly a year free of discomfort following a hydrocortisone jab, but it has come back with a vengeance!
My query is, have any other female sufferers noticed a connection with their menstrual cycle? My symptoms were always worse prior to my period, and are usually a precursor to a migraine attack. Since I have started the menopause, I still seem to have the increase in CTS symptoms monthly, followed by the migraine. It all seems connected, and I wondered if there was evidence to support this.
Anyway, keep up the great work with this site,
Sallym
I had 5 months or so before the injection wore off. As Sally experienced my CTS came back with a vengeance and spent last night with my hand hanging out of the bed even though I was wearing a splint. I did not fancy another injection as I think the
Consultant touched a nerve which shot up my thumb. I had my right hand operated on today and the anaesthetic was not as painful as the steroid injection.
I tried to get my gp to give me another injection, but he wouldn't, saying I had to be referred to a specialist. The specialist said that he was not keen to give repeated injections, as the evidence was that they became less effective over time, and that the operation was better done sooner rather than later. He wouldn't give me the injection to give short term relief prior to the op, as it might have a detrimental impact on surgery.
Incidentally, I bought a splint recommended on this site, and it has massively improved the discomfort at night.
Interesting that one specialist's view of the evidence can be so opposed to another's. I can find absolutely no evidence that injections become less effective over time - indeed there are no published studies at all of second and subsequent injections to provide evidence either way (but we are about to publish a study). Similarly there is no evidence that I can find to support the idea that injecting shortly prior to surgery has any bad impact on the outcome of the surgery - quite the reverse in fact - we find that patients who have had several injections before surgery tend to do better after the operation. The idea that the operation is 'better done sooner than later' is very much a surgeon's viewpoint! As you will have gathered from my surgical prognosis page this actually applies only in the special circumstances of severe CTS. Good luck getting it treated and I'm pleased to hear that the splint is working as first-aid. JB
There is clearly some link between female hormones and CTS and thus a variation in symptoms with the menstrual cycle would be no surprise but I am not aware of any systematic attempt to document this in the scientific literature. I have met a few patients who have made the same anecdotal observation however.
Out of curiosity - after a 1 year response to steroid, did anyone consider repeating it or was the attitude simply that after one relapse it should obviously be operated? I'm curious about treatment policies in other parts of the UK. JB