22 year old classical guitar player
Hi. I will try and make this as simple and easy to understand as possible.
I just finished undergraduate in classical guitar. I first had wrist tendonitis left hand. Went to physical therapy did stretches. ( this was late may, june). Developed a very very very (very) slight numbness in the thumb and burning sensation in the middle finger. Now I have barely any wrist pain at all.
It is now october. My symptoms are as follows
right hand: irritated burning sensation in index and middle finger very occasionally with computer use and piano, guitar.
left hand: burning sensation in middle finger and very slight numbness in thumb, exacerbated by computer and guitar, piano.
The pain level is very low in general. at a max of about 3-4 out of ten. no numbness really, just pain and irritation
I HAVE TRIED the following:
stretching, which included physical therapy, strengthening exercises, and the "carpal tunnel institute" stretching program, all of which result in worse symptoms
acupuncture: no effect for 2 months
increased exercise: no effect for 1 month
yoga: no effect for 1 month
arm massages: no effect
I have ordered a dvd from the tendonitis expert about his exercices for carpal tunnel and the c-trac device. Both of which I will try and attempt to give results. I may even try a chiropractor. I am desperate.
My nerve conduction study showed no signs of carpal tunnel syndrome according to the neurologist and technician.
Should i consider splinting or cortisone injections? or even surgery....
ok so my next step is to get an ultrasound, ask my neurologist. thanks a lot. wow i dont know if this is a relief or not but that would be great if indeed i don't have cts. Are there any other questions you would ask me that can narrow down the cause of this problem and what do you think that the other potential causes could be. could it be wrist tendonosis or arthritis? thanks a lot for your answer you've made my day(i think).
oh i forgot to mention that the phalen's test induces pain in my middle finger sometimes (?). my symptoms are very inconsistent but numbness and tingling are not really there....
Phalen's test is not entirely reliable. The possible alternative diagnoses are discussed on this website and are quite extensive. It's pretty much impossible to give worthwhile one-to-one advice without being able to see you and examine the hands, arms and neck though. Although it is a simple matter when the problem is CTS and only fairly minimal examination is needed, once you start looking for other things it becomes much more of a full medical so your neurologist is undoubtedly in the best position to offer advice on how to proceed. JB
I would guess that this is probably not CTS, though it is interesting that none of the things you have tried so far actually have any high quality evidence supporting their effectiveness in CTS so the failure of all of those things to produce a response does not really tell us anything useful one way or the other. I would not spend money on the c-trac device without more evidence that your problem really does lie in the median nerve at the wrist. It would be useful to know your symptom score from this website. The other obvious things to do here would be check the ultrasound imaging as well, as that can show up CTS sometimes when NCS are normal but I would not be too surprised to find that gives normal results too. What does your neurologist think the diagnosis is? JB