Advice (and reassurance) needed pls
Hi there,
First of all I would like to compliment this helpful website. It's very helpful indeed.
I'll attempt to give you a thorough context! Back in April I tripped over a concrete step and put a lot of my weight on out stretched hands. It didn't particularly hurt, in fact my pride hurt more. I didn't think about it again.
Throughout April I spent a considerable amount of time a day using my NetBook (mini laptop). It was the Easter holidays and I had reports and presentations to catch up on. I began to notice that my right thumb had a numb area which initially came and went. It is down the left hand side of my knuckle. I than began to experience a dull ache in predominantly in my index and middle finger, as well as shooting pain. I also had a burning pain when I moved my wrist significantly. At night this pain and dull ache got worse and over time my thumb muscle has weakened. I went to the GP at the end of April and he suspected carpal tunnel syndrome. He gave me anti inflammatory drugs to take for two weeks and told me to rest my right hand whenever possible. I bought a wrist splint wore this all the time and used my left hand for typing/writing and driving where possible. No change.
I returned to the doctors who referred me for nerve conduction tests. By the end of May i began to have symptoms in my left hand and I was struggling. They signed me off & I've been resting both hands and wearing a splint. I've been prescribed Zapain, which has some impact on the pain but no improvements. I sought physiotherapy who equally confirmed I have suspected carpal tunnel syndrome and tendonitis along both thumbs. She gave me ultrasounds and advised icing my wrists, wearing splints, rest and suggested some exercises. I'm now going once a week. I went back to the gp who then referred me to an orthopaedic surgeon.
I went for my nerve conduction study last Thursday. I explained my symptoms to the clinician and she completed the test. She commented that it did not sound like classic carpel tunnel syndrome. She followed this up, with a question about whether I felt well in myself and if I had experienced weakness in my legs (which at the time I felt well and no weakness). Her questions however, since then, have started to make me aware of restlessness in my leg and tiredness (but not sure if that's me being paranoid!). As a result of her questions I decided to go straight to A&E to get an x ray to confirm that the fall in April had not been the cause of the pain. The x ray didn't find anything so the doctor sent me to make an appointment for a bone scan, this has been arranged for the 4th July.
I'm still waiting for the nerve conduction results and once the orthopedic surgeon receives these I will get an appointment through. I did your questionnaire and it came out as 8% likely for carpel tunnel syndrome.
I'm worried if the test are negative. Will the orthopedic surgeon still see me? If the bone scan comes through as negative for fractures, where do you go next? Up until last night I had never experienced the tingling/ numbness of my arm until last night. could this be because i had loosened my wrist split which i always wear? i had previously only woken due to dull aches and pains. I appreciate it's a waiting game but I'm getting upset and anxious as it all seems to be taking so long. I guess what I'm asking, is that, from your knowledge & expertise does it sound like carpel tunnel and if not what do you recommend I do next? My minds in over drive!
Sorry for the lengthly post!
Thank you so much for your prompt response and answers.
That's a relief to hear that the orthopaedic surgeon will still see me. I guess anxiety and panic set in when the clinician told me It doesn't look like classic carpal tunnel syndrome. The questions she asked then evoked additional fear that it might be something more serious. I wish I could say that this fear has diminished, but I'm afraid that it's causing more problem - I can't sleep, feel Nauseous and have lost my appetite. The worst thing is I'm associating any pain, twinge or feelings of restlessness/tireness in my body as another symptom. The irony is, the pain in my hands has lessened over the last couple of days, But this may be due to the medication Or simply a 'good couple' of days. I've rang the doctors a couple of times, but the results are still with the hospital. The hospital suggested it would be a couple of days, Whilst the doctors have said it will be at least a couple of weeks. this of course delays the appointment with the orthopaedic surgeon. I've decided to go back to the doctors tomorrow to talk about my concerns And try and push for other possible tests - As they were so stuck on carpal tunnel syndrome from the very beginning.
I can't remember the name of the professional who completed my Nerve conduction test, but I remember looking at her badge I'm being relived by her title. I asked at the time whether she could tell me of the possibilities of my symptoms, but she said this was the role of the doctor once the test are analysed. I'm tempted to go private to speed up the process, But I may be overreacting. I feel slightly pressured given I'm due to start a new job at the beginning of August and I would hate to hand in sicknote before I've even begun. I think I may purchase Dragon software in preparation for any adaptations I'll have to make (In the hope I'll be able to drive by then).
Thank you for this forum, it's useful to get my thoughts down as well as for seeking advice.
If it is CTS then it is worth bearing in mind that it is not related to typing so investing hard earned cash in weird keyboards and voice dictation may not be a good investment unless you want to try them for other reasons.
I've always been puzzled by the difference in perception between general practice and hospital of the time it takes test results to come through. I know from my end that we write reports on the day of the test and put them in the outgoing post yet primary care round here insist that they regularly wait 2 weeks or more for reports. I guess it is the same in your area but I didn't think the post was that bad yet. If the civil liberties and privacy brigade would let us have a decent, integrated clinical records system across the whole of the NHS this would be less of a problem. My own patients of course can ask for their results on here, at least for CTS, but I appreciate that not everyone can do that.
Name badges can be difficult (I am very bad at wearing one at all myself) - the healthcare professions seem to have suffered from serious title inflation over the last few years and there are lots of rather grand sounding titles around which actually tell one very little about the person's qualifications. From her comments however, whoever did your test was clearly not a doctor so I would not get too hung up on their comments implying that other diagnoses might be lurking in the background. Try to relax a bit and wait for the orthopaedic consultation at least. JB
If you have an orthopaedic appointment then they will see you. Many orthopaedic surgeons in the UK ignore the results of nerve conduction studies if they think they do not fit with the clinical picture anyway so they certainly aren't going to be put off seeing you by the NCS results one way or the other. Fractures are orthopaedic territory so they should be able to give you a qualified answer about the injury. It's very hard to suggest a diagnosis. Having looked at your questionnaire answers you do have some symptoms that may be CTS but the history of the way the symptoms developed is a bit odd and I wonder if you are actually getting a little bit of secondary CTS caused by some other problem to begin with. It's a pity they did not tell you your NCS results at the time - I wonder if they were done by a doctor or a technician (or in some cases nowadays someone not qualified in clinical neurophysiology at all I'm afraid). JB