seeking advice/help


I started having pains in my left wrist approx. Jan 2013, at first I thought it may be contributed to my Rheumatoid Arthritis. Approx in March the pain got worse and was constant. I 'stuck it out' as I had an appointment with my Rheumatologist in April. Unfortunately I saw her 'understudy' and it was an end of day appointment. I felt she wasn't listening to me and was a little condescending. Eventually she went to see the consultant who came in to briefly discuss my pain. She checked my wrist over and informed me that the swelling wasn't fluid so didn't need draining, she then sent me for an xray and referred me to Occupational Therapy (I am still waiting for my appointment with OT). She also gave me a splint to wear.
The pain most days is unbearable so I decided to go and see my GP. he said I have Carpal Tunnel Syndrome, rest it and take painkillers. This was 5 weeks ago. I went back to him last Friday and there is no improvement, he told me to ring my Consultant! I rang her Monday morn to discover she is on holiday for most of the school holidays.
Basically my question is:-
can my consultant perform any treatment or should I return to my GP? I hate to be a nuisance to either of them


I see you came out with a 10% score on the questionnaire which makes it quite unlikely that your problem is CTS - but not impossible. It can be particularly hard to diagnose CTS in the presence of rheumatoid arthritis and the questionnaire has just as much trouble with this as doctors do, so the first thing you need from a diagnostic point of view is some tests to to try and establish whether you do have CTS as well as rheumatoid. Both nerve conduction studies and ultrasound imaging would help with this. Depending on where you are in the country your GP may be able to arrange these directly - nerve conduction studies are generally more available than good quality ultrasound for nerve problems. Until the diagnosis is sorted out it's not really possible to recommend treatment rationally but splinting, rest, conventional analgesics for pain and local icing can all help symptomatically with quite a few of the potential diagnoses so it's worth experimenting a bit with symptomatic treatment. One might also contemplate the possibility of a trial of local steroid injection but it would be wise to see your rheumatologist before embarking on that because of the rheumatoid. JB

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