CTS Injection Update

Yes if the first one seems to have responded quite well then it is entirely reasonable to inject the other. JB

Hi, I had my other wrist injected on the 20th November (right side), since then it seems to be a lot worse. In fact when working, I get a lot of pain and cramps after only 4 hours working, that's only half way through the day. To top it off, the left wrist is also got a lot worse. I am even having trouble holding a paint brush, pens, and sometimes dressing has become difficult.

Sounds like we should see you again and review that. I'll send out an appointment. JB

I have not received an appointment yet?

Very sorry - should have happened by now - - how does next Tuesday (21st Jan) sound  - I can squeeze you in at the end of the morning clinic about 12:30 JB

That would be great. See you then.

OK - there probably is not time for the appointment letter to reach you - just turn up anyway - you know where we are. Sorry again about the delay. JB

Any idea when might get my appointment with the hand surgeon? I know it's a different clinic, but the wrist pain is starting to travel up my forearms, making work very difficult.

I would think 3-6 weeks from when we made the referral on 21st Jan might be about average at present. JB

Had a phone call this afternoon. Have an appointment on the 11th March at QEQM.

That is about 6 weeks isn't it - not a bad guess, sorry it's not sooner. JB

Hi Doctor Bland

I was seen in Mr Smiths clinic today. Afer a discussion, examination and xray the doctor (not Mr Smith, but can't remember his name) decided that he would re-inject both wrist directly into the carpal tunnel. The injection were done at approx 3:30pm, there was some pain, but no shocks or tingling. I know he used an anesthetic (I asked what he was using). However, about 10 minutes after I had left the hospital, both hand had gone and remain almost completely numb apart from my little fingers.
It is now 20:14pm and they show no signs of improvement, should I be concerned? I would have thought if it was caused by the anesthetic it would have worn after 5 hours?
I am due back in six weeks for a follow up and to discuss surgery.

Sorry but I didn't know who else to ask.

Kind regards
Nicola

No problem. It does sound like the effect of local anaesthetic added to the steroid injection - the sparing of the little finger indicates that they did not manage to anaesthetise the ulnar nerve too. I have never seen the point of adding a local anaesthetic to the injection but lots of people still do it. I would only worry about it if it has not worn off by morning. Let me lnow tomorrow please. JB

Thanks JB.
Left hand had regained full sensation, right hand still has some numbness along the area to the left of the thumb muscle (Thenar Crease area? I looked it up so I could give a more accurate description of the area ). Both wrist are very stiff and painful, but that should be ok in a few days.

Sounds like the left hand was just the anaesthetic. That small patch of numbness on the right side would be in the terriotry of the palmar branch of the median nerve I think. This branches off above the carpal tunnel and passes outside it so it's possible that might have been injured by the needle if the person injecting was very unlucky indeed to hit it directly - did you feel anything unusual during the placement of the needle on that side? JB

Didn't feel anything unusual, certain didn't hurt any more then the other side. Although then he did push the fluid through after a while it hurt further up my forearm, I did tell him and he stopped. He also said that both wrist were very tight and he did have a fair bit of resistance when trying to inject.

If it is the palmar branch of the nerve it will probably recover fairly well from just being mildly traumatised by the needle so I would not worry about it too much, though it may take a while. Let me know how it develops. JB

Thank you very much for your help, I will let you know in due course.