Carpal Tunnel Syndrome - update in OP...

stratslinger

Well, it appears that over the years I've developed a case of Carpal Tunnel Syndrome - I go in this afternoon for an EMG test to help determine how severe.

For a little background: I'm 32, I've played guitar since I was 16 (though much less over the past 3 or 4 years - owning a home apparently rearranges some priorities!), I work in computers, and as many on this site do, I enjoy playing a video game or three. So I've figured for a long time that I was a prime candidate.

I've noticed over the past couple of years occasional tingling in my fingers - usually it was gone in a couple days, so I never thought much about it. Then along came this month: A couple big DIY projects around the house have led to significant night-time wrist pain and off-and on (or on-and-on-and-on, in the case of two fingertips) numbness in my hands. I saw the doc yesterday, and Carpal Tunnel was his initial diagnosis.

My biggest concern, right now, is that I haven't felt two fingertips (index and middle, right hand) since installing that floor 3 or 4 weeks ago. I'm hoping that doesn't mean nerve damage. I'm also hoping that I don't have to just stop everything for too long - I've thankfully just about wrapped up work on a master bedroom renovation, but now I'm just getting started working on my basement workshop, and I'm actually really enjoying the work. I'll stop completely, for a time, if I need to. But it's gonna make me nuts! :P

So - for anyone out there who's been through this, what can I expect? How successful are non-surgical treatments? I'd like to avoid anyone rooting around inside my hands if at all possible - these things are my livelihood and quite important to most all of my leisure activities, so I don't want to risk them unnecessarily!

Update:
Thanks again folks, for the advice. I got to see the hand surgeon this morning, and as it turns out I only have a mild case of Carpal Tunnel Syndrome, aggravated by another injury. My current symptoms should be manageable by medication (lots of Vitamin B6 and a 5 day course of oral steroids) and continued nighttime bracing until the nighttime symptoms go away.

Now, if my primary doctor had just told me this same info a week and a half ago, and made the exact same prescription, I'd probably be mostly better by now. I'm starting to suspect that I need to find a better doctor - this guy and his office staff have just screwed up too often lately.

meeker

I have been borderline for years because of my hobbies and work. The very best thing you can do is ice, forearm massage, and stretch. I have been able to hold it at bay and gain strength back because of those three things. If I forget for a few days and I can feel it tightening up, ice, massage and stretch and a couple days later I am right as rain.

BladeX

My carpal was work related so I got physiotherapy covered by WSIB here in Ontario which helped. If you can't afford physio, as mentioned above, ice pads on the wrists (ice pad can be covered with a small towel as direct contact I found too cold) helps (I believe I did 10 minutes for each wrist). The stretch above also helps (start off gently! You may not be able to go as far back as in that picture which is okay!)

Other stretches that help are:

Tendon Glides:



If you find the stretch above (that meeker posted) hurts too much, you can do one similar to it. Hold your arm straight out, palm facing up. Move your hand so your fingers face towards the ceiling. Then move them back to the original position and repeat. This does a wrist extension like the above stretch. AGAIN, you may at first be able to only move your hand into a 45 degree position or less. THIS IS FINE. You do not want to go to far as it can cause more damage. You will find with time you will be able to do the full 90 degree angle and the stretch above.

In time (not right away) you will be able to use one of those digi-flex finger exercisers. Start with a very light weight and squeeze every finger individually, not as a fist as this will build some strength.

I would HIGHLY recommend physiotherapy or something similar if you can afford it/can have it covered by some sort of plan as they tailor what exercises to do and when for your case and adjust if you are getting better or worse, they usually do some stretches that require a second hand and also use ultrasound therapy as well as one of those electrical pad machines.

LewieP's Mummy

I've had surgery twice for it. I have Poland's syndrome affecting my left hand, arm and shoulder (bones, muscles, nerves and blood supply) so I have to use my right hand for everything. Consequently, when I developed CTS I was totally stuffed. I went to my GP, who referred me to hospital. 5 weeks later, I had nerve function tests which showed CTS in my right hand, and no carpal nerve in my left. 1 week later, I had surgery. There are other treatment options, but the CTS had developed very quickly, and surgery was the best option.
Pre-surgery options include:
1. physiotherapy
2. avoiding what causes it (!)
3. steroid injections into the affected wrist to reduce inflamation
4. splints to rest your wrist and stop you using your hand too much.
My surgeon was surprised at how severe it was, and commented about the muscle tone in my hand - he had expected it to be much worse on seeing the nerve function test results. I play guitar - my right hand is my chord hand, my left I strum with. He said the guitar playing had kept my hand working. Woo guitar!
I had loads of physio after the surgery, my hand is mainly fine now, it depends if I type or use a mouse too much.
Anyway, I now (mainly) use dragon naturally speaking on my PC at home and at work. Takes a while to get used to, but its fairly easy to use - typing makes my hand go numb.

Oh, and I stayed awake to watch the surgery first time round! It was really interesting.

GameHat

I had a very mild case of CTS

I had numbness in both pinky fingers (one of the early symptoms, as I understand it)

I was able to fix my problem with two things:

Simple wrist braces - (Walgreens. A simple brace with a metal insert that keeps the wrist straight)
Better posture - an effort to sit up straight and an effort to never bend my wrists when typing. After a year or two, this feels natural.

Your problems sound more severe, so continue seeing medical professionals. But my two suggestions above might well help. The wrist braces are cheap (maybe $20) so I'd suggest trying them regardless.

stratslinger

Thanks folks! I've been wearing a brace on my right wrist most of the time since Tuesday, and it's certainly helped me to sleep better. I'd consider the left - but it's hard enough to manage with only one wrist splinted up, I don't think I could easily pull off both.

I had the EMG test yesterday, and should get results later today. The test was interesting: for anyone unfamiliar with it, they basically strap a small electrode to a nerve at the base of your wrist, then a receiver (I guess?) to the end of the finger that nerve supplies, then hit you with short little jolts of electricity to measure the conductivity of the nerve. On both my hands, the electrodes on the pinkie finger and thumb made my hand jump with every jolt - just a very strong twitch. On my middle finger, however... Well, I could feel the jolt, but my fingers never twitched at all. I'm not sure if that's expected, due to a lower voltage put on that nerve, or if it's a bad sign. Guess I'll know in a couple hours.

On a related note, I did a stupid thing last night. I was getting very close to completing the first stage of my basement workshop update, and decided to put in a couple hours on it last night. Nothing huge - just cutting down some pegboard and 1/4" hardboard to size, hanging them on the wall, then locating and cutting holes for electircal boxes. Well, I guess I overdid it a little bit. The brace let me sleep without right hand problems, but I woke up several times from left hand issues.

It kills me too - I'm taking a 3 day weekend this weekend, and I had intended to work more in the shop. Now, I'm just going to have to sit around on my duff all weekend.

BladeX

LewieP's Mummy wrote: »

I've had surgery twice for it. I have Poland's syndrome affecting my left hand, arm and shoulder (bones, muscles, nerves and blood supply) so I have to use my right hand for everything. Consequently, when I developed CTS I was totally stuffed. I went to my GP, who referred me to hospital. 5 weeks later, I had nerve function tests which showed CTS in my right hand, and no carpal nerve in my left. 1 week later, I had surgery. There are other treatment options, but the CTS had developed very quickly, and surgery was the best option.
Pre-surgery options include:
1. physiotherapy
2. avoiding what causes it (!)
3. steroid injections into the affected wrist to reduce inflamation
4. splints to rest your wrist and stop you using your hand too much.
My surgeon was surprised at how severe it was, and commented about the muscle tone in my hand - he had expected it to be much worse on seeing the nerve function test results. I play guitar - my right hand is my chord hand, my left I strum with. He said the guitar playing had kept my hand working. Woo guitar!
I had loads of physio after the surgery, my hand is mainly fine now, it depends if I type or use a mouse too much.
Anyway, I now (mainly) use dragon naturally speaking on my PC at home and at work. Takes a while to get used to, but its fairly easy to use - typing makes my hand go numb.

Oh, and I stayed awake to watch the surgery first time round! It was really interesting.

I forgot about the splints/braces! Helped alot.

A little off topic but I just had to comment: You stayed awake to watch the surgery? Holy crap! I think my stomach is way to weak to handle something like that.

stratslinger

BladeX wrote: »

A little off topic but I just had to comment: You stayed awake to watch the surgery? Holy crap! I think my stomach is way to weak to handle something like that.

You and me both. If it comes to surgery, my doctor is going to have strict instructions to knock me the hell out. None of this "we''ll sedate you and you won't remember a thing" garbage either. Me=unconscious, or it doesn't happen!

i n c u b u s

In my case I was prescribed 800mg of Ibuprofenfor the pain but other than that just to stay off of heavy activity. Before I could go through several hours of non stop guitar playing if I was in the mood but now I try and keep it to a minimum or at least do it in intervals. When my CT first started flaring up I literally would be woken up in the middle of the night because of the shear pain my wrists and hands would go through and when driving for little more than 15 mins would cause my hands to go numb. Now its either the less stress on my hands has relaxed the tension or I've just gotten used to the pain because it rarely bothers me anymore. As far as surgery goes what I've heard is the younger you do it the better but the downside to that is that at any point it is not guarenteed to work so you could be 32 and have even more damage do to the procedure. My boss had multiple surgeries in both her wrists and she says her hands were never the same again (grip loss, strentgh, etc), so I'd seriously think about it if you want to consider surgery. Talk to your doctor about it and weigh your options, in my case my doc suggested I give up playing guitar but I believe you share my opinion and that is never gonna happen.

Black Ice

Any advice on how to prevent carpal tunnel? I thought I had it for a week, it was pretty bad (it ended up being tendinitis in my wrist), I'd like to do what I can to not get it.

LewieP's Mummy

Yep, I watched the surgery. I've also watched when I had to swallow a camera to check for ulcers! And hey, I stayed awake for childbirth - really, I suppose I had to, cos it was me birthing ... but that's a wholely different thread!

Anyway, back to the CTS.
I've found sleeping with my hand raised to by my head helps with the numbness, and taking regular breaks from a physical activity that triggers numbness - eg, if I'm using a jigsaw to cut wood, I do it in short bursts, rather than all in one go, and I get my local wood shop to do as much cutting as I can persuade them to. An orbital sander/buffer is even worse, so it took me a day to sand and wax the wooden paneling in the hall in my house. I knew it would make my hand numb, and just decided to take my time.
I can play guitar for about an hour at a time, before it becomes difficult. In the weeks leading to my first surgery, playing was increasingly difficult, as I couldn't move my fingers fast enough for chord changes. Its much better now.
The key to recovery is lots and lots of physio - exercises to stretch your fingers, ones to make pincer movements between each finger and your thumb, rotation of the wrist (gently at first), and I used a stress ball for strength/grip.
All this was about 9 years ago, I still have to be careful, but its so much better than it was.

meeker

Black Ice wrote: »

Any advice on how to prevent carpal tunnel? I thought I had it for a week, it was pretty bad (it ended up being tendinitis in my wrist), I'd like to do what I can to not get it.

Do the stretches mentioned earlier. Take breaks at the computer or any hand/wrist intensive activity. Pretty simple.

stratslinger

Ya know, I keep reading about how people have "lived with it" for so long before doing anything, and wondering why. But - I've been doing a few things over the past few days and realizing that my wrists hurt when they probably shouldn't - only they have done so for some time now. I guess I've been living with it myself for some time now.

Anyway, I got my EMG test done, the doctor's office reported there was some neuropathy in both hands. Didn't really say whether it was a lot or only a little, but they did refer me to a hand surgeon. I go talk to him in about a week. On the bright side, he does have an occupational therapist in his office, so there's at least some chance that he'll look at this and say there's no need for knives and such yet.

Which brings me to what I think is the root of my concern about the surgery. If I understand it right, they basically go in and cut the ligament (tendon?) that's pinching the medial nerve, thus releasing the pressure on that nerve and allowing it to function correctly again. But what the hell happens to that cut ligament? I mean, it's there for a reason, right? Are there significant differences in hand function after it's been cut?

I guess these are all questions the good (I hope!) doctor will be able to answer for me, should this proceed in the direction of surgery. Now, I just need to try to not focus in on it too much for the next week or so.

Darkewolfe

Take this with a grain of salt, as I've never looked into it. I was told by a chiropractor that some of the symptoms often thought of as carpal tunnel can be traced to other problems, and can sometimes be helped by chiropractic work. I haven't looked into it, but it's always something to consider, I suppose.

Also, gabrieljosh, I just did that exercise and could freaking feel it stretching my right forearm. I didn't think it was going to do anything, but holy crap.