Carpal Tunnel v's Neuropathy

Recently (2 years) I have been getting increasingly painful hands/wrists. Initial diagnosis (12 months ago from from GP) was carpal tunnel and a trip to the OT resulted in a splint to wear when painful and especially at night. I believed it helped. Symptoms were pins and needles and numbness and a slight reduction in hand strength. I was warned that I would probably need surgery at some time for carpal tunnel syndrome.

Last week i went back to the GP (I had been kneading bread and my hands were really painful and the splint did not seem to help). His assessment was again carpal tunnel and I was referred to an Orthopaedic Surgeon (Hand Specialist). The surgeon is not convinced it is JUST carpal tunnel. He thinks it is a percentage carpal tunnel and a percentage nerve damage from the diabetes. The surgery will only address the percentage that is carpal tunnel. This is difficult to assess. The consequence is that I could have the surgery and get little (if any) relief.

Schroedinger's cat!!!

Any thoughts? Anyone else been in this boat?
Helen

Hi Helen

I had a bit of a similar experience 8 years ago after the birth of my son. I found it increasingly difficult to pick him up when he was about 1 year old - you know the way - us facing each other and my hands under his arms - the pain through my thumbs up my wrist was awful and I also had a reduction in hand strength. Trip to the docs and referred to orthorpaedics same as you. They said that it was carpal tunnel syndrome but there could also be swelling of the tendons running through my fingers casued by diabetes and so the tendon was unable to pass easily through and so causes pain. I got injections into each wrist initially which worked well and lasted about 3 years. I then had to go back and I had local anesthetic injected into each hand and the surgeon picked at the tendon with a needle - it was a very strange feeling but was very effective. Think i may have to go back again soon as some activities - bike riding, tennis seems to really aggravate it and cause pain in my index fingers again ...I just have to be careful. I've been diabetic for 32 years so I guess these things perhaps happen after such a long time - I'm only 42 so thought they might happen a little later in life though

Access the orthopaedics about swollen tendons and see what they say. Good luck and hope you get it sorted

Since giving up the kneading the wrists (and hands) have been significantly better...still getting the pins and needles in the left hand but all in all it is manageable. I have decided to put it all on the back burner and watch what I do. The surgery could cost me about $3000 so I want more than a "maybe some improvement". The injection (cortisone) is an option I will consider before I consent to surgery. Thanks for your comments. Helen

Please be aware that a cortisone injection is likely to impair healing and could compromise any surgery later.
My upper limb consultant advised me against cortisone and I went ahead with CTS surgery to both hands....separated by time of course....both hands now in good working order.
Regards
Garry

Garry,
What were your symptoms? How long did you put up with it and did you have any other indications that it may not be CTS? Did you have an occupation that exacerbated it? Sorry for the pop quiz but I tend to be upfront.

One of my worries is that I do have reduced sensation in my hands...the family jokes that i ought not to test the temperature of the bath water for the kids! My other indication was that the pain (according to the hand specialist) ought to feel much reduced when I put the splint on as it holds the hand in perfect position (dorsi-flexed) to allow maximum space for the nerve...and it did not relieve the pain.

When I went to see the surgeon I was prepared to have the surgery as I had been warned 12 months before that that was probably what I would need but he essentially talked me out of it.

I checked your bio info and I have been a diabetic for about the same length of time!
Thanks for your help, Garry, Helen

OK the pain got to me and I had the surgery on Tuesday. I had a BG of 10 when the surgery was about to start and I was happy that it would not go lower but anaesthetist was wary and insisted on a 4% glucose drip! When conscious ...you guessed it BG of 14.2!

Will I have the other hand done? Don't know ask me in a week or so. Helen

Take a little while but in around three weeks and you will see an improvement I trust.
Hope it is a nice neat job.

Regards
Garry

Hi i had CTS surgery about 4 yrs ago, since i would wake during the night in pain or with pins and needles. Apart from the fact that the nurse put the sling support to high which caused some for pain for the first 48hr it was the right decision for me, if or when my left hand starts to become problematic i will opt for surgery again.

Rgards Lyn

Thanks Garry and Lyn,
I went and saw the surgeon yesterday (3 days post surgery) and he is talking waiting 2-3 weeks before having the other hand done! This makes sense as I will have my daughter here and she can do the to and froing for me until I get back to it all. The palm of my hand is quite bruised and the wrist is painful...limited driving,,,no lifting etc. I am also the least patient person I know! The wrist is probably as painful as the wrist was presurgery!

Helen

The R hand is fine (difficulty lifting heavy objects) so have bitten the bullet and will have the L done next Friday (20th). Patience?

Helen