Carpal tunnel or arthritis?

[kirsty1987]

My hands feel fat and painful, the pain is in the index fingers and thumb on both hands but my left is worse. I get pins and needles and they feel like they go up my arm. I can't grip very well and I seem to be dropping things a lot. I've had blood tests and my RA nurse said that there is no sign of a flare. Been back to doctors who say I've got to go for tests. Is this carpal tunnel or has anyone with RA had this? Thank you for reading. Kirsty

[sylvi]

It could be ra and blood tests to my mind are not always a good indicater of a flare. Just beause your bloods are low like mine doesn't mean your not suffering.xxxxx

[oldtimer]

Carpal tunnel syndrome is quite common in RA, but can be due to other causes. Have you tried wrist splints? A lot of people have said that they help with this especially at night.

Have a look back through posts about carpal tunnel and you will find quite a few. A nerve conduction test is quite straight forward and would give a good idea whether you have this. Usually doesn't give you pain going up the arm, though. Any problems with your neck where the nerves come from?

And it could be postural rather than inflammatory too, so worth looking at that.

[Braecoon]

I recently saw my Rheumy who said that my index finger and thumb pain was tendonitis. At its worst I couldn't straighten or bend my index finger. I couldn't hold the kettle or a tea cup in that hand. I also get shooting pain from my elbow and shoulder going down the arm. The Rheumy said that despite my high RA factor I was not exhibiting the 'normal' signs and symptoms of RA as i seemed to be manifesting my auto immunity as tendonitis instead of swollen joints. My pinky finger on same hand has a boutonnière deformity (medial slip tendon has detached from the middle bone in the finger) leaving me with a lovely hump, and sadly after the Rheumy did an ultrasound review of it, it is now showing some signs of bone erosion. I had been drug free for a year due to side effects from three different DMARD medications, so as a result of the early signs of damage I am now trying my 4th DMARD Leflunomide.

Hope you get some answers from your tests, but it could turn out to be a non typical manifestation of your RA.

[DelicateInput in reply to Braecoon]

I have searched the internet and RA does affect the tendons particularly as well as the joints, but this does not seem to be well recognised in the UK. Most of the websites stating this are overseas ones.

I had the same symptoms as you at onset. Woke up one morning to a stabbing pain in mid thumb joint and fingers jammed on right hand. They were so stiff that I could not turn a tap, use a key to open the door, handle change in my purse, write my name, pour a cup of tea. Also there was profound weakness and lack of feeling in both forearms with pain and severe pain in the wrist, so I could not pick up a kettle or saucepan. Also right shoulder pain. Two weeks later, the left hand went the same way but not the shoulder. I smashed all my crockery and dropped my hoover down the stairs. I could not do up buttons, pull a zip or get dressed. On ultrasound, this was tendonitis in the hand and shoulder and a piece of tendon had popped out of its sheath on the first finger of the right hand. Over the ensuing weeks, other areas like the elbows, foot arches, knees were involved. I also had a swollen big toe with a rash.

After the ultrasound I had a cortisone injection in the shoulder which was a big help temporarily but it did not do much for the hands. I was allergic to prednisolone, which was useless anyway, and told that because of this there could not be any inflammation. I had a nerve conduction test but the result was good. I was then told to come back in a few months to see how I was getting on.

Meanwhile, I had electro acupuncture on my hands and shoulder and it was fantastic. It was painful at first and after half an hour I was about to give up when my fingers started moving and the pain from the acupuncture went, so I carried on for the full hour. This relieved the pain for 3-4 days and brought amazing flexibility. I was over the moon. Then the pain came back so I booked another session. The same thing happened and I had a course of it. At the same time, the Chinese doctor advised taking Chinese herbal medicine tablets. This brought amazing relief. I also used skin patches impregnated with Chinese herbs on my shoulder and rubbed in hot oil - both extremely effective.

I went back to the hospital and the rheumy said he wanted to do an MRI on my right hand. That showed an improvement - ultrasound had shown synovial thickening with increased vascularity and tendonitis, effusions on the wrists. This was also on the MRI but it was much improved as were the blood tests. Rheumy then diagnosed inflammatory/rheumatoid arthritis - which he could have diagnosed earlier on greater evidence.

Electro acupuncture is well worth a try. I was in an awful state for around 9 months, could not work and had to keep paying people to do things for me. At the station, people used to tap me on the shoulder and tell me my dress was undone and offer to zip it up, and I pretended to be surprised. I could not get a bra on half the time. It was all a nightmare living on my own. I used to get almighty cracks of pain across various parts of my hands which made me scream (at the gym, in the street). People must have thought I was barking. Going to the gym and swimming used to reduce the pain and loosen me up but also, strangely, anti histamines brought quite a bit of pain relief.

[Channelle]

Hi kirsty i also have swollen hands with pins and needles also getting shooting pains up both arms rheumy told me it was because of all the swelling and inflamation. and that it would go away once the swelling goes down .i really hope so i also cant lift anything either its really annoying and sore. i am only on my second dose of mtx i was only told in june i had ra and have been out of work 8 weeks let me know how you get on at the docs hope you feel better soon x

[Scottishlad]

I find that I can get Carpal Tunnel if I have an under lying flare. I often do silly things with my arms when I sleep (I often wake up to find I have been sleeping with my arms folded, this leads to problems with my wrists).

I find using Thermoskin wrist braces helps stop me straining my wrist.

[Kariss]

It could very well be carpal tunnel. I struggled with it for 10 years, and it started before my RA was diagnosed. Hormone fluctuations can also trigger it, eg pregnancy or menopause. Wearing a wrist splint is the best way to help if it is carpal tunnel, especially at night when it seems to be worst. Eventually mine got so bad in my right hand that I had to have it operated on. My sister, interestingly, developed carpal tunnel whilst going through the menopause and hers went away completely when she went on HRT- however she doesn't have RA and there is a definite link.

Your doctor should be able to diagnose it for you, and as Oldtimer says you can also get referred to have nerve conduction tests which will determine if it is carpal tunnel. (These sound worse than they are - they stick electrodes on your fingers and pass a little charge through to measure reaction and determine how bad the compressed nerves might be.)

All the best, hope you find out soon as carpal tunnel is a real irritation! Xx

[zannie]

I had the same symptoms as you. After a nerve conduction test ( about three weeks later ) The neurologist informed me that an operation was not really necessary. I could have a steroid injection if the pain continued. The pain has gone, and now two months later, I still feel normal. I hope you have the same good luck. All the best. XX

[kirsty1987]

The doctor is sending me for tests hopefully I will find out when I'm going soon. I will let you all know. Thank you all for replying Xx

[marie66]

Oh hi, I have similar symptoms to yours initially they thought I had carpal tunnel and sent me for nerve conduction tests too and to orthopaedic surgeon. He took one look and referred me to rheumatology. All in all it took 9months and 2 minutes with rheumatologist got me an RA diagnosis!

He said carpal tunnel symptoms caused by severe inflammation and swelling crushing the tunnel - makes sense I suppose! Still wearing splints almost a year later as its still swollen and so very painful - remains to be seen if when swelling eventually goes Carpal tunnel symptoms go...guess we shall see! M x

[Coastwalker]

Pins and needles are listed symptoms of both B12 Deficiency and Low thyroid (Hypothyroidism )

[Bandido]

9 years ago I has similar symptoms but no pins and needles. Orthopaedic consultant had many tests done and concluded that I needed carpal tunnel in both and told me it was ten minute op. I asked about my symptoms and how they cam together but he said coincidence. I declined the operations. I am so glad. As with all RA the problems started moving about so not CT syndrome

[kirsty1987]

Hey everyone, just to let you all know I've been for a nerve test and was told there and then it's not carpal tunnel. Hands are still the same feeling fat and numb. Not sure where to go from here 😕 Xx