Carpel tunnel help

[bernese1225]

I’m hoping for advice on how to ease the pain, numbness and swelling in my hands. I had nerve induction studies (NIS) done last Thursday and the results show severe carpel tunnel in both wrists/hands. I’ve had symptoms since last November that are getting progressively worse. I had a MRI on my neck just before lockdown and was unable to get treatment. The doctor who carried out the NIS said I need surgery on both hands so now I’m waiting to be referred to a hand surgeon. I’m unable to take anti-inflammatory meds as I’m taking prednisolone. Soaking my hands in warm Epsom salts has helped until today. I’ve woken up with swollen fingers on my left hand that look like sausages. Any advice would be much appreciated 😊

[Lolabridge]

I’m sorry to hear you’re suffering and are going to have to wait for surgery. I think you need to contact your GP or Rheumy for help in the meantime. Perhaps an increase in the Prednisolone dosage for a short time would reduce the swelling and you could try some compression gloves to see if they help.

[Pat9442]

I had both hands done last year and have got full feeling back in both which is really good as I was warned the nerve damage might be permanent. Keep exercising your hand, stretch your thumb and fingers and maybe get a squashy foam ball to keep squeezing

,worked for me

[bernese1225 in reply to Pat9442]

Thank you, did you have endoscopy or open surgery?

[Pat9442 in reply to bernese1225]

Open surgery. Very quick

[wishbone in reply to Pat9442]

What exactly was wrong with your hands?

[patsymay13]

Do you wear a hand brace , I found them really helpful in taking the pressure off x

[bernese1225 in reply to patsymay13]

I do but the swelling seems to be worse when I take them off x

[patsymay13 in reply to bernese1225]

Yes I know what you mean I must admit I nearly lived in mine until I had the OP and wore the longer ones for bed , I had it both hands like you have but only had my right hand done as it seemed to get better in my left after that , the surgeon said that may happen and thankfully it did it's hard but just try not to lift anything heavy like a full kettle etc also maybe push gp for a quick referral hope you manage to get some relief soon x

[bernese1225 in reply to patsymay13]

Thank you x

[Hidden]

I could be completely wrong, and would love to be corrected if I am, but my understanding is that CTS (and the very similar condition I have called Cubital tunnel syndrome) can cause you to feel like your fingers are swollen, but rarely if ever causes any physical swelling. It’s a condition caused by nerve impingement, rather than being an inflammatory process, although the impingement can be worsened by inflammation within the tunnel as a result of arthritis. Sausage fingers, on the other hand, formally known as dactylitis, is generally considered a specific, inflammatory arthritis related issue: it’s how I finally got my diagnosis. If you’ve got sausage fingers, I’d be contacting my rheum because from my understanding, it would suggest the flare is worsening in spite of the pred.

[bernese1225 in reply to Hidden]

Thank you. I have my 6 monthly appointment with my rheumatologist on Wednesday, by phone due to Covid so I’ll mention it to him.

[Bunterface]

I had operations on both hands, a few weeks apart, for carpal tunnel some 4 years ago. Local anaesthetic and all done very quickly, full recovery in both hands. It wasn't long afterwards that I was diagnosed with RA and so started a long and complicated process with the meds and which worked and which didn't, etc. I had a chat with a consultant who firmly believed that carpal tunnel syndrome IS sometimes an early indication of an inflammatory condition. He went on to say that he was a firm believer in avoiding invasive surgery procedures by administering the appropriate RA meds to treat the carpal tunnel as a first line of attack. I wish I had met this chap before having had the surgery done! But again, my hands made a full recovery, so if you DO have the surgery, try not to worry! Good luck. X

[nomoreheels]

Comparing symptoms to mine (which were textbook apparently, certainly when I had it first time) I'd say you're taking it that the inflammation in your fingers is due to carpal tunnel. As far as I'm aware, & I could be wrong of course, it's not usual for fingers, or hands, to become inflamed with CT so is it possibly your RD having a go at them & you've thought it's relative do you think?

Anyway, I found dangling my arm over the edge of the chair helped somewhat, similarly whilst in bed, though that wouldn’t be possible with both hands affected. To be honest I didn't really find the splints eased symptoms, though I did persevere with them hoping they would. Otherwise I’m afraid nothing helped until the release op.

I had CT release around 9 years ago, left hand. LEF caused what turned out to be temporary symptoms the second time 3 years ago, CT in both hands plus peripheral neuropathy. This was confirmed by stopping it after those results came back & repeat nerve conduction study/EMG a couple of months after, by which time symptoms had subsided & the NCS/EMG confirmed this.

Is there a specific reason you can't take prednisolone & NSAIDs? It's just I’m prescribed both, & in fact was taking both to try to ease CT symptoms both times, & wondered if it was something personal to you or if you'd been advised it wasn't an option.

[bernese1225 in reply to nomoreheels]

Hi nomoreheels, I maybe should explain my past symptoms, taken from my diary....

February: I’ve been waking up with either no feeling in either one of my arms since November. At first I thought it was the way I was laying in bed. I’m a side sleeper and tend to cross my arms, bending my wrists. I wear wrists straps to stop this as my hands were going numb. I noticed my full arm going numb even when I hadn’t been laying on it. I changed my pillows numerous times hoping it would help.

I woke up one morning in February and both arms from elbow down were numb. I couldn’t get out of bed and struggled to sit up. It takes around 50 minutes to a hour to get feeling back and when it starts to come back it’s so painful I cry. My GP sent me to musculoskeletal and I had an urgent MRI scan on my neck at the beginning of March. My appointment to get the results was yesterday but was cancelled due to Coronavirus. I rang my GP and she gave me my results over the phone...Cervical disc prolapse with radiculopathy. Results show disc changes in neck, no cord compression, stenosis. Osteophytes at 3 points have caused narrowing, trapping nerves - this is causing the pain in my arms. She said it’s really bad timing because I need physio on my neck, stretching exercises but I’ve got no chance of being treated. The physio I saw at the musculoskeletal clinic rang me to say he’s sending a letter to my GP and requesting an MRI of my head. I told him my GP said I needed physio and he said he’s not convinced it would help.

June: Spoke to GP as symptoms are worse in hands. Cannot fully straighten fingers on left hand. Electric shock type pain in both hands especially if I try to grip anything. Only sleep 2 to 3 hours then pain waking me up throughout the night. She read my MRI results and referred me to a spinal surgeon.

July: Spinal surgeon looked at MRI and didn’t think it was coming from my spine, sent me for nerve induction studies. Studies show severe CT in both hands. Waiting for referral to hand surgeon.

Do you think these symptoms normal to CT?

I can’t take NSAIDs with pred due to having GERD.

It’s the two middle and little finger on my left hand that are swollen. They feel worse than they look but definitely don’t feel hot or like RD pain.

[nomoreheels in reply to bernese1225]

I can't be sure but maybe this helps. When my CT was diagnosed I didn’t have too long to wait for my op, around 3 months, but in that time the symptoms worsened from just being my hand affected to it creeping up to my elbow & then all the way up to my shoulder. The pain was significant, even though we're used to or know the pain of RD by the time my op came it was, I hesitate to say off the scale but it was bad enough to cause me to have sleepless nights, & I can sleep through thunderstorms. Now, it may be coincidence given you have disc problems or it could be you're experiencing pain from both? Don't know if that would make any sense? What you describe as electric shocks I can understand, I had the same sensation both times, pre op & before stopping LEF.

Typically CT doesn’t affect the little finger as it's not the median nerve that controls it, if that's the right word, it's the ulnar nerve which also controls half of the ring finger, again, why only half of the ring finger is affected by CT as the side nearest the middle finger is controlled by the median nerve.

I don't know if any of this is helpful if it's confused things more?!

[Biofreak]

I concur with nomoreheels. I suffered badly with carpel tunnel. My GP gave me pregabalin which alleviated the symptoms for me but made me feel a bit spaced out so wasn't ideal. Eventually it was a change in medication from rheumatology that did the trick . My first biologic treatment was Etanerçept which managed to improve my Rheumatoid Arthritis no end including the carpal tunnel.

[Mumcon]

It’s so sore!! I had carpel tunnel in both and had them operated on and what a difference, that was 10 years ago and I’m still good They gave me splints while I was waiting for surgery they were like plaster casts and went up to the elbow but it only made mine worse I hope you get taken soon as it will make all the difference x

[bernese1225 in reply to Mumcon]

Thank you

[Wobbies]

I have carpal tunnel but when my RD meds were working it all but disappeared. The meds aren't working at the moment, so it is back. Only thing that helps is night splints although it still wakes me up sometime and I have to get up and walk around shaking my arms to try and ease it. No not want op as am hoping that change of biologics will get it under control again. We can live in hope if we die is despair. 🤞

[Bethany02]

When my hands got bad before I wore the splints during the day where I could and at night the compression gloves although the ones the ot gave me I found too big and not effective. What I love now is a massage I bought almond oil and add frankincense essential oils to make a 5% dilution I'm not sure if it's the oils or the act of massage that makes it feel better but it does it for me. Worth a try anything is.

[bernese1225 in reply to Bethany02]

Thank you I’ll try that.