Undiagnosed Hand/Wrist/Arm Pain

[flguy]

Hi, I am in need of everyone’s suggestions. Almost five years ago I began feeling sharp pain in my left hand fingers while typing on the computer. Three days later I began feeling the pain in my right hand fingers. The pain eventually spread to my wrists and lower forearms to the point I had to begin using voice recognition software at work in order to maintain my employment.

I sought treatment at the famous Andrew’s Institute and underwent a nerve test, which came back negative. They diagnosed me with tendinitis, and gave me cortisone shots and anti-inflammatory medication, which did not help. After two years of increased pain, they ran nerve tests again, which came back positive for carpal tunnel syndrome. I decided to undergo carpal tunnel release surgery on my right hand at their advice, but this did not offer any relief. In fact, I have been in much worse pain since the surgery. My entire hand has maintained a tight feeling (middle finger extremely tight), and my hand and arm below the elbow is noticeable extremely red compared to the arm that did not undergo surgery.

In the two plus years since surgery, the pain has moved into my upper forearms, elbows, and lower biceps. I have undergone numerous nerve tests, blood tests, MRI’s on my right hand, wrist, forearm, elbow, shoulder, and cervical spine, all of which have returned negative.

I recently travelled to the Mayo Clinic and received no diagnoses other than I may have “complex regional pain syndrome.”

Does anyone have any ideas or suggestions? Any medication advice? I’m currently under no medication, but I am in pain 24-hours a day. I feel overwhelmed with trying to maintain my employment to provide for my family. I am a federal law enforcement officer and I’ve been threatened that I may be forced to undergo a fitness for duty medical exam and was told that, “you wouldn’t pass.”

I also live with chronic right knee pain as I’ve undergone two unsuccessful meniscus surgeries and an unsuccessful micro-fracture surgery. I am only 34, so they will not give me a knee replacement.

Four months ago I underwent a right shoulder labrum and bicep tenodesis surgery, which appears to be healing correctly, but I still do not know how these injuries arose. I can only think of possible of things I’ve done in my youth that may have contributed to my problems: playing baseball, lifting weights, and typing too much on the computer and phone

[rabbits65]

I too have tenosynovitus (R.S.I ). In Other words repetitive strain injury.

Unfortunately there is no cure , it is to do with the lubrication in the sheath of the tendons drying up and this makes the tendons grind, thus you get extreme pain.... The only way out is to totally refrain from what your doing that is aggravating it.... 30 years ago I had to give up typing, piano playing, bowling, playing tennis, cleaning windows, cannot use an iron.. And I'm afraid that's it basically... It's a dam nuisance, the ache can go all the way down from the base of the neck to the wrist,, you learn to live with it to a certain extent..... Sorry for bad news,,,,, good luck though.....

[flguy in reply to rabbits65]

Do you have lumpy areas under your skin that cause sharp shooting pain when you touch the area or press upon it? I have this issue, yet the MRI’s don’t show anything and the dermatologist told me he doesn’t feel anything. I had a biopsy done and it came back as

A) Mild superficial perivascular lymphocytic inflammation,m. (skin, right arm radial, punch biopsy)

B) Dermal angiofibroplasia with features of healing skin response. (skin, right arm ulnar, punch biopsy)

I have no idea what this means, and the Mayo doctor took no time to explain.

[flguy]

Also, my MRI results on my forearm said there was no tenosynovitus as you suggested:

1. Normal MRI examination of the right forearm without evidence of active

myositis or fasciitis.

Findings:

Normal bulk and signal characteristics of musculature along the right forearm.

No evidence to suggest active myositis or fasciitis. No tenosynovitis or

evidence of active tendinitis. Included osseous structures are unremarkable

without evidence of fracture or focal osseous lesion. No abnormal mass or

fluid collection along the right forearm.

TECHNIQUE: Multiplanar multisequence MR imaging of the right forearm was

performed without and following the uneventful administration of 10 mL

Gadavist intravenous contrast material.

[lupus_01]

What you really need to do is rest your arms but i guess short of winning the lottery you still need to work. You could ask for gabapentin from your gp. It will help take the edge off the pain but it is not an opiate. I was prescribed gabapentin when i had a diagnosis of RSI. It helped along with rollerball mouse/keyboard.

[flguy in reply to lupus_01]

I tried Gabapentin, but I got no relief. When I had shoulder surgery I used my arm very little for 5 weeks, and felt the same. I do agree that a different mouse helps. I use a vertical mouse, but I should try a roller ball and see if it benefits. I’ve been through a lot of keyboards! Any suggestions?

[lupus_01 in reply to flguy]

I had one like this rsi-shop.co.uk/products/con...

[KatieRL]

I had similar issues some time ago and was diagnosed with RSI (Repetitive Strain Injury). I was signed off work for 2 weeks and told to rest and in particular no typing! When I went back to work I was given a new chair (with arms) and a footrest. I purchased a new 'shaped' keyboard and mouse which immediately made life easier for me. I was also recommended to take two paracetamol, four times per day, nothing stronger. Good luck with your treatment.

[flguy in reply to KatieRL]

Interesting. My ortho told me NOT to use arm rests. I do use Tylenol but wonder if it even helps. What is a footrest supposed to do? Keep your body properly aligned?

[jpain]

Have you been referred to occupational health? Or asked your work if they can get someone external in to do a thorough dse assessment?

[flguy in reply to jpain]

Mayo Clinic said they have a program I could take. I may need to look into that. I’m not sure if my work can get someone to do a DSE assessment or not. Thanks for the suggestion I will look into that. Kind of nervous to ask my employer directly as they seem like they are waiting for me to hiccup so they can give me a medical exam.