← Return to Carpal tunnel symptoms and PMR: What choices do I have?

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@dawn_giacabazi

Hi @pfafpa & Thank you John for the tag 😉 @johnbishop
I am a Certified Nurses Aide by trade and currently over use my hands daily - I care for many patients every day and teach transfers to staff, patients and caregivers daily and utilize computers to document everything daily. By the end of my day I can barely lift a 4oz glass of water.

My experience with carpal tunnel is a bit different as I do not have PMR. I have bilateral CTS and DeQuervain tenosynovitis. Although CTS is one of the most common workplace injuries, it is not as common as people think. It is estimated to affect roughly 8 million people in the United States, but if consider the total population it only equates to about 2.5%. Because there is some overlap in symptoms, it’s understandable who actually have wrist tendonitis may confuse it with CTS.

The key difference lies in the location of the pain. I was told by my doctor that CTS is felt on the palm side of the wrist and in the thumb, index and middle fingers. When pain occurs on the other side of the wrist, it likely tendonitis or another nerve problem. A common sign of wrist tendonitis is numbness in the pinky finger. This symptom does not overlap with CTS because the median nerve does not reach the pinky.

Now to add yet another twist to finding a differential diagnosis I currently am suffering with a flare up DeQuervain’s tenosynovitis. Which mimics a lot of the symptoms of CTS and often sends me to bed in tears. I have been in physical therapy 3 times a week for treatment for over 3 months with very little relief. I see the orthopedic surgeon next week and am very eager to see him.

There is a very special test my orthopedic does that tells him exactly what the cause is. The most common test is called the Finkelstein maneuver. Your clinician will have you make a fist with your fingers closed over the thumb, then quickly bend your wrist down toward your little finger, pulling the tendon through the narrowed sheath. This movement is quite painful in people who have de Quervain's tenosynovitis. I had it in my right hand about 3 years ago and now it plagues me in the left. In the past a special hand brace designed much simpler to CTS brace provided much needed rest and relief and doc prescribed Methylprednisolone (Depo Medrol) was very successful treatment.

Here’s a link to some information on De Quervain.
https://sportsmedicine.mayoclinic.org/condition/dequervains-tenosynovitis/

Can you share what kind of tests and other treatments you have tried?

Thanks
Dawn

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Replies to "Hi @pfafpa & Thank you John for the tag 😉 @johnbishop I am a Certified Nurses..."

John and Dawn, thank you for your emails. Yes, I do want to stay off Prednisone if possible. A lot of work to taper all the way to zero and don’t want to go backward. I’ve had some side effects (thin skin, weight gain, etc.). And my rheumatologist wants me to stay off if possible. I went to hand specialist this morning, who did diagnose CTS after doing a number of neurological tests. He gave me a cortisone shot (more steroids!) and said brace it at night and give it 6-8 weeks. So we’ll see.