Hello all,

I posted a message earlier on here and have not gotten any replies. I was wondering what everyone else thought of my situation. I went to the doctor in April. My hands were waking me up at night feeling "asleep". He told me I had bilateral CTS and gave me shots in both wrist. Sent me of an MRI on my wrist. Came back normal (no cts). Then MRI on neck. He then said I have a "pinched" nerve and sent me to Neurosurgeon. He said CTS and arthritis in neck. Had EMG done and it came back normal. So now he says tendonitis. Can tendonitis make your hands feel the way mine does? They are stiff in the mornings and sometimes I can hardly bend my thumbs. I don't have intense pain just aching all the time. They go to sleep when I talk on the phone and when I prop up on my elbows. Sometimes I get a "shocking" feeling from my elbow to my finger tips after "proping" up for a while. If it is tendonitis why does the doctor keep wanting to see me every month. He said we may need to repeat the EMG in a few months. Why? If it is just tendonitis. Any suggestion would be appreciated. I am just so confused at this moment.

Sorry so long. Just need some answers.

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kayjoe

Dear kayjoe,

I'll try to help. I am not a hand expert but I have had problems with my hands and still do. I had surgery on one hand but not for CTS. Do not under estimate tendonitis. If I had a choice between breaking a bone or tearing a tendon, I would rather break a bone. I have had surgery on my bones and tendons and the bone heals much faster - at least from the standpoint of post-op pain.

Sounds like you have had a lot of tests. I think your Dr. is wise to monitor your condition. Tendons and nerves travel through the same tunnel in many places down the arm. There is a limited amount of space in which they are contained so if your tendon is inflamed, it can swell and put pressure on the nerve which is right next to it. Pressure on a nerve can cause numbness and tingling sensations.

The nerve also has branches that control the muscles which is what helps us to be able to move our hands and fingers and use them in a meaningful manner. An EMG measures the electrical activity of the muscles. Signals from the nerves control the muscles. If this part of the nerve becomes damaged due to pressure (or whatever), then the ability to use the muscles may be hampered causing weakness (temporary or permanent). I would imagine that is why your Dr. is keeping a close eye on things. Areas of nerve compression aren't always easy to diagnose even with all of the sophisticated diagnostic tools available. Your Dr. may also be watching for other problems. I am glad you aren't having a lot of pain because tendonitis can cause pain. I hope this helps some. Take care and good luck.

Brooke

Ever have a nerve condition test done? There are a lot of conditions that can be mistaken for CTS. Does your pinkie fall asleep? The backsides of your hands? I have "golfers elbow" in my right arm. It's a real pain. Good luck with your condition.

Thanks Brookej for your information. I was not trying to under estimate tendonitis. From what I gather about tendonitis it is very painful. I am not having intense pain just aching all the time. Waking up at night with my hands asleep. Do you have EMG's done for tendonitis? Why? I am no hand expert either. I have been told that tendonitis is almost like a muscle strain only worse and it hurts to even move. I am not experiencing that.

My employer says this is not a work related injury. I went to the doctor at first using my health insurance. After about a month of testing and seeing the doctor (which said it was CTS), I contacted a lawyer and he told me that I should have been signed up for worker comp. I told my employer this and they signed me up then. Now my health insurance doesn't want to pay for my MRI's because they say it is work related. So you can imagine why I am so confused at this moment.
Anything else you may want to add, I would apprecite. Thanks again


Thanks fedorov5549 for you input also. I have not been tested for any nerve conditions. When I wake up at night, it seem that my whole hand is asleep. That was the initial reason that I went to the doctor. I just wanted to find out about it and if it was my job causing it I was going to change jobs. Now everything is so screwed up. Still confused. Thanks again for your input.

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kayjoe

kayjoe,

I apologize if I confused you more but you said if I wanted to add anything else that you would appreciate it. Here goes! Try doing a search for carpal tunnel syndrome or more specifically - anatomy of carpal tunnel syndrome if you haven't already. I have found some good pictures at some websites that better explain what is difficult to explain with words alone. I don't believe EMG's will aide in the diagnosis of tendonitis but they will help to tell how well the muscles may be working. Tendonitis may ultimately cause the muscles to not work very well and that is a big problem.

It is a cascading effect. - a series of reactions. You have to have nerves in order to use muscles. If a big nerve in the right place got cut in half then you would become paralyzed because the nerve would no longer be able to send messages to the muscle and tell it that you want to move that muscle so you could do whatever it is you wanted to do. Nor would you have sensation to the affected area. On a lesser scale, if the nerve is getting pressed on (but it is still there) then you feel numbness, tingling, and may not be able to use the muscle you want to use very well because it is not getting the full impact of the signals that are sent to it by the nerve. Seems to me that pressure on a nerve causes numbness and/or tingling first, then some form of discomfort (pain, or in your case aching), followed by weakness in the muscle. That is why I think your Dr. is talking about doing another EMG - to see if there is enough pressure on the nerve to cause an interuption in the signals to your muscles. If another EMG comes back abnormal next time then mabey they will have a better clue. That doesn't much help you with the numbness, tingling, or aching you are presently experiencing. Anyway, if the tendon is irritated, then it swells. That makes the tendon fatter so it presses on the nerve that is right beside it and I already said what pressure on a nerve can do.

I can sure see why you are confused. I would be too. Seems like you are getting the run around from the Dr.'s, workman's comp., and the insurance co. Like fedorov5549 said, there are a lot of conditions that can be mistaken for CTS. Has your hand been x-rayed? You didn't mention that but an x-ray is less expensive than those other tests. I hope they at least got an x-ray to rule out arthritis in your wrist. You said the neurosurgeon said arthritis in your neck. If you have it in your neck, you could very well have it in your wrist. That was my problem. I had a classical presentation so I am sure that simplified the diagnosis. I was also referred to an excellent hand specialist and it is my understanding that the type of arthritis that I had can be mistaken for CTS if numbness/tingling occurs. I wasn't having numbness or tingling, just a lot of pain. My surgery for that was a complete success and it only took an examination of my hand and an x-ray to diagnose it. The joint injection, meds, and splint did not help so I had surgery.

Personally, I would stay away from lawyers and workman's comp. and stick to my insurance co. if possible. Get the treatment I need and let the insurance co.'s attorney persue the employer and workman's comp. if they thought it necessary. I have read too many horror stories about workman's comp. on these forums.

fedorov5549 - My left pinkie finger fell asleep a few weeks ago and it hasn't awakened yet! No pain or weakness, just numbness. Funny you should mention golfers elbow. I don't have elbow pain but I think I have been leaning on my left elbow a lot lately which may be compressing my ulnar nerve and causing the numbness in my pinkie. I have been trying to evaluate what I have been doing differently that may be causing numbnees in my pinkie and that is what I have come up with so far. BTW, do you actually golf? Good luck with your elbow pain.

kayjoe - I wish you the best of luck and I hope you get some resolution soon. Please keep us posted.

Brooke

Brookej,

Thanks again for the input. I understand a little more as to why the doctor would want to do another EMG. I had x-rays done before the MRI's. They were ok. I was using my health insurance to go to the doctor when I first went. But they sent a letter to me saying that they thought it was work related because the MRI I had done on my wrist came back normal (no CTS). So....my lawyer says Tendonitis is a work related incident and my employers says not. My employer says that my health insurance and worker comp will have to fight it out. See what I mean about being confused? http://www.healthboards.com/ubb/confused.gif I am just so tired of going to the doctor. Sometime he makes me feel like this is all in my head or something. I have to travel about 60 miles to see him and that is getting tiresome too. Not only am I having to miss days at work but also my husband because I can't drive there myself (don't know my way around). I have not missed any work other than going to the doctor visits so I guess I should consider myself lucky. There are days that my arms feel like they could just fall off but I keep on going. I work for a very small company (about 25 total workers there) so if I miss any it puts a strain on everyone else. I didn't want to cause any problems for anyone just wanted to find out what the problem wasn and fix it or get a different job. Now it is all messed up. http://www.healthboards.com/ubb/tired.gif Sorry, I didn't mean to run on and on with this. Thanks again and I will keep you posted.

I won't go into all the problems I ahve had with CTS bilateral if you won't you can read it with in the last 20 days of this forum. The NCV study can tell you if the nerve is being pinched off in the Carpal Tunnel and also in the elbow and ulnar nerve. I have irreversable damage and it is nothing to play with. Please take care of your hands because no one else will and certainly not your employer. It is very hard to get insurance to touch you once workman's comp takes over or visa versa. I have been fighting with my company since November 99, and even though they paid for the surgery they didn't file it with the state so they can dicate what the dr says and anyone else. I have also had a MRI done on my neck which shows possible dislocation of C-4/5 and C-5/6 and mild hernation of C-3/4, larger hernation of C-4/5, and very large hernation of C-5/6. The hand Dr. that did my surgery said he had done all he can do for the pain and numbness and didn't know what else to do. When I showed him this report he had a fit. I told him this was going on at the same time and no one bothered to look for a reason for it just sayuing I shouldn't be having this much pain and numbness. I now have headaches I can't stop, my arms feel as though they are going to fall off after working 8 hours and can barely drive home. I have limited motion in my shoulders, my hands are numb and hurt all the time and get worse as does my headache. They have allowed me to have this and do nothing about the problem becoming worse. Please follow your Dr. advice and if you are still hurting and having numbness please keep on persuing endlesly. You have only one set of hands and you need them. Also Workman's comp is suppose to reinburse you for mileage to and from the Dr. and the time you loss from work so please keep up with all this and keep copies of all your mileage and loss of time and your medical records for the lawyer can get this money back for you if they won't give it to you. I know I have been long winded but maybe I have helped some Good Luck and take Care. God Bless