I had bilateral CTS surgery last year and kept having pain and numbness in my arms down to my hands. In the last month after working 8 hours I felt like my arms were going to fall off they hurt so bad. My hand Dr. kept saying he didn't know what was causing this pain as I shouldn't be having this much. pain. My family Dr. sent me to a Neurologist and he said I had Moderate CTS again and needed an MRI of my neck. The MRI showed Degenerating Disk Disease in the C-spine with mild bulging at C-3 to 4 and large bulging at C-4 to 5 and C-5 to 6 with the disk effacing the nerve root on the last two and also desiccation at the last two also. The back Dr. said I was in bad shape. He is trying me on an anti-imflamatory and muscle relaxer and home chin traction for two weeks. I had got to the point I am having a headache all the time especially on the right side that even my scalp hurts. Is that possible? I have been on the medication for a week and a half and the pain has increased especially on the right side. I still have trouble sleeping and can't sleep on my right side. I feel as though knives are sticking in my neck. From my middle finger to the pinkie is cold and numb. I can't get comfortable anyway I lay down, I can't sit for long. the right side of my face feels as though it is drawing or tingling. The Dr. said if I didn't improve he would set up a myelogram and compair it with the MRI and would have to probably do surgery and this involved fusion of C-3 to C-6 and he wasn't sure of the vertrebres in the T-spine. Have any of you had problems like this and caused these symptoms? What options do I have and what type of questions do I need to ask and how long do you think recovery would be and Would this do any good. I am getting worse and worse. I have put a call into the Dr. and his nurse said he would call me back Monday that she would have to let him discuss it with me and we would have to decide what to do? I already have 42% damage in my hands from the CTS what will this do to me? Please help what you can.

Sorry to hear about all that. Sounds like the problem may have began with the cervical problem, resulting in CTS. The reason for this is called "Double Crush Syndrome." What this means is that disruption or compression at a more proximal(close to body) sight, makes the nerve more susceptible at distal(further away from body) sights. Several of those areas that you are speaking of(nerve roots)make up the median nerve. Did you have a Nerve conduction study or SEP prior to hand surgery? That would have helped to differentiate. Also, if there was numbness over the thenar eminance, thumb part of the palm. The nerve that goes to this actually goes over the carpal tunnel, not through it, suggesting there is a problem before the carpal tunnel. This may be suggestive but is not 100%, but I would think there was a NCS prior to sugery, so not to say there can't be two or more things going on.

Pain in the head can result from muscle spasm and or hypertonicity. Muscles themselves can be pain generators but when it comes to the pain in the head, this could be a result of compression or irritation of the greater occipital nerve and or artery, in particular. See if you have point tenderness at the base of your skull, just below that little knob and there are also two just below and on each side. So this might help to explain where your pain is coming from, not to mention potential treatment, e.g. manual therapy.

As far as the potential for surgery, you may find it the best choice if your are experiencing an increase in neurological symptoms. Have you tried any manual therapies yet, PT, Chiropractic, Physiatry? Not for your hands, but your neck.

Hope things turn for the better,
Prouzy

Prouzy, I had a NCV/EMG before bilateral CTS Release and it showed severe CTS in both hands and the only option according the the one that did the test and the Dr was surgery. The medium nerve was completely pinched off in both hands to the extent that I had lost all use of my hands and the FCE and impairment rating showed 42% damage in the upper extrementies. I am know using chin traction at home. When I first went to the Dr. My hands were completely swelled, severe pain like cramping and they were numb completely this is when he gave me the splints, vit. B-6, and celebrex and then then ordered my first NCV/EMG. study. I do have pain under the knob at the base of the skull what does this mean. It is real tender and sore. Could this be causing my headache? I can't even lay on my right side. the pain is too great. I did have pain in my hands under my thumb in both hands and this has returned more in the left hand than the right. But my wrist on the under side is swollen on the right more than the left. I have a high tolerance for pain but this is really getting to me. I hurt down both arms into my hands and it feels as though someone is sticking knives into my neck. It gets so intese I get real hot and break out into a sweat and then the coldness increases n my hands on the last three fingers. It is hard to do anything and nothing seems to help but my neurological symptoms seem to increase. I actually feel as though my arms are going to fall off or I have something under my arms and need to get rid of it.

Sounds like you do have more than one thing going on, though related in other ways. For instance, the fact you have entire arm pain might suggest the problems in your neck are a factor and/or thoracic outlet syndrome. So the DDD in your neck may have been related to the bilateral CTS, whic may be why they did not heal properly/totally, as well as rehab, taking away the cause, Vit B deficiency, diabetes. etc. In any event, the neck problem has now really surface and should play a role in the hand problem. The body is one big chain, and as we get older, the more one link in that chain can have an effect of the rest. The pain at the base of the skull may very well be realted to your pain in the head. Ever heard of a tension headache? That results from cervicogenic cause, the neck. Hypertonic muscles themselves can cause pain, as well as compressing other structures such as nerves and blood vessels. When the muscles become dysfunction, the joint is soon to follow, such as the facet joints in the vertebral column, Joints don't have blood flow like a muscle, they get their nutrients from the synovial fliud in the capsule, and stay healthy by movement, allows for exchange. Another example of this would be after your surgery for CTS, you had to restore movement to muscles and joints? My guess is that your neck is somewhat tight and maybe still, not to mention being reluctant to want to move because of pain? The upper cervical region is responsible for a great deal of important movement, especially Co, C1, C2, so when that is gone, it can affect the area resulting in pain generators from trigger point, facet irritation, hypertonic muscles, and so on.

Hope this helps a bit,
Prouzy

Sounds like you do have more than one thing going on, though related in other ways. For instance, the fact you have entire arm pain might suggest the problems in your neck are a factor and/or thoracic outlet syndrome. So the DDD in your neck may have been related to the bilateral CTS, whic may be why they did not heal properly/totally, as well as rehab, taking away the cause, Vit B deficiency, diabetes. etc. In any event, the neck problem has now really surface and should play a role in the hand problem. The body is one big chain, and as we get older, the more one link in that chain can have an effect of the rest. The pain at the base of the skull may very well be realted to your pain in the head. Ever heard of a tension headache? That results from cervicogenic cause, the neck. Hypertonic muscles themselves can cause pain, as well as compressing other structures such as nerves and blood vessels. When the muscles become dysfunction, the joint is soon to follow, such as the facet joints in the vertebral column, Joints don't have blood flow like a muscle, they get their nutrients from the synovial fliud in the capsule, and stay healthy by movement, allows for exchange. Another example of this would be after your surgery for CTS, you had to restore movement to muscles and joints? My guess is that your neck is somewhat tight and maybe still, not to mention being reluctant to want to move because of pain? The upper cervical region is responsible for a great deal of important movement, especially Co, C1, C2, so when that is gone, it can affect the area resulting in pain generators from trigger point, facet irritation, hypertonic muscles, and so on.

Hope this helps a bit,
Prouzy

Thanks Prouzy you have really helped a lot. I can understand where my headache is coming from now. I talked with the back Dr. yesterday and he is going to do a myelogram on my cervical spine the 18th and do a CT scan at the same time. I think the constant pain I am having stems from the verterbres in my neck. I can turn my head and it feels as though it catches and my neck makes a grinding sound. Anyway the Dr. is going to compare the myleogram CT enhancement imaging with the MRI film that I had done. I know it is the worse pain I have ever had and thanks for answering my questions you have been a great help, helping me to understand more what is going on. Sometimes I feel like I will never get back to normal

Hi Bamabrneyes2,

I just read your entry and I am sorry that you are having continued problems. You have been under stress for a long time, and pain will stress the system. Has you doctor given you anything to help you sleep, besides the anti-inflammatory? I'm wondering if Prozac or someother anti-depressant might help. I know people with chronic back pain that take the anti-depressants just to get thru the day.
I am worried, for you can't go on like this without some kind of relief.

HI,

How have you been...I checked the RSD (off the main bulletin board) discussions. Have you looked at Ruperts' entry. You might have RSD. How is the workers comp treating you?

Hi MaryAnne I am still hanging in there. My neck is still giving me fits and it hurts down both shoulders down my arms and into my hands. The Dr. I saw was going to do something, then they called work to see if it was workman's comp well when the nurse got through with them the Dr. decided there was nothing more they could do. I can't take celebrex because I am alergric to sulfa and it in there, vioxx and relafen cause ulcers in my mouth so I can't take them either. He sent me to a chiopractor and he said my neck was in bad shape and he said it was liked it was trying to reverse directions have you ever heard of that. Well he made my neck hurt worse on both sides now and the Dr. said to stop seeing him. He also used a acupuncture shock wave on my hands and turned it up to 10 and I could barely feel it.He said most people are ready to come off the table at 3 . The other Dr. has me on muscle relaxers 4mg and I still have to take advil with them to rest enough to sleep. Work has written me up with untruths and wouldn't let me file a rebuttle said they could fire me on anything. I refused to sign it and got a copy and sent it to my lawyer. I have a mediation hearing on December 14th on all my claims with a mediator of my lawyers choosing and he is with the state industrial relations. I was suppose to get a raise October 29th but now they are saying it will be the end of December can you believe that? A girl that had been there less than a year and was out on maternity leave and came back well the job I was suppose to get on 1st shift they gave it to her younger and less senority so I have to stay on second. I went to get out my savings and can't get it I called employees realtions manager about it and he hasn't called me back. By the way the nurse that was at the plant got dismissed (FIRED) didn't want someone rehired and called the company physicians office and told them to fail him on the physical. They didn't and when the employee manager found out about it there was almost a knock down drag out in the office. They didn't want me to find out about it but I did. I notified my lawyer. The general talk around the plant was if she did this this time how many more has she done like that and to who? I have an appointment in January to see a well known specialist that is highly recommended if I can make it til then. How are you doing? Are you better? Thanks for caring and keeping in touch.

HI,

Compared to you, there's not much going on with me. I'm sorry that you can't take the Vioxx/celebrax. I have success in that it deadens most of the pain, and I think taking it will allow me to work. The only side effect I have is the tiredness and weight gain. (I can take it a week gain 5-8 lbs, get off it and loose the weight, its mostly water.)
Let me/us know how your meeting on Dec. 14 goes. Your situation is interesting. Can the industrial relations board help? I would think, if you get this straightened out,you have done a big favor for your management. Let me know what the specialist says as to your ability to continue to work. Can you still do your job?
I'm not surprised about the nurse, some people stick their nose into business where they have no knowledge or right, creating more trouble. And I'm not surprised about the maternity leave lady. Its was the same way at the school system. This is one reason I didn't fight them for reinstatement to my position. These women already have their claims/leave covered, and they gave me NO help with my situation. Its the attitude, it can't happen to me, I'm not going to work that hard. Or, I just won't do the job and blame it on so and so.
The only problem I've had, and I had to write the security officer at the school system, involved the schools calling me (presumably) for a position using our unlisted phone number. We have 2 phone lines, one unlisted the other listed. So, first the schools system didn't report my claim, then I tried to make them cover it, then I had to involve an attorney, then they said I could never work for them again, and then the schools called me for a position. (This is typical for them, in that no one takes responsiblity, management or human resources.)
I had to turn down a couple of jobs, I couldn't drive to the location, I don't want to take the chance of furthur damaging my right arm. But, the market seems to be picking up, so I do believe I will be employed within the next couple of months. I having to pull my CD's out of savings, but these were for emergency use.
Keep in touch.