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    Old 11-19-2003, 07:34 AM   #1
    Tasha2003
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    Carpal Questions

    I assume I do have carpal because when I do that test (the one they suggest you try where you put your hands together and elbows out) my hands go numb. I have hypothyroid trouble and diabetes, so these can also contribute.

    Have gotten to the point of waking with numb hand on the right, and some lower arm pain almost every other night. I am not into surgery, and I know if I wear splints at night, things feel better. However, I have deQuervains tendinitis, which is made worse by splints at night.

    What I am wondering is if there is anything I can try to help this out before resorting to surgery or testing? I do not have weakness in my hand, and right now only one hand is involved. I'm wondering if even wearing splints during the day will help?

    I do spend lots of time on the computer, and since I know that isnt a good thing the only thing I thought of trying was using a natural keyboard.
    Any thoughts or suggestions on any of this?

     
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    Old 11-19-2003, 08:38 AM   #2
    1Ageless
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    Quote:
    Originally Posted by Tasha2003
    I assume I do have carpal because when I do that test (the one they suggest you try where you put your hands together and elbows out) my hands go numb. I have hypothyroid trouble and diabetes, so these can also contribute.

    Have gotten to the point of waking with numb hand on the right, and some lower arm pain almost every other night. I am not into surgery, and I know if I wear splints at night, things feel better. However, I have deQuervains tendinitis, which is made worse by splints at night.

    What I am wondering is if there is anything I can try to help this out before resorting to surgery or testing? I do not have weakness in my hand, and right now only one hand is involved. I'm wondering if even wearing splints during the day will help?

    I do spend lots of time on the computer, and since I know that isnt a good thing the only thing I thought of trying was using a natural keyboard.
    Any thoughts or suggestions on any of this?

    Perhaps you should request and EMG/nerve conduction study to confirm a diagnosis of carpal tunnel syndrome.

     
    Old 11-19-2003, 12:19 PM   #3
    lidia09
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    Cool

    Hi Tasha
    It's best not to wear splints during the day as well as at night. The reason is that if you keep your hands/wrists immobile, muscles can get weaker from lack of use then you end up with even more problems. You could maybe use them while you're typing though if you found that comfortable but not for very long periods of time. I got that advice from a very good orthopaedic surgeon.

    Hypothyroidism & diabetes does make you a higher risk for cts right enough. Have you tried taking 100mg Vitamin B6 per day? Bromelain is also a very good natural anti-inflammatory. You can buy it in tablet form or eat heaps of fresh pineapple. There's steroid injections available for cts which help by reducing inflammation around the carpal tunnel. I've heard they're quite temporary though.

    That test you did is a reasonably accurate one. That's how I was diagnosed - no fancy tests I had the surgery around 7 years ago which helped quite a bit but now I've got Cubital Tunnel Syndrome.

    Good luck
    Lidia

     
    Old 11-19-2003, 12:32 PM   #4
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    Lidia.......

    Quote:
    Originally Posted by lidiajamjar
    Hi Tasha
    It's best not to wear splints during the day as well as at night. The reason is that if you keep your hands/wrists immobile, muscles can get weaker from lack of use then you end up with even more problems. You could maybe use them while you're typing though if you found that comfortable but not for very long periods of time. I got that advice from a very good orthopaedic surgeon.

    Hypothyroidism & diabetes does make you a higher risk for cts right enough. Have you tried taking 100mg Vitamin B6 per day? Bromelain is also a very good natural anti-inflammatory. You can buy it in tablet form or eat heaps of fresh pineapple. There's steroid injections available for cts which help by reducing inflammation around the carpal tunnel. I've heard they're quite temporary though.

    That test you did is a reasonably accurate one. That's how I was diagnosed - no fancy tests I had the surgery around 7 years ago which helped quite a bit but now I've got Cubital Tunnel Syndrome.

    Good luck
    Lidia
    Lidia: Thanks, I had heard of the vitamin thing, so that might be worth a try. I cant wear splints at night though (and that is the problem) because I have de Quervains tendinitis, which is made worse by splints at night. That's why I wonder if wearing them during the day will help the "Carpal" or not?

     
    Old 11-20-2003, 11:58 AM   #5
    lidia09
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    Re: Carpal Questions

    [QUOTE=Tasha2003] I am not into surgery, and I know if I wear splints at night, things feel better. However, I have deQuervains tendinitis, which is made worse by splints at night.

    Hi Tasha
    Sorry but I got a bit confused about the splint thing. First you say that things feel better with splints at night then that the splints made the deQuervains worse.


    I thought that the conservative treatment of deQuervains involved the use of thumb splints? I was given a fantastic little thumb splint by a PT as my right thumb has lost much of its muscle. It prevents my thumb from bending & at the same time is firm enough to stop my wrist from bending too. Would a splint like that not be something you could wear at night?

    Lidia

     
    Old 11-20-2003, 06:53 PM   #6
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    Re: Carpal Questions

    [QUOTE=lidiajamjar]
    Quote:
    Originally Posted by Tasha2003
    I am not into surgery, and I know if I wear splints at night, things feel better. However, I have deQuervains tendinitis, which is made worse by splints at night.

    Hi Tasha
    Sorry but I got a bit confused about the splint thing. First you say that things feel better with splints at night then that the splints made the deQuervains worse.


    I thought that the conservative treatment of deQuervains involved the use of thumb splints? I was given a fantastic little thumb splint by a PT as my right thumb has lost much of its muscle. It prevents my thumb from bending & at the same time is firm enough to stop my wrist from bending too. Would a splint like that not be something you could wear at night?

    Lidia
    Lidia: The Ortho. gave me splints for my wrists and forearm for the de Quervains. If I wear the longer one (up the arm) at night, my Carpal doesnt bother me but my wrist tendons lock up severely and then when I get up in the morning they are stuck. Though it doesnt last long, it's very painful. I cant even open up my eyeglasses and put them on, because my wrist is stuck. So they said, the wrist splints should never be worn at night but only during the day.
    However, I spoke to a friend who had carpal problems, and she suggested a mouse pad with wrist rest on it, and I did buy some vitamin B6. She also said she wore her wrist splints all day long, and it still helped the problem. We shall see?!

     
    Old 01-05-2004, 10:28 AM   #7
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    Thumbs up Re: Carpal Questions

    Quote:
    Originally Posted by Tasha2003
    I assume I do have carpal because when I do that test (the one they suggest you try where you put your hands together and elbows out) my hands go numb. I have hypothyroid trouble and diabetes, so these can also contribute.

    Have gotten to the point of waking with numb hand on the right, and some lower arm pain almost every other night. I am not into surgery, and I know if I wear splints at night, things feel better. However, I have deQuervains tendinitis, which is made worse by splints at night.

    What I am wondering is if there is anything I can try to help this out before resorting to surgery or testing? I do not have weakness in my hand, and right now only one hand is involved. I'm wondering if even wearing splints during the day will help?

    I do spend lots of time on the computer, and since I know that isnt a good thing the only thing I thought of trying was using a natural keyboard.
    Any thoughts or suggestions on any of this?
    Tasha ~
    You say you spend a lot of time at the computer. I worked for a Board Certified Hand Surgeon as OR Tech for many years. If you understand the anatomy of carpal tunnel, perhaps you can better understand the situation of the problem. There are rows of carpal bones in your wrist. Your median and ulnar nerves, along with arteries, tendons, ligaments etc also run in and between the carpal bones (through the carpal tunnel) of the wrist. The median nerve gives power to the thumb, index, and partial long finger, and the ulnar nerve gives power to the fifth finger, ring finger, and usually ulnar side of the long finger. An EMG / nerve conduction study will confirm carpal tunnel syndrome, cubital tunnel syndrome, or other syndromes, such as thoracic outlet, deQuervain's syndrome, brachioradialis problem etc. The more time you spend at your computer doing keyboarding or any type of repetitive motion, without any sort of intervention, this carpal tunnel situation can progress. Some of the major symptoms of carpal tunnel syndrome are numbness and / or tingling of one or both of the nerve distributions (median or ulnar nerve distribution), dropping items you are trying to carry, numbness or tingling of your hand that can awaken you at night, weakness of the hand. The nerve is the softest and finest of the anatomy (tendon, arteries, nerves, etc...) that goes through the carpal tunnel, therefore, the swelling compresses the nerve which causes the symptoms. There are two surgical options; open carpal tunnel release, or endoscopic carpal tunnel release that relieves the pressure on the affected nerve. It can be done as an out-patient with a local anesthetic and you would probably be in a cast or splint for two weeks with sutures, and then on to hand therapy. I have had experience with steroid injections, which have many side effects, and I feel should never be used unless absolutely necessary. Splinting and "resting the nerve" and cutting back on repetitive motions can help. An EMG / nerve conduction study is not terribly painful; it measures the amplitude and velocity of your nerve(s) that is affected and will give you your diagnosis. As I said above, this could be a problem other than carpal tunnel, such as cubital tunnel, thoracic outlet, etc... I would highly recommend a BOARD CERTIFIED hand specialist, which is usually a Plastic and Reconstructive Surgeon with a Fellow in Hand Surgery, a very specialized field of medicine. Just remember how important your hands are to you, and keep yourself as ergonomically correct during work as possible, including neck position, head position, height of monitor, height of your desk, etc... GOOD LUCK.

    Last edited by 1Ageless; 01-05-2004 at 10:33 AM.

     
    Old 01-06-2004, 07:31 PM   #8
    Tasha2003
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    Re: Carpal Questions

    Quote:
    Originally Posted by 1Ageless
    Tasha ~
    You say you spend a lot of time at the computer. I worked for a Board Certified Hand Surgeon as OR Tech for many years. If you understand the anatomy of carpal tunnel, perhaps you can better understand the situation of the problem. There are rows of carpal bones in your wrist. Your median and ulnar nerves, along with arteries, tendons, ligaments etc also run in and between the carpal bones (through the carpal tunnel) of the wrist. The median nerve gives power to the thumb, index, and partial long finger, and the ulnar nerve gives power to the fifth finger, ring finger, and usually ulnar side of the long finger. An EMG / nerve conduction study will confirm carpal tunnel syndrome, cubital tunnel syndrome, or other syndromes, such as thoracic outlet, deQuervain's syndrome, brachioradialis problem etc. The more time you spend at your computer doing keyboarding or any type of repetitive motion, without any sort of intervention, this carpal tunnel situation can progress. Some of the major symptoms of carpal tunnel syndrome are numbness and / or tingling of one or both of the nerve distributions (median or ulnar nerve distribution), dropping items you are trying to carry, numbness or tingling of your hand that can awaken you at night, weakness of the hand. The nerve is the softest and finest of the anatomy (tendon, arteries, nerves, etc...) that goes through the carpal tunnel, therefore, the swelling compresses the nerve which causes the symptoms. There are two surgical options; open carpal tunnel release, or endoscopic carpal tunnel release that relieves the pressure on the affected nerve. It can be done as an out-patient with a local anesthetic and you would probably be in a cast or splint for two weeks with sutures, and then on to hand therapy. I have had experience with steroid injections, which have many side effects, and I feel should never be used unless absolutely necessary. Splinting and "resting the nerve" and cutting back on repetitive motions can help. An EMG / nerve conduction study is not terribly painful; it measures the amplitude and velocity of your nerve(s) that is affected and will give you your diagnosis. As I said above, this could be a problem other than carpal tunnel, such as cubital tunnel, thoracic outlet, etc... I would highly recommend a BOARD CERTIFIED hand specialist, which is usually a Plastic and Reconstructive Surgeon with a Fellow in Hand Surgery, a very specialized field of medicine. Just remember how important your hands are to you, and keep yourself as ergonomically correct during work as possible, including neck position, head position, height of monitor, height of your desk, etc... GOOD LUCK.
    1Ageless: Thanks for the reply. I have actually tried to cut back on computer time, started doing stretching exercises and taking B6 vitamins. I'm seeing a chiropractor with Kinesiology background on Thursday in hopes of gaining more info.
    I have thyroid disease and type I diabetes, which can further complicate CTS. So far, I do not have weakness or problems during the day, but do have at night.
    we'll see how it goes.
    Btw, if you have hand surgery and it is your right hand, and you're right handed, what in the world do you do? I wear an insulin pump and need my hands to change out pump supplies etc. I have no clue how I would get by with my left hand?

     
    Old 01-07-2004, 07:48 AM   #9
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    Re: Carpal Questions

    Quote:
    Originally Posted by Tasha2003
    1Ageless: Thanks for the reply. I have actually tried to cut back on computer time, started doing stretching exercises and taking B6 vitamins. I'm seeing a chiropractor with Kinesiology background on Thursday in hopes of gaining more info.
    I have thyroid disease and type I diabetes, which can further complicate CTS. So far, I do not have weakness or problems during the day, but do have at night.
    we'll see how it goes.
    Btw, if you have hand surgery and it is your right hand, and you're right handed, what in the world do you do? I wear an insulin pump and need my hands to change out pump supplies etc. I have no clue how I would get by with my left hand?
    Tasha ~
    Cutting back or completely laying off your computer or doing any repetitive motion for a while can help the swelling. An anti-inflammtory, such as Aleve, may be of some help. You have stated that you know your thyroid and diabetes problems can cause complications. Most of the CTS symptoms are at night, with numbness and tingling awakening you. Many people sleep with their wrists flexed, and this will cause pressure on the nerve. Unfortuntately, I was misdiagnosed with traumatic carpal tunnel after an airbag injured me. I challenged the surgeon's diagnosis and told him "I feel like there is a fracture." I also reminded him that I had worked for one of the finest microvascular hand surgeons in the large metro area of a large city, and I watched him clench his jaw. He continued to insist that I have surgery, which I opted not to do, since I was certainly convinced his diagnosis was not correct. He chose to inject my wrist area with steroids "indefinitely." Unfotunately, at that time, I did not know the severe risks with steroids, and I found out the hard way. The surgeon insisted I undergo the surgery, and I reluctantly did so via the endoscopic route. His surgery failed! I still had the same symptoms that were not at all consistent with carpal tunnel syndrome symptoms. He again began to inject me with steroids until my hand withered, bled under the skin, turned my carpal bones to mush, and the thenar eminence (the fat part of your thumb on the palm side) had withered. I immediately sought a second opinion with a second Board Certified Hand Surgeon that only specialized in "hands. After three years, an x-ray was taken, and my suspicion of a fracture was very correct. I had walked around with a wrist fracture for three years and it was never x-rayed prior to that! The second surgeon tried to save my hand, but the damage had been done. A DEXA-scan revealed that I also had osteoporosis in my left hand and forearm, showing about three carpal bones scattered up into my hand. An arthrogram revealed torn ligaments. I now have the use of only my right hand and arm. I really do miss my left upper extremity ~ I fall much easier now since I don't have two hands and arms to break my falls if I should trip, and I cannot catch myself, therefore, causing further injuries. Now I get to learn to be a handicap ~ I would strongly urge anyone not to put this off ~ Make sure your surgeon has a very good reputation by checking out certain websites that patient advocate, Sydney Wolfe, MD, can supply for you if you key in that name in your search engine. Don't believe everything your doctor tells you. Get a second opinion. If you have a phsician that you truly trust, ask him who HE would send his wife to for the absolute best care. Many of the medical education hospital facilities have some of the finest surgeons, since they are "teaching physicians" and they are not in it for the cash or a quick cure, or unfortunate misdiagosis and false trust from patients. ALSO, make sure you have an EMG / nerve conduction study with a good firm diagnosis prior to undergoing this surgery! Mine showed "possible mild early unsymptomatic" carpal tunnel syndrome, and the doctor doing the EMG agreed that my symptoms were not consistent with carpal tunnel syndrome. If I can attempt to get by with only one hand and arm the rest of my life, I think two weeks out of your life to save your hands is definitely worth it!!!

    Last edited by 1Ageless; 01-07-2004 at 08:07 AM.

     
    Old 01-07-2004, 07:57 AM   #10
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    Re: Carpal Questions

    Quote:
    Originally Posted by Tasha2003
    1Ageless: Thanks for the reply. I have actually tried to cut back on computer time, started doing stretching exercises and taking B6 vitamins. I'm seeing a chiropractor with Kinesiology background on Thursday in hopes of gaining more info.
    I have thyroid disease and type I diabetes, which can further complicate CTS. So far, I do not have weakness or problems during the day, but do have at night.
    we'll see how it goes.
    Btw, if you have hand surgery and it is your right hand, and you're right handed, what in the world do you do? I wear an insulin pump and need my hands to change out pump supplies etc. I have no clue how I would get by with my left hand?
    The post op splint or cast can leave your thumb and fingers free. Explain the necessity of your insulin pump prior to surgery and ask for that type of splinting post op. Your wrist is what needs to be immobilized for two weeks to heal. Sutures should stay clean and dry. The endoscopic surgery is just two tiny incisions that may require a suture or two on each incision ~ no sweat... IF YOU ARE IN THE RIGHT HANDS OF THE RIGHT SURGEON.

     
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