Test results

Apologies - that is because, unusually, I was not in the department when you were tested. The right hand was grade 2 and the left hand grade 1 - JB

Hi. After I had the injections, the relief was almost instant, and lasted through the summer holidays in August. When I went back to work at the beginning of September, the symptoms started up again. I now have long indentations along both
forearms and some weakness in my right wrist. I have to support heavy objects when carrying them.When I wake up in the night both my hands are dead, and the only way of bringing them back to life , is to lie on my back with my arms straight out either side, back sides to the bed. I also lose feeling and get numbnesshenholding things like my mibile phone, and writing on the board at school. I tried splints, but they irritated my ji arms so much the skin peeled off. Any further advice? regards

Sounds like time to check them again. The 'indentations in the forearms' don't sound like CTS but the rest of it is very much recurrent CTS so we should see how bad it is now. I'll send you out an appointment when I'm next in the Canterbury office at the weekend, JB

Thanks. jo

Appointment letter now in post, not until after Easter I'm afraid JB

Just an update. Don't know if it is related to using my mouse pad a lot at work, but woke up this morning and the end of my right middle finger was numb. I thought it would improve during the day, but if anything, the numbness is spreading down the finger, and is from the first knuckle joint now. Any idea whether it is likely to spread to my other fingers?
I have my appointment letter, thanks.
Jo

Assuming that it is part of the CTS and not some other problem then the fingers which are potentially involved are the thumb, index finger, middle finger and the adjacent side of the ring finger - at least so long as you are built the way the anatomy books say you are (a few people have slightly non-standard anatomy). In 'standard' CTS, loss of sensation should not involve the little finger or the palm of the hand because the nerves to those areas pass outside the carpal tunnel. This anatomical rule does not necessarily apply to symptoms other than loss of sensation however. JB

Hi
I was just concerned as up until now the numbness has been intermittent, so to have.it permanently numb is annoying. Worried that I could lose feeling permanently in the two fingers and thumb.
Jo

More persistent numbness usually is a sign that CTS is getting worse but it is unlikely to progress to being a permanent deficit in a short period unless there is an acute change in pressure in the carpal tunnel. Occasionally you see acute CTS secondary to an injury of some kind with the very rapid development of high pressure in the carpal tunnel but these are usually extremely painful and it is also usually obvious from the history what the precipitating injury is. JB

Thanks for the reply. I am off work from Monday for two weeks. If you get a cancellation that I can squeeze in on, could you let me know please, as my appointment isn't until the end of April. Thanks, Jo

There's a cancellation this morning (Tuesday 27th Mar) at 12:30 if you can fill that. JB

sorry, only just checked on here. I need a days notice to leave work, as i have to ring in by eight and send work in by email. next week or week after, I will be ok at short notice.

Now that we've progressed another day through the diary and this morning's round of changes and cancellations it looks as thouugh there is a cancellation on 12th April at 11:00. However I am out of the office for a few days now and there is no guarantee that someone else will not grab that space before I get back. I am the only person who regularly reads this site I'm afraid. I will email some of the staff who are still there and we will see if they manage to bring the appointment forward but my main office manager is on leave at present so I'll have to contact one of the other staff. If we do manage to get that slot then they will put a new appointment letter in the post. JB

thanks. jo

Hi. I had try second round of injections last Tues. at Whitstable, and have not had the numbness and pins and needles as much at night, but strangely enough, the night of the injection I had numbness in my ring and little fingers! I am now getting pins and needles in both hands including all fingers and the palms. It is not waking me up as much as before, but strange that the symptoms have spread.
Have you noticed any difference in symptoms depending on where the injection is done? When I had the first injections , I am pretty sure that they were done central to my wrist, but DR Ribchester did them off centre towards the outside of the wrist. The only difference immediately after the injections was that I bruised this time on my right wrist.
Any thoughts?
Jo

The site of injection does not seem to make any statistically significant difference to the outcome, though I have to admit that it has not been very systematically studied. Bruising appears to be random and presumably is just a matter of whether a small vessel is injured on inserting the needle - much as with taking a blood sample - sometimes they bruise, sometimes not. Involvement of the little and ring fingers is usually indicative of trouble with the ulnar nerve at the elbow. Dr Ribchester should be seeing for review 6 weeks after injection so we will see what they feel like then. JB

Hi
My hands are getting worse again, mild in my left hand, but now different in my right. I have been getting woken up at night by numbness and tingling in my right hand as before, problems drying my hair, writing in books, on the whiteboard, typing, using ipad etc. I now have intermittent, excruciating pain in my right middle finger. When it plays up, it feels as though the whole finger is on fire, spreads to the palm of my hand as burning/tingling, then the back of my hand, then I get pain along my arm. Shaking out/placing my arm at right angles to my body does nothing to alleviate the pain. The pain subsides a bit after about 5-10 minutes, then takes up to 20 minutes to pass completely. Do you think this could be part of the CTS? It usually wakes me up once or twice in the night, then about 5 in the morning.
I am wondering if I might need another round of injections?

It could all still be CTS but there is always the possibiity of developing some other problem. As it's a year since I last saw you it's probably a good idea to test them again and I'll send out an appointment. JB

cheers

Hi. I have been wearing my splint on my right hand again at night, due to being woken by the searing pain at night. I am now getting the pain even with wearing the brace. It lasts for about an hour -hour and a half. I then have stiffness in the palm of my hand/ knuckles during a large part of the day. I am off work this week, I don't suppose there is any chance of being injected at clinic tomorrow? I have an appointment next week for a re-test I think, but am desperate. The brace is also causing a reaction with my skin....

I don't think we have any facility for injection this week I'm afraid, though we can probably do next week. We could also check whether Estuary view could do anything quickly. JB

That would be great thanks. Jo

Looks like the earliest that can be managed is Thursday am this week in Canterbury

Ok. Thanks, will be there at 9.30.