Steroid injecton hit the nerves?

nlights31
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I'm thankful I stumbled upon your website. It has great information. Thank you!

I have suffered from CTS for over 10 years... longer if I can add in CTS due to pregnancy 25 years ago.

Up until 2 years ago, I was able to handle it with taking an ibuprofen on occasion and splinting both wrists at night. The last 2 years have been quite bad. I suspect this is due to my job working in a food bank, lifting/carrying heavy boxes and sorting through hundreds upon hundreds of cans and boxes of food.

The pain these last 2 years has been constant and night times have been, by far, the worst. I would wake up in severe burning pain, to the point on not being able to go back to sleep. This is even when wearing my wrist splints. Over and over I would tell my family physician how painful it was. He had me tested for rheumatoid arthritis, MS and when those test came back negative, he would tell me to continue to splint and take some over the counter pain medication. I was taking Tylenol with codeine and that wasn't helping. I even took CBD/THC candies, but those didn't help much either.

On March 8, 2019, I decided to have cortisone injections instead of opting for surgery. I can't afford to be off work for any length of time. My injections were Kenalog 40 40mg/ml plus Lidocaine to inject both wrists. When he, my family physician, gave the first injection, there was an excruciating shooting pain up my left thumb. Within a few seconds, my hand was completely numb. I told my Dr about that shooting pain, but decided to continue on to my right wrist. In that injection, I had the exact shooting pain up my right index finger. Holy cow! It was so painful! Within seconds, that hand went numb due to the lidocaine.

After the freezing came out, I had terrible pain and numbness in both hands, specifically the left thumb and right index finger. 5 days later, I called the dr. office and spoke to receptionist. She in turn spoke to dr who said it's most likely "Cortisone Flare" and to call back if the pain persists a further 3 days. Well... the pain and numbness was still there. It was like having electrical shocks up those digits when doing things ie: pulling up my zipper, reaching into a pocket, washing in the shower, grabbing a pen, lifting items at work, etc. I was also back to splinting at night of my own direction.

I called dr. again after a week (couldn't get through the phone earlier). I spoke to dr. and he prescribed me Gabapentin 100mg 3x/day. Over the course of 2 weeks on that medication, nothing improved. I call again and went in to see him. This is now a month since my injections. When I told him that I think he hit a nerve on each hand, he said that he didn't, that the nerve was compressed due to the volume of solution he injected. I don't believe him. He upped my dosage of Gabapentin to 200mg 3x/day. and instructed me to wrist splint at night (which I was doing) and all day as well. I've been doing that and still no improvement to this day, almost 8 weeks after the injections.

I will be calling him back this coming week to tell him of no improvement with the higher dose medication or full-time splinting.
All in all... I shouldn't have to splint everyday, I shouldn't have this pain, shocks, numbness. It's like I traded one problem for another. My CTS symptoms at night seem to have disappeared, and my hands don't ache anymore. The pain I feel now is very different than the pain of the CTS symptoms. Shocks constantly, numbness of the two affected digits, pins and needles every now and again, painful fingertips on all fingers except pinky fingers, but specifically on the affected digits.

I've had to stop playing my bagpipes these last 8 weeks because of the shocks I keep getting. Before, I always had pain while playing, but I dealt with it as I love playing my pipes. Now, it is really a shocking task without the splints, and with splints on full time, I can't even hold my set of pipes properly in order to play :(

I still work each and every day at the food bank because I can't afford not to work. It's really interfered with my work. I'm dropping cans all the time, and without the splints, I was getting shocks constantly. My fingers hurt so bad by the time I got home from work, even with the splints.

In ways, I wish I hadn't taken the injections and just lived with the pain or opted for surgery. Did he hit nerves in my wrists while injecting? I have no idea the outlook. Will the nerves heal on their own? Will I be on medication (that doesn't appear to work) for a long time? Will I still require surgery? What's the next step? What questions should I ask my dr.? No conductive tests were ever done. I had no idea that they should have even been done or even that they existed. Should my dr. have sent me to a specialist instead of doing the injections in his office?

Looking forward to hearing some suggestions.
Thank you for taking the time to read my issues.
Lisa/nlights31

jeremydpbland
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It certainly sounds possible that those injections were given into the nerve instead of into the surrounding tissue but of course one cannot be sure. You can sometimes get an impression of whether this has happened if you do an ultrasound scan within a few days of the injection but it's probably too late for that now and in any case it depends to some extent exactly where the needle was placed. We have been collecting a series of patients in whom we think this has happened, usually when the injection is done by someone who does not do a lot of them, and the good news is that in most cases the severe pain does seem to settle eventually, though in one of my patients it took 3 years. At this point you should get some nerve conduction studies done to find out how much nerve impairment there is and take it from there. JB

nlights31
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HI Jeremy,

Thank you so much for your reply. I'm happy to hear that in most cases the severe pain settles.
When I visit my doctor next, hopefully in the next week or so, I can ask him about the nerve conduction study.

I appreciate your input :)
Lisa/nlights31

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