Return of symptoms
I had a steriod injection in December, in both wrists. My left cts responded well, no further discomfort. However, the symptoms have returned in my right hand, numbness at night, and pain and discomfort during the day. Oddly the pain appears to be located in the area where the injection was administered. Is that normal?
Dispite the injection being extremely painful, is there any possibility of another one? I really don't want to have surgery!
The numbness, pins and needles at night were waking me up again. I started wearing the splint again, which is effective, some of the time. Other times it still wakes me up. During the day I get pain in the area where the injection was given, especially when driving and carrying my one year old god daughter. When driving I have to remove my right hand from the steering wheel and shake it about the rest it for a while, before using it again.
Sometimes during the day I get pins and needles for no reason at all.
Looking at those updated symptom scores it's quite a striking contrast between the two sides, with the right hand probably feeling a little worse than it was to start off with now. Come and drop in to tomorrow morning's clinic if you are free (Thursday 14th June) and we can think about re-injecting it, though unless someone fails to turn up we may not be able to test it. Turn up anytime between 9 and 12. JB
Sorry! I did not pick up the message until today, 16 June! I would not have been able to attend, as I had a funeral to attend! I am available, this Thursday, at the moment.
Nick is away next week so there is no-one in this coming Thursday's clinic to inject I'm afraid. You could try calling the SIPC office on Monday and see if any of our injecting GPs are available to do one at short notice. I'll have a further think about it on Monday as well - let me know what SIPC say. JB
Would it be more beneficial, to wait and have a test prior to having the injection?
In an ideal world we would do both very quickly but as both the CTS clinic and the injection arrangements are pretty busy at present I suspect we will end up doing whatever we can first. We can work it out once we know what dates are available for injection. JB
At least I now have a space to see you next Monday - we will put a letter out in tomorrow morning's post. JB
The earliest I can be seen is the 6th in Charing. I am therefore happy to attend your clinic on Thursday, for my injection.
I remembered why the injection was not as painful last night, a friend advised me to take analgesia before I leave the house! That might have been what made the difference!
Probably as much psychological as a real analgesic effect... but that doesn't matter as long as it worked! JB
The response of my right hand was amazing this time, after I got over the initial soreness. I was able to stop using my splint at night without any problems. I do hope the effects will last longer this time.
I'm afraid it seems to be just as random as the first one when you look at times to relapse for second injections compared to times to relapse for first ones. There is the paper by Visser which suggests that patients with milder neurophysiological abnormalities have longer remissions but I have not been able to fully confirm this in Canterbury data. The only other thing which seems to be at all predictive is the subjective severity score before injection. Yours was 3.36 which would translate to a mean time to relapse of about 350 days in Canterbury patients. We'll see how it turns out. JB
The right side was neurophysiologically more severe so it is tempting to take that as an explanation for why that side might respond less well but I'm not sure that is really the case. Quite a few people do seem to describe more pain the second time around, often around the wrist, but when I have tried to find hard evidence to support this previously I have failed. Amongst all that uncertainty you may be pleased to hear that we could certainly re-inject it. I would quite like to know how the nerve conduction studies have changed however so the best way to do it all would be to see you in the Thursday morning carpal tunnel clinic and do the whole thing in one visit. The only problem with that plan is that my Thursday morning clinics are currently booked up until August - how bad are the symptoms at the moment? (one thing you can do to quantify that is to do a new severity questionnaire on here - the link is on the My CTS History page) JB