Return of symptoms

Dear Dr Bland

I visited the clinic for an EMG in autumn 2010 and had a steroid injection from Dr V Brown on 20 October. I can't remember my grading on the EMG. Symptoms minimal till April this year when I started riding Whitstable to Canterbury and back every weekday on my electric bike. Symptoms now as severe as previously. Bike only means of personal transport. What do you think I should do?

Many thanks for your advice

Kay (Karin Richards)


There are two options really, either inject again 'blind' or test it again and then decide. Every situation is a little different so, for example, I would be more inclined to inject again immediately if symptoms were very severe, if they were exactly like the original symptoms and if the response to the first injection had been very good whereas I would be more inclined to test again when my waiting list is shorter, ore time has passed since the origianl test or where the original CTS had been more severe. Yours was grade 2 incidentally. At the moment I would not be able to see you until the latter half of August, unless there is a cancellation for next week that I do not know about yet. You can let me know about the severity of your  current symptoms in a slightly more quantifiable way by completing the symptom questionnaire online here. I can then compare it with your old answers from last year. The other obvious thing to do is to splint it at niight again and I hope yu are doing that already. JB

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