Why has a steroid injection made my CT worse!!

Graham Gold
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I have had CT for about 10 years, and received a steroid injection in my wrist 8 years ago form my GP in the UK and noticed a huge improvement in just a few days. However it has returned quite badly. I visited a recommended surgeon on Samui who said that it had become much more acute and I needed surgery asap but I asked for another injection just to get me
through the next few months. This time the injection was done at the base of the palm of my hand (which I questioned) and immediately the 'pins and needles' was acute. When I returned home I googled this and websites suggested he could have gone into the nerve.

I called him and he said the pain would have been unbearable if that had happened and he told me the sensation was due only to the chemical reaction of the steroid and the pressure of the injection. One week later and it is no better, it feels like Carpal Tunnel was actually administered as opposed to the relief I was expecting, and now have a permanent pain throughout the right side of my palm, which was not there before! It is obviously impossible to extract the steroid, and he said it should improve over the next 2 weeks, but relief was immediate after my first injection in the UK. So did he do something very wrong? The numbness in my index and 3rd finger now exists permanently. So my other question is: Will surgery remove not just the original
CT problem but this new one I have. can anyone help please with correct advice!

jeremydpbland
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It is certainly possible that the injection was given directly into the nerve - this is a well known, though fortunately rare, complication of local steroid injection at the wrist. It may be more likely with an approach from the palm, at least if done 'blind' as opposed to using ultrasound control, but no-one really knows. The other difficulty with intraneural injection is that they are so rarely documented that we don't really know how to predict the outcome and all you can really do is sit tight and wait for a while. The most useful thing one could do at this point would be to get some nerve conduction studies done to find out exactly how bad nerve function is. Despite what the surgeon said, it is not usually possible to assess this just by looking at the hand unless it has advanced to a stage of being almost beyond repair. JB

Graham Gold
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many thanks JB! Appreciate your time in replying.

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