A few questions about carpal tunnel Pain Management? I am 36 Male if that even has much to do with it? I am right handed and going for surgery on my right hand which had the strongest symptoms in 2 weeks, the left hand will be done after. Since diagnosis ( about 1 1/2 months ago ) the symptoms in my left hand have progressively gotten worse. At the time of diagnosis I was told that I have had CTS. for some time and have missed it over the years. So now the muscle at the base of my left thumb has decayed ( which I had no idea at all till diagnosis ). So what I have been getting is a radiating pain that goes up my left arm through the elbow where there is a great deal of pain that continues up to my left shoulder and up the left side of my neck. This causes sleep loss, irritability and makes most simple tasks quite difficult and painful. I never noticed anything until after being diagnosed so I am a little confused, I'm sure there is a psychological connection to this but the pain is VERY REAL! I have not found much relief with the brace on my left.
Carpal tunnel syndrome (CTS) is much more common in females than males. It tends to be more idiopathic in females, and work related in males (but that is not an absolute). CTS can be brought on in persons who do a lot a strong continuous or repetitive grasping and in those who work with equipment that vibrates. Keyboarding has not been shown to be an etiology for CTS, though the topic is still hotly debated. There is a lot of overlap in females around forty years of age who also do a lot of computer work. Now, having the wrists in poor positions while typing (either sharply flexed or hyperextended) can cause compression of the median nerve, resulting in symptoms. It is not uncommon, when we sleep, for us to bring our hands up under our chin, flexing the wrists down. This compresses the nerve, causing pain, and waking the patient. Splints are worn at night, just to keep the wrists straight, preventing compression of the nerve. Symptoms can also be brought on by static grasping, such as holding a phone for awhile, grasping the steering wheel too tightly, extensive mouse work, etc.
Since you have atrophy of the thenar muscles (the muscles at the base of the thumb on the palm side), you have had CTS for some time. Atrophy is a very late stage symptom. Unfortunately, atrophy usually does not completely resolve after decompression of the nerve. As to whether or not "normal" function is regained after decompression is related to how long the nerve has been compressed.
The arm pain you are having is very common in CTS. The pain from nerve injury is often a deep ache or boring pain. It is almost impossible to get away from. It is not psychological.
One thing that should be looked for in your case though, is the so called "double crush syndrome". In this case, the nerve is compressed in two (or more) places. In other words, the nerve could be pinched in the neck and in the wrist. This should have been checked for when you had your electrical studies done. It's important because if you have a double crush, decompressing one area, but not the other, your symptoms will not go away.
Again, the pain in your arm, is in your arm, it is not psychological. If you have any concerns about your diagnosis or treatment plan, go over it with your surgeon. Wishing you the best.
Hey, thanks for your reply. I am going to see my regular doctor on Tuesday and I will let him know exactly what has happened since I saw the surgeon. Since I posted the first time I have noticed a small lump in the middle of my wrist, which seems to where the pain radiates from. I have read a little about "bible bumps" ,cysts in that area. I have a gut feeling that there is something like that going on in there. I have a few friends whose mothers have had this surgery and I've been told it's a breeze. It's the newer surgery where they just cut the band... about 7 - 9 minutes and your done! I just hope this pain goes with it.
It sounds like you may have two distinct problems going on. Just like a dog can have both ticks and fleas, you can have two diagnoses.
One is the carpal tunnel syndrome (CTS), which is compression of the median nerve within the carpal tunnel at the base of the palm. It's a tight squeeze: the tunnel is bounded on three sides by the carpal bones and closed across the top by the transverse carpal ligament. Through this tunnel runs nine tendons and the median nerve. The nerve has the consistency of cooked spaghetti. So, it is going to be squashed if there is swelling or thickening within the tunnel.
A carpal tunnel release (CTR) is done in one of two ways. Open, through a small incision longitudinally at the base of the palm (standard, tried and true procedure). The incision is only about an inch long. The other way is with the use of a 'scope. The skin incision is transverse at the base of the palm and a camera and knife are inserted. This is a newer, slick procedure, but has not been shown to be better than the standard way. In both techniques, the main thing is to cut the tight band over the median nerve. In your case, since you have atrophy of the thumb muscles, most hand surgeons will do the standard approach, so that they can make sure the nerve is completely released.
Your second diagnosis sounds like a ganglion cyst. These are an outpouching of the lining of a joint or tendon, that fills up with synovial fluid (which looks like apple jelly). These are indeed called "bible bumps". Why? Because in the past they were hit with the biggest book in the house, which was usually the family bible. This technique is not recommended, because other structures tend to be injured when you hit a hand/wrist with that sized object!! Most of the time, a ganglion cyst is only a cosmetic problem, but it can cause discomfort if it presses on surrounding structures. Like when doing push ups.
The bumps are usually left alone, unless they are causing problems. They can be aspirated (the fluid sucked out), but they usually come back. The cyst can be taken out surgically, again either open or with use of an arthroscope.
So, you need to discuss both of these conditions with your surgeon. Hope you have a successful carpal tunnel release and get back to activities as soon as possible.
Wow that was a great post by Gaelic and I agree, you have 2 separate conditions, most likely a ganglion cyst as well as possible neck, shoulder, elbow issues. Ice is always good to help knock down the swelling and numb the pain at least temporarily.
Since getting carpal tunnel pain myself, I have looked around and researched the web trying to avoid having to get surgery. I have found many sites that go into great detail about things you can do to alleviate the pain associated with this condition. Probably the best one was this site 'link removed by admin' I found that this site talks extensively about diet and exercise and even massage techniques. It does also sell a product that I bought and it does what it says it will do. Relieve your pain in three days. I was amazed at the results. Even without buying the product I think a lot of people will get results with just the info on the website. I highly recommend it.