Does anyone know why carpal tunnel would now involve cramping in the palm of the hand? The right hand started doing this about a week or so after the left hand had the surgery over 5 weeks ago. The left hand has not healed yet and about the time the incision in the wrist bled and turned red, I have been having some kind of fever/chill episodes and got ahold of the doc on Saturday and tried to explain the situation and he thinks I'm fine but reluctantly called in an antibiotic. After 2 days on the antibiotic, the fever/chill episodes have GONE! The redness in the wrist is not as bad, but still kind of painful and the left hand now cramps when trying to grip anything! I think I will go crazy - although I'm already that way!
It is a type of focal dystonia in the hand. The muscles of the thumb which are innervated by the median nerve, originate off the fascia in the palm. So, sometimes, grasping or opposition type movements will cause the muscles to cramp.
You should try to determine exactly what type of activities seem to bring it on the most. Is it writing (fine movements), strong grasping, or prolonged (static) grasping. Then try to modify the movements that bring it on.
If it is static grasping, take frequent breaks. Schedule the breaks, so you do not wait till the hand in cramping before resting.
If it is strong grasping, use instruments or tools that provide you with better biomechanical advantages, so you don't have to work so hard. In other words, use pliers with longer, padded handles or use instruments to turn tight nuts off bolts, instead of using your fingers, and so forth.
If it is the fine movements like writing, check you writing instruments and how you are holding them. Many people try to strangle their pencil when they write. If your knuckles blanch when writing, you are strangling your pencil. These patients need to relax their grip. Use large caliber writing instruments (like you used in kindergarten). You can get foam or silicone tubes to go on the pen or pencil, making it larger and padded. Also, try to not use just the fingers for the majority of the writing. For taking notes or a lot of writing where it really doesn't matter what it looks like, use the whole upper extremity when writing. Save the use of just the fingers for very fine work, where what it looks like matters. When writing like this, take frequent breaks.
Hope your hand heals well and your symptoms resolve. Remember, it takes time for the soft tissues to heal, then they have to be rehabilitated, and that takes some time. The underlying tissues are still healing when the skin incision has healed. You may be trying to do too much, too fast. Mother nature tends to work only at her own rate.
Cramping with carpal tunnel - before and aft. surg.
Wow. You are the only one who has any idea of what is going on. Well, it first made its appearance after driving the car with the right hand and that was at least an hour or so after driving. I was waiting at the doc with my daughter who had an unresolved sore throat - I really don't recall doing anything with the right hand at that time (the right hand has also carpal tunnel syndrome but not done yet) when I noticed pain shoot down from the wrist and then the cramping. I just about cried as I thought I had experienced every pain, burning, numbness, shock like pains that this condition could produce (as well as it going up the arm). I was able to get the med. assistant to get me some ibuprofen and called my hand doc and they had never heard of anything like this, even the one today who called to remind me of my next appt. She had CTS and this was new to her. Yes it is any kind of gripping motion that seems to set it off with both hands - including the one that has had the surgery done. I'm typing with one finger stretched out to avoid any kind of "grip" I drove my daughter to a friend's house (5 mins. away) and on the way there it started to cramp, so I stuck both arms through the steering wheel to maneuver and told her she had better find a way home. Thanks so much for replying. I can fold my towels with my left a little until the cramp starts and that's the end of the laundry for the day.
Unfortunately, I've seen too many of these cases over the years. It is not something that is taught in the usual hand training programs. Usually, only modification of the instruments or biomechanics seems to help. Remember, with static grasping (like when driving), change your hand positions frequently and try not to grasp the steering wheel too tightly.
When you are doing activities like folding the towels, plan breaks in the routine, before the pain sets in. As you know, once the pain starts, it's usually the end of that activity for a while. So, every fourth towel, for example, stop and stretch out your palms, wrists, fingers, and rotate the shoulders and neck for about 15 to 20 seconds. The start up again.
The actual cause of this focal dystonia is still really not known. It is speculated that it may be due to local ischemia of the tissues. Is it the muscle contractions that cause the ischemia or is it the alternation in the muscle action due to the changed innervation from the CTS? No one has been able to prove anything yet.
So, it's treat the symptoms the best you can. Good luck.
Thanks so much. I just got through looking at this "condition" and decided to check the site again - except I haven't checked my email which would have told me that you replied. I noticed a lot of posts are saying things like neurotransmitters in the brain, and talking about basal ganglia etc. Well if neurotransmitters are part of the problem I have to tell you that I have been on antidepressants etc for 30 years due to a huge emotional shock I encountered after the birth of my 3rd child, so I could easily go along with the neurology theory of the brain. I see my doc on Monday and I guess we will see what he says although as far as I know he doesn't know much about this and he is a hand surgeon, so neurology is probably not in his field! I had to drive today (taking the back streets again) and when it started to cramp, I immediately let go and pushed my arms through the steering wheel with the hands out straight and fingers flared out, so I will continue to not use them in any type of grip as much as possible. This is going to be a huge challenge for a person used to using hands for so much!
I went to see the doctor 2 days ago and he has put me on Arthrotec (some kind of anti-inflammatory). I am back to typing one finger again. I tried typing with both hands for a few seconds last night but that hurt too much. The scars and a large area of my palm turn purple now. He actually listened for awhile but would cut in if he thought I was taking too long to say anything. I just told him of the hand cramping and details of when it happened etc. As I was leaving his office I happened to ask if he knew what focal dystonia was to which he replied "let's not go there!" and that is about all. I still feel very frustrated and I am going to go to another doctor for a second opinion. My hand that had the surgery was the "severe" category and now my right hand is hurting to the elbow and it was only "moderate" in July! I hardly do anything and I just want to cry!
I have now solved the mystery of the cramping in the hands. It is still associated with the carpal tunnel syndrome and does not seem to be one of the symptoms that most people associate with carpal tunnel. I was able to get ahold of something called The Carpal Solution - basically some kind of stretchy thing that goes on the back of your hand - got it for my right hand because I did not like the idea of having this same surgery with the kind of results I got, and the cramping disappeared literally overnight. Oh it has 3 tape pieces that pull on the palm of the hand. I noticed that within 2 days the cramping disappearing from the untreated hand but the one that had the surgery (which by now I could not even put a glove on or any kind of gripping motion in any way including the fingers bending) had pain going up the arm again - this was the final straw that sent me to surgery on the left hand. So I got ahold of this carpal solution for the left hand and you know now I have absolutely no cramping in the left hand either. I believe the pain that I thought was post-operative was actually still the carpal tunnel syndrome because with this little "bandaid sort of remedy" it is great now, and I can type all I want with both hands and no ill effect. I am able to go back to my favorite hobbies including wiring and carpentry and I feel fine!