Medical Questions > Conditions and Diseases > Carpal Tunnel Syndrome Forum

Hard to make a fist. Help!

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Learn the basics about carpal tunnel syndrome here: causes, risk factors and complications....
Are some people born with carpal tunnel? More here on what can cause carpal tunnel syndrome and who is at risk of developing the condition....
Carpal tunnel syndrome is accompanied by very clear signs and symptoms. But how do symptoms change as the syndrome progresses? More info here....
I was recently diagnosed with carpal tunnel. The doctor who performed the tests said it was a mild to moderate case. Although my hand always hurts, sometimes it is much more tolerable than other times. This happened to be one of the rare days where the pain wasn't as bad. I wonder if I went on a day when the pain was very bad if the results would have shown a more serious case?

I am writing mainly because it always hurts to make a fist. Some days it is worse than others, but it always hurts nonetheless. The pain feels like it is mainly in my middle finger. I can feel a bump/pop in the base of my palm when I try to make a fist. I can do it, but I have to squeeze hard and it hurts very bad. If i accidentally fall asleep without my wrist brace, I won't even be able to close my hand at all when I wake up. I'm just wondering if this is a result of my carpal tunnel. I assume it is, but I can't find any information about someone with my specific problem on the Internet. I do deal with the regular side effects as well such as tingling and numbness. Is the pain when I try to close my hand normal too?

Any information would be appreciated. If it helps to know, I am a 22 year old male. Average height and weight.
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First Helper kurtismj
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replied February 16th, 2011
Community Volunteer
Hi kurtismy and welcome to ehealth: You sound like you have all the classic signs of CT...Some days it can be bad and other days good...It will hit different fingers and not just prey on your wrist area...Being in the computer age I guess this is something that we must learn to live with...I have found that running very hot to warm water over my wrist and hand before I go to bed can relax the muscles...Take care....

Caroline
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replied February 18th, 2011
Kurtis, I could almost have written the same 2 paragraghs that you have. I just had a nerve conduction test done and had the same result that you have had. I was also wondering about whether the test results would change if the test was done on a day when the symptoms were worse. On the surface, it would seem logical that the results would change if there were more pinching of the nerves but I don't know. I also have been having trouble completely closing my hand so there are at least 2 of us with this symptom. My doctor wanted to give me a cortisone shot and excercises to try to fix the problem but I have scheduled surgery instead because I don't want to be going back and forth for more shots in the future. It is unknown if the shots would work. On the other hand, it is also unknown if the surgery will work but after dealing with these symptoms for a number of years I feel that the shots would only help temporarily and would not be a permanant fix. My symptoms are improving slowly after resting my hand for about 3 months. I'm sorry that I couldn't give you a more definitive answer to your questions but at least you now know that others have the same type of symptoms that you have. I'm just kind of winging it also and looking for some good info. Good Luck.
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replied July 8th, 2011
Hard to make a fist.
Kurtis,

I am having exactly same symptoms, hurting middle finger, hard to make fist, bump in the base of the palm. I am professionally software engineer and i predominantly work with computers minimum 8 hours a day. Have you done any treatments? If you have please keep updated. I want to get rid of this situation.

I am having serious concern hence will be booking appointment with GP.

Gamecio, how did ur surgery go? did it help?
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replied July 9th, 2011
silwal,
The surgery helped tremendously. I would highly recommend it if required. I was concerned about being able to lift weights but have started again and have had no major problems. I had the procedure done in March and went back to work in May. Since going back to work my other have is "going numb" and I am considering having it done also but will wait until the symptoms worsen.
I am very curious about the bumps in the palm of your hand as I have two of them still which were there before the surgery. I asked my surgeon about these but did not receive a satisfactory answer. I have assumed that the pressure on the nerves may have caused some muscles in the hand to "knot up" but this is only specualtion.
Hope this helps,
Please let me know if you find out any info. (cause or cure) on these lumps. Gamecio.
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replied July 10th, 2011
Gamecio,

Thanks for your answer. i have doctor's appointment after a week. Lets see what will doctor say.

I feel maximum pain when i try to fold one finger (specifically little finger and ring finger) and stretch other 3 fingers at the same time.

I am glad to hear that your surgery was successful. Can I ask where did u do the surgery?

I have one lump that I can feel the base of my palm. It moves when I move fingers to make a fist. I also feel it is some type of muscle inflammation. Though I dont know what caused it in the first place.

I will let you know my future conditions.

Thanks
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replied July 22nd, 2012
ct
i have had the problem some years , had ijections and they worked for 2 years but now the problems back , as i close my right hand maualy i can actually see my tendon pop through my wrist ( extreamy painfull ) .back to the doctors tomorrow !
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replied July 10th, 2011
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silwal,

The bump in the palm is most likely flexor tenosynovitis, especially since it move with finger motion.

These are most commonly located in the palm, at the base of the finger (rather than at the base of the palm). But, the nodule can be located anywhere along the tendon sheath. Since it is an inflammation of the tendon sheath, it can cause discomfort with motion of the finger.

Diffuse swelling of the synovial tissue in the carpal tunnel can sometimes present as a mass +/- discomfort. Since all of the finger flexor tendons run through the carpal tunnel, this inflammation may affect the fingers also.


Another thing it could be is a ganglion cyst. These cysts can arise from a joint or a tendon sheath. They will sometimes also move with tendon motion. If the cyst is in the carpal tunnel, it can also cause carpal tunnel syndrome.


So, it takes a fairly thorough examination of the hand to ferret out exactly what the problem is and what is the best way to treat it.

Good luck.
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replied July 11th, 2011
Hi Gaelic,

Thanks for your explanation. I searched the terms you have mentioned and found the images quite scary, though they are informative.

As per my conditions, The lump in my base of the palm is not visible from outside one has to press on the region to feel it. The lump moves only when folding my ring finger.

The strange thing is if I fold ring finger and try to straighten other 3 fingers it hurts bad. The problem seems to be with my ring finger.

I use computer around 8 hours a day, though i dont have to prepare big lengthy documents, my work consists moderate amount of typing. While using computer and typing it doesn't hurt at all. I can type with my troubled right hand easily, but I do sometime feel a bit of uneasiness.

I am desperately waiting for doc appointment day.

Thanks
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replied July 13th, 2011
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silwal,

Be sure not to confuse infectious flexor tenosynovitis with inflammatory flexor tenosynovitis. The infectious type is a surgical emergency, where there is still a fairly high rate of amputation. This is NOT what I think you might have.

The inflammatory type is very common. And, though it can be very frustrating, it is usually very treatable.


It is quite common for other fingers to hurt, when moving just one. The flexor profundus tendons to the middle, ring, and small fingers, actually arise from just one muscle belly in the forearm. You can demonstrate this, by holding the middle finger completely straight with your other hand, then try to flex the other fingers. This is due to the conjoined profundus tendon.


As you can see, the biomechanics of the hand/fingers is very complex. So, if the problem does not get better soon, you may need to see a hand surgeon.

Good luck.
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replied July 14th, 2011
Thanks Gaelic,

Your replies are helping me to prepare for the doctor's appointment. My pain is still here, during the morning as I wake up, making a fist hurts bad. I feel apprehensive about the state of my hand.

According to your explanation it sounds like I dont have the carpal tunnel syndrome, am I right?

What sort of treatments should I undergo inorder to diagnose my condition? I live in England and to get an appointment one has to wait for a long time.

This pain started when I played tennis a month back. The pain then disappeared for a week then it started hurting again. It is creating pressure and frustation.

Should I avoid typing or lifting heavy weights? Will this help to avoid worsten my condition?

I really appreciate your help,

Silwal
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replied July 14th, 2011
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silwal,

No, it doesn't sound like carpal tunnel syndrome. In this condition, numbness and tingling in the thumb, index finger, and middle finger is the prominent symptom. Pain can occur, due to ischemia of the nerve.

But, thickening of the tendon sheaths, can show up in the carpal tunnel. The tunnel is just an anatomic region, bounded by the carpal bones and the transverse carpal ligament. Through it runs nine tendons and the median nerve. So, it can get pretty tight in there.

Unfortunately, many general practioners, when they see a hand problem, say it is either arthritis or CTS, without really doing a thorough exam. Hopefully, you are seeing a hand surgeon or an orthopedic specialist.

In terms of diagnosis, a very thorough history and hand examination can usually determine what is going on. Depending upon what the exam shows, then x-rays, ultrasound, bone scan, MRI, or electrical studies may be necessary.

In terms of activities, basically, if you can put up with the discomfort, you can do about anything. A general rule, is that discomfort is okay, but sharp, intense pain is not.

Hope you find out what exactly is going on. You definitely don't have a run of the mill problem. Good luck.
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replied July 16th, 2011
Hi,

Today, i was just giving exercise to my fingers.. i was repeatedly moving my fingers in wave motion. Suddenly i felt like muscles are rubbing with one another inside my palm. that area started to burn.

I can also feel that my hand is bit swollen.. but its hard to notice.

I am waiting for monday's appointment.

Thanks
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replied December 24th, 2011
same problem
i have the same exact prob. But its in my left hand & i am right handed. The hand i always use the most on my pc etc is the right so i would think it might not be CT in my case hopefully..
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replied December 24th, 2011
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ericvflores,

Carpal tunnel syndrome (CTS) classically shows up with numbness and tingling in the radial sided digits; thumb, index finger, middle finger, and the radial half of the ring finger.

As the condition progresses, most patient do develop pain in the hand, due to ischemia of the nerve.

But, not all hand pain is CTS.


It is actually quite common to have inflammatory flexor tenosynovitis, especially if you have an occupation that requires a lot of repeated grasping or flexion of the fingers.

The flexor tendons to all of the fingers are covered with a synovial sheath. This sheath contains synovial fluid, which lubricates the tendons, so there is minimal friction with motion. However, if the sheath gets irritated and inflamed, it will swell. This can cause pain and swelling in the palm of the hand, anywhere along the tendon sheaths.

It is most commonly located at the base of the fingers in the palm, but, again, can be anywhere from the distal forearm to the finger tips. Some patients actually develop nodules on the flexor tendons. These nodules can become entrapped in the pulley system of the flexor sheath, causing locking of the finger in flexion. This is called a trigger finger.


If you are having a lot a problems with your hand, you may want to see a hand surgeon for an evaluation. It often takes a very thorough examination to figure out exactly what is going on in the hand. Unfortunately, the primary care providers are often not well versed in a good hand exam, thus all hand pain is attributed to CTS or arthritis.

So, again, if you are having problems, see a specialist. Good luck.
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replied September 22nd, 2012
ct or arthritis
My hand has been hurting for the past couple of days. It hurts non stop and even worse when I make a fist and grab something. Everyone keeps telling me that it could be ct or arthritis. As far as I know I haven't done anything to sprang it.
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replied September 22nd, 2012
My hand has been hurting for the past couple of days. It hurts non stop and even worse when I make a fist and grab something. Everyone keeps telling me that it could be ct or arthritis. As far as I know I haven't done anything to sprang it.
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