Right Index Finger Pain (please Help!)

I apologize for the below posting. It is very long and wordy. However, it is a detailed representation of what i've been going through over the last 5 months. If there is anyone out there they can offer me some suggestions other than what i've already tried, I would very much appreciate it!

10/20/04: approximately 2 weeks before surgery, right index finger knuckle had slight tingle and itch. Over the next 2 weeks, it began to hurt. I discussed this w/dr. Zeiger. He said after the surgery, pain should go away.

11/4/04: Dr. Evan zeiger (neurosurgeon) performed cervical fusion on c-5/6. I had prior fusion (1998) on c-4/5. I woke from surgery and finger pain was still present. He said to give it several weeks and it will eventually go away.

11/22/04: finger worsened. I talked to Dr. Ghori (neurologist). He said it was a good sign (pain) that the nerve was not permanently damaged. He brought by samples of trilepital (150 mg) for me to take. He said it was for epilepsy, but it also helps with nerve damage pain.

11/23/04: went to see Dr. Charles feagin (orthopedic hand specialist and plastic surgeon). I was having some tennis elbow pain. He gave me a cortisone injection, which he has done several times in the past. I talked to him briefly about my finger. He said if it got worse, to give him a call.

12/8/04: had first follow up meeting with Dr. Walter haynes iii (neurosurgeon and one of Dr. Zeiger’s partners in b’ham). This was pertaining to my cervical fusion 11/4/04. He took some x-rays of my neck and said everything looked good. I mentioned my finger pain. He said it should go away in a couple of months. Recommended I use neurotin (600 mg/day). He also ordered me a medrol dose pak. Said there probably is some swelling that could be causing the finger pain. The medrol pak is an oral steroid which should take care of this. Also wrote me a prescription for physical therapy to get my legs back to full strength. I also complained that went I stretched, I would cramp up. He said one I get back into my exercise routine, the cramping should go away.

12/30/04: pain has continued to intensify. It has migrated from my knuckle towards the tip of my right index finger and radiated into the top of my hand. Dr. Zeiger’s office recommended an epidural, which I had done today by Dr. Steve jones (anesthesiologist ). Dr. Jones slowly drove the needle in. He told me once he injected the epidural space, the pain should go away within seconds. Unfortunately, it didn’t. He said to give it a few days. But I could see the look on his face that he was surprised I didn’t have the slightest bit of relief.

1/5/05: I had my 2nd follow up meeting w/dr. Zeiger in b’ham. He looked at my hand and said the surgery he performed had nothing to do with my hand. I mentioned the other minor herniation in c-3/4. He said it was so minor, it wouldn’t be causing my problem. He had me get an x-ray of my hand and then recommended I see a rheumatologist. He said an injection into the mcp joint should provide relief.


1/11/05: Dr. Feagin gave me a cortisone injection for the radial nerve in the mcp area (knuckle). I waited several days without the slightest bit of relief.

1/26/05: I went back to Dr. Feagin. He gave me another cortisone injection in the lower part of the top of my hand. He asked me prior where the pain began. I told him and he said that’s where the radial nerve route was. So his goal was to inject where the pain began. No results. That evening, I did some research on the internet. It seemed my pain could be caused by bursitis or rsd. After reading about reflex sympathetic dystrophy (rsd), I prayed it was not that.

2/11/05: my physical therapist, chuck outlaw (p.T.), then referred me over to southeast pain management. I had met with Dr. Mark willis (anesthesiologist) earlier. He had said a ganglia nerve block should do the trick. Today, he did the procedure. He told me within 5 seconds, the pain would be gone. Not! He then told me I wouldn’t leave his office in pain. He gave me 4 shots of novocain directly into my right index finger area. I still felt pain. He told me he could cut my finger off right now and I wouldn’t even know it. He tested it by having my close my eyes and look away. He asked what he was doing to my finger. I told him he was digging his finger nail under my finger nail. I opened my eyes and saw the disbelief Dr. Willis had. He said there was no way I should have been able to feel that. I left his office in pain. He recommended trying a radial frequency (rf) on c-6/7. He said those were the main nerve branches that radiate out of the spinal cord into my right hand area. He also wrote me a prescription for more neurotin. He said he wanted to build me up to 1800 mg of neurotin per day. I began taking more neurotin this evening.

2/21/05: went for cervical mri at flower’s hospital in dothan. It showed some minor to moderate herniation in c-3/4. Most everyone I talked to said it wasn’t significant to cause my finger pain.

2/23/05: several days ago, I had spoken with Dr. Ghori. He mentioned he had a friend that did acupuncture. So today, I had my first of 6 acupuncture treatments administered by Dr. Bayer cheng (anesthesiologist) here in dothan. Each session lasted 30 minutes. Needles were placed at various locations on my body. He strategically placed electric shots/pulses on certain needles. No results.

2/24/05: 2nd acupuncture treatment.

2/25/05: 3rd acupuncture treatment.

2/27/05: 4th acupuncture treatment.

3/1/05: 5th acupuncture treatment.

3/3/05: 6th and last acupuncture treatment with no results.


3/7/05: went to Dr. Willis office to have the radial frequency (rf) performed on c-6/7. He said it was the opposite of the ganglia nerve block. He didn’t guarantee that it would work though. It was very painful. He went in through the neck area. No results. He said to give it several days though.

3/15/05: 1st consultation with Dr. Hassan kesserwani (neurologist in ozark, al). Dr. Kesserwani graduated from the mayo clinic in minnesota. He came highly recommended. Dr. Cheng referred me to him. Dr. Kesserwani said it was a clear case of digital neuritis. It was a form of rsd but could be treated. He suggested doing an emg next week to test of the extensiveness of the nerve damage. In the meantime, he game me several lidoderm patches to attach to the highly sensitive areas until my next appointment. He said the problem is local and has nothing to do with my back.

3/21/05: went back for 2nd visit with Dr. Kesserwani. He started out by placing some small sticky patches on different parts of my right arm and right neck and shoulder area. He then administered small pulses of electricity. He came to the conclusion that my right index finger nerve was not damaged. He also did some strength test and said everything appeared normal. I told him that was fine, but my finger is still hurting. We went back to his office. He told me I needed to take digital pictures of the finger. He said there was clear discoloration in the areas of highest pain. I told him at this point that it’s my own body, and when I lay down at night or turn my neck a certain way, the pain continues to shoot out. So I asked that he still conduct the emg on me. He initial said it wasn’t necessary after the electric shock test. So he conducted the emg by sticking a needle in my arm in different locations and listened to the pitch. He said there was some bad noises in the c-56/ area. I reminded him that’s where my disk was removed back on 11/4/04. He said other than that, the emg was negative. So it was not my back that is causing all the problems. I even brought the copy of my mri taken back on 2/21/05. He didn’t see anything concerning to him. He then drew a picture for me of my nerve. He said the only thing he can think of at this time is that I have vasculitis. That is, not enough blood supply is getting to the nerve. It was probably due to some swelling and inflammation from my back/neck area. He recommended I get a solumedrol steroid (1 gram) per day for 3 days. It would be administered through an iv placed on a one hour drip cycle. He also wrote me a prescription for zostrix crème (cayenne pepper) to apply 3 to 4 times per day to the injected area. He said it would burn, but its purpose is to kill the small pain fibers just under the skin. I will see him again in 4 weeks for a follow up.

3/22/05: I went back to see Dr. Willis about my neck discomfort and tightness. He earlier had recommended multiple local anesthetic injections into the “trigger points”. It should break down the muscle spasms that were so tightly balled up. I told him I was going in the next 3 mornings for my solumedrol treatments. I was concerned about my blood sugar, since I was diagnosed with diabetes 6 years ago. He asked if it was under control. I told him 6 months after I was diagnosed, I was given a clean bill of health from my family doctor, Dr. Edwin morriss iii (internal medicine). I do not take any insulin or medicine. It has been weight controlled for the past 5 ½ years. Hemoglobin a1c test have all been perfect since then. Based on this information, he said he could give me the injections now without any problems. He gave me 10 shots in various trigger point areas.
3/23/05: 1st solumedrol iv injection done at flower’s hospital. It took about an hour. It wasn’t very bad. I immediately experienced a metallic taste in my mouth. It lasted till around 6pm that evening. I also felt nervous, jittery and anxious. I noticed my hands very slightly shaking. Jeffery (rn) told me these were very common side effects of the solumedrol. He also told me to watch my blood sugar and blood pressure. Also said I might feel very hungry, which I did. I checked my blood pressure before bed. It was 150 over 95. I was very concerned.

3/24/05: before I went in, I checked my blood sugar. It was 195. Again, I was very concerned. I did my 2nd solumedrol treatment. I told jeffrey about the nasty taste. He told me to suck on some lemon drops or peppermints. All the side effects came back. I felt anxiety all day. But at 6pm, most of the feelings went away. I also had trouble going to sleep the night before.

3/24/05: I called Dr. Zeiger’s office this afternoon. I spoke with gayla. I told her the continued problems with my finger. I wanted to see if Dr. Zeiger could review my case and hopefully help me or refer me to someone at uab. I told her i’d gone to just about every local specialist, and have been unsuccessful. I mentioned it’s time for me to go out of town. She said for me to fax her all my notes (history). Dr. Zeiger would be back in the office on monday and he’ll review it. Then if he wants to see me, we’ll set another appointment. Be sure to bring a copy of my recent mri done in the cervical area. I also received a call back from chuck outlaw. He has a specialist at uab that might be able to help me.

3/25/05: I did not sleep well again. I went in for my 3rd and last solumedrol treatment. I checked my blood sugar before the treatment. I was up to 205. Again, they mentioned that once the steroid filters through my body, my blood sugar should go down to normal levels. They checked my blood pressure. It was 125 over 64. I felt much better about this.

3/25/05: current condition and conclusion: initially, I had a small itch in the right index finger knuckle. Over several weeks, the itch developed into severe pain. The pain grew to the tip of my finger and radiated towards my wrist on the top of the hand. I am scared this pain will continue to extend up my arm. Over the past 2 months, it has not progressed. Pain is ignited when the area is gently stroked or grazed. Also laying down or turning my neck aggravates it. Extremely hyper-sensitive! Hard pressure or massaging feels good. On a scale of 1-10, the pain is always a 3 (dull pain). But when aggravated (which is often), it spikes to an 8. It is a very sharp, stabbing shooting pain that generates from the top of my hand to the end of the finger. Fyi, the left side and top of the index finger and a small area from the right index knuckle down towards the wrist is the most sensitive. The right side of the index finger gives me no problem. The rest of my hand and fingers are in perfect condition. Total duration of problem is approximately 5 months. At this point, all treatments have failed. There is one interesting footnote. I took a cruise to cozumel, mx 3/10/05 – 3/14/05. I drank plenty of beer. I did not complain about my finger one time. Somehow, it must have had a numbing effect on the nerve pain sensors.