Discussions By Condition: I cannot get a diagnosis.

4 yrs of Hand Pain -- Need Help

Posted In: I cannot get a diagnosis. 4 Replies
  • Posted By: handpain
  • January 27, 2009
  • 04:52 PM

Have experienced pain in left hand (right handed person), specifically ring and middle fingers. Started like electrical shock down my fingers. Finger tips become very sensitive. Pain is worse when I lay down and also very sensitive to cold weather. Now I have I noticed that when my hand is hurting, my fingertips are warm. Other people can feel the difference in temperature between my hands. I have been to hand specialist and neurologists. Am currently on Lyrica, 75 mg twice a day and am in considerable pain. Pain takes my breath away sometimes, keeps me up at night and affects how I do things daily. Have been tested for carpal tunnel several times and also have had MRI's of my hand, neck and shoulders. Hand also seems worse when my shoulder and neck are bothering me -- have done office work for close to 20 years. Am 43 yr female.

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  • The relationship to your neck is interesting. The lower neck specificially the 5th, 6th, 7th Cervical and 1st Thoracic vertebrae has spinal nerves that go down the arm to the ring finger side of the middle finger, the ring finger itself and pinky. It is common that when these nerves get irritated symptoms occur in the hand specificially in those fingers. MRIs and CTS tests are usually inconclusive. A common cause of these symptoms is a misalignment of those vertebrae which can cause the irritation to the nerve. If you have not already done so I would get a screening and consultation with a Liscensed Doctor of Chiropractic. Let him check those levels of the spoine to see if in fact there is any irritation to that nerve. Nerve tests done by neuroilogists like an EMG, NCV, or SSEP are very specific tests which means if they find a problem then can tell you exactly what fibers are involved. However they are NOT very sensitive. If there is intermittant or slight irritation to the nerve from a misalignment of the two segments it will not show up on those tests. Chiropractors have very simple tests to determin if the segments are misaligned and if nerve irritation is present. My recommendation is to find a locol DC and go talk to him. If he sounds like he makes sense and finds nerve irritation at the level of C6 through T1 or even T2 I would give him a shot. Best of luck to you, hope it helps. Dr_Hands
    Dr_Hands 2 Replies
    • January 28, 2009
    • 07:59 AM
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  • Is the pain on the palmar side or backside of your hand?C7 nerve root irritation causes symptoms in the index and middle fingers but on the backside(also called dorsal side).
    richard wayne2b 1232 Replies
    • January 28, 2009
    • 02:38 PM
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  • Thanks for the information you both have provided. I am sorry, but not sure which side -- it is so intense. I will try to figure that out.
    handpain 1 Replies
    • January 28, 2009
    • 05:14 PM
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  • Okay, I think the underlying cause here is more local than anything cervical. Chronic inflammation of the common digital nerve where it passes through the carpal tunnel at the wrist crease would be my guess and I don't think that pregabalin or Lyrica would be very therapeutic in this instance. Carpel tunnel syndrome need not be present for you to experience these symptoms as well, but since your occupation as an office worker would likely entail repetitive tasks using a word processor, typewriter, etc., then I would wonder whether this represents the antecedent to such chronic circumstances with your wrist pain. I would also wonder whether the muscular tension at the level of the neck and shoulder is not coincidental rather than causative in nature. Incidentally, I would have no doubt that a chiropractor would indeed be able to locate and identify the "nerve irritation." I don't subscribe to chiropractics and if indeed there is any relief to be gained in the way of pain management by these folks, it is typically in the manner of relieving muscloskeletal pain through the use of physical therapy rather than manipulation. An injection of 1% lidocane with betamethasone might prove beneficial to determine whether it provides relief from the pain. Best regards, J Cottle, MD
    JCottleMD 580 Replies
    • January 29, 2009
    • 01:53 AM
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