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Having pain in hands and wrist. Had Carpal tunnel surgery. Help?

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General & Family Physician
Practicing since : 2009
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My name is XXXXXXX and I am having some serious issues with my hands from the wrist out to my fingers. The pain wakes me up at night and I can't close them with any strength. I have been to Dr.'s and specialists at the Hand and upper limb clinic in London ON , they have done x-rays and MRI's and Dr.Bing Gan told me that there is nothing wrong with my hands. I had Carpal tunnel surgery in Sarnia ON last feb/12 on my left hand. I am in pain 24/7 and especially at night. Any help would be much appreciated. PJM
Posted Mon, 10 Jun 2013 in General Health
Answered by Dr. Luchuo Engelbert Bain 2 hours later
hi and thanks for the query,

I understand how frustrating it can be when one visits lots of doctors for a health issue and it actually persists. However, considering the pain is bilateral, attacking the small joints and mostly at night, I suggest this pain should have a strong inflammatory component.

Its fundamental to have measures of inflammation carried out. An erythrocyte sedimentation rate and a C reactive protein measure is very important. Any past history of rhumatologic disease in the family should noted. Its true that the classical joints usually affected in gout are untouched, but rare cases have been described in smaller joints. A serum uric acid level titre could be useful. A complete rheumatologic screen is my priority is this clinical state. Diseases such as rheumatoid arthritis, atypical vasculitis and other systemic conditions should be screened for.
A complete blood count, rheumatoid factor titre, anti - nuclear anti bodies (ANA) measure and TPHA/VDRL. Atypical infections like chronic syphilis infections could attack the bones.

A complete clinical review, including a detailed past medical history, coupled with these laboratory tests as shall further be guided by the clinical review could be useful. I strongly suggest you book an appointment with rheumatologist. Wishing you the best of health.

best regards,
Luchuo, MD.
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