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I Have Pain And Mild Stiffness For The Last 4

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Posted on Wed, 10 Jun 2020
Question: I have pain and mild stiffness for the last 4 months or so. it kind of goes away with rest and not using my hand, but comes back after i use it or lift something heavy. Again, I believe there is no loss of strength or any weakness which I am aware of.

I think this could be carpal tunnel but the neurologist did do both emg and ncs on that muscle and found nothing. But troubles started after my visit with the neurologist, so i am not sure what to make of it. The finger and the thenar muscles twitch sometimes, but again all random. I used to get numbness in my hands when asleep like couple of months ago but not anymore. I do have pain (on a scale of 10 i would say 2 but bumps up to 4 when i use my hand a lot, especially while playing games on phone or using a controller).

I have circled the region in black where i get the pain and also where I feel if there's atrophy or not or just a dent. The 3rd image is also about my right hand.

Also, attached image of my left hand for reference.

Thanks
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
I have pain and mild stiffness for the last 4 months or so. it kind of goes away with rest and not using my hand, but comes back after i use it or lift something heavy. Again, I believe there is no loss of strength or any weakness which I am aware of.

I think this could be carpal tunnel but the neurologist did do both emg and ncs on that muscle and found nothing. But troubles started after my visit with the neurologist, so i am not sure what to make of it. The finger and the thenar muscles twitch sometimes, but again all random. I used to get numbness in my hands when asleep like couple of months ago but not anymore. I do have pain (on a scale of 10 i would say 2 but bumps up to 4 when i use my hand a lot, especially while playing games on phone or using a controller).

I have circled the region in black where i get the pain and also where I feel if there's atrophy or not or just a dent. The 3rd image is also about my right hand.

Also, attached image of my left hand for reference.

Thanks
doctor
Answered by Dr. Dr. Erion Spaho (3 hours later)
Brief Answer:
Probably carpal tunnel syndrome.

Detailed Answer:
Hello and thanks for the query here at "Ask a Doctor" service.

I have read your new query, I saw the pictures of your hands that you uploaded too.

I see atrophy of your thenar muscles of the right hand compared to the left hand.

I assume that this was not present to the moment of the evaluation by the Neurologist.

In my opinion, the atrophy and the pain after the hand use are caused by carpal tunnel syndrome.

For a correct evaluation, an EMG and nerve conduction study should be repeated and compared to the last one.

Discuss with your Neurologist for these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Dr. Erion Spaho (0 minute later)
Brief Answer:
Probably carpal tunnel syndrome.

Detailed Answer:
Hello and thanks for the query here at "Ask a Doctor" service.

I have read your new query, I saw the pictures of your hands that you uploaded too.

I see atrophy of your thenar muscles of the right hand compared to the left hand.

I assume that this was not present to the moment of the evaluation by the Neurologist.

In my opinion, the atrophy and the pain after the hand use are caused by carpal tunnel syndrome.

For a correct evaluation, an EMG and nerve conduction study should be repeated and compared to the last one.

Discuss with your Neurologist for these issues.

Hope you found the answer helpful.

Let me know if I can assist you further.


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Erion Spaho (7 hours later)
Dr, are you sure that’s atrophy or that it appears to be atrophied or just normal dent? The EMG and ncs was done 4 months ago and that muscle was tested.
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Dr, are you sure that’s atrophy or that it appears to be atrophied or just normal dent? The EMG and ncs was done 4 months ago and that muscle was tested.
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Follow up: Dr. Dr. Erion Spaho (1 minute later)
If possible can you mark or draw out where you see the atrophy?
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
If possible can you mark or draw out where you see the atrophy?
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Follow up: Dr. Dr. Erion Spaho (5 minutes later)
Also can muscle wasting if present occur within 4 months of carpal tunnel I heard and read that takes years for atrophy to happen.

I am seeing a neck specialist in 2 weeks time, will he able to look at my hand and see if there’s any atrophy or not?
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Also can muscle wasting if present occur within 4 months of carpal tunnel I heard and read that takes years for atrophy to happen.

I am seeing a neck specialist in 2 weeks time, will he able to look at my hand and see if there’s any atrophy or not?
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Follow up: Dr. Dr. Erion Spaho (8 minutes later)
The reason for me asking whether you are sure or not is due to the fact the image which has blue and black circle was taken in January and I did show it to the neurologist. The one which has no drawing(circles) and the one which has green circle was taken yesterday
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
The reason for me asking whether you are sure or not is due to the fact the image which has blue and black circle was taken in January and I did show it to the neurologist. The one which has no drawing(circles) and the one which has green circle was taken yesterday
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Follow up: Dr. Dr. Erion Spaho (4 minutes later)
Also, it would be great if you pointed out where you see the atrophy?
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Also, it would be great if you pointed out where you see the atrophy?
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Follow up: Dr. Dr. Erion Spaho (32 minutes later)
Also attached 2 images of my palm for your reference , the one which has some red band/thread is my right palm
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Also attached 2 images of my palm for your reference , the one which has some red band/thread is my right palm
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Follow up: Dr. Dr. Erion Spaho (25 minutes later)
Also, would like to let you know that I did show my hand to the neurologist at that time and he did not see anything with it, could that mean my hand has always been like this or do you still see an atrophy?
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Also, would like to let you know that I did show my hand to the neurologist at that time and he did not see anything with it, could that mean my hand has always been like this or do you still see an atrophy?
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Follow up: Dr. Dr. Erion Spaho (1 hour later)
Is this a sign of early stage split hand? Just curious?
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Is this a sign of early stage split hand? Just curious?
doctor
Answered by Dr. Dr. Erion Spaho (10 hours later)
Brief Answer:
Answered below.

Detailed Answer:
Welcome back.

It is difficult for me to be sure if it is atrophy or not since I can't examine you.

The atrophy suspected by me is the one within the blue circle ( in comparison with the other hand).

It is possible for the atrophy related to tunnel syndromes to start to develop within months.

Anyway, there is no progression from the January (black and blue circle) until yesterday (green circle).

It may be also the position of the index finger during the picture that may give the impression of the dent or atrophy.

Pincer grasp should be evaluated by the Neurologist.

In my opinion, since you report for new symptoms after four months, a new EMG and nerve conduction study is necessary.

Split hand syndrome does not debut with pain, so, I don't think it is your case.

I don't see any problems with your palms.

Hope this helps.

Feel free to ask if you have further questions.

Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Dr. Erion Spaho (0 minute later)
Brief Answer:
Answered below.

Detailed Answer:
Welcome back.

It is difficult for me to be sure if it is atrophy or not since I can't examine you.

The atrophy suspected by me is the one within the blue circle ( in comparison with the other hand).

It is possible for the atrophy related to tunnel syndromes to start to develop within months.

Anyway, there is no progression from the January (black and blue circle) until yesterday (green circle).

It may be also the position of the index finger during the picture that may give the impression of the dent or atrophy.

Pincer grasp should be evaluated by the Neurologist.

In my opinion, since you report for new symptoms after four months, a new EMG and nerve conduction study is necessary.

Split hand syndrome does not debut with pain, so, I don't think it is your case.

I don't see any problems with your palms.

Hope this helps.

Feel free to ask if you have further questions.

Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Dr. Erion Spaho (47 minutes later)
1.)When i do the pincer grasp, my index finger pains and have some discomfort. Do you suspect anything neurological or some nerve issue which is manageable?

2.) Can a EMG and ncs study miss carpal tunnel or nerve issue if its like early on?

3.) So there is no progression from the XXXXXXX picture and the recent one right? My pcp told me that's the way my hand is as I have dents on both side my right hand being the dominant is little more pronounced than the left. Also, that i might have a tendon issue as the pain runs all the way to my wrist and sometimes to the top of my arm.
What do you think could this be a tendon issue?

4.) Can a neck doctor like a sports medicine specialist see if thats atrophy or not? Just by physical examination can you rule out atrophy?

5.) So which muscle is that? And what can cause atrophy of that muscle?
I had it during my last neurologist visit and the dr was not concerned by it.

6.) I can easily lift any thing heavy just with the finger alone but then I can pain in the finger and the thumb muscle and wrist and then it spreads to the entire arm, what could be causing it?

7.) Neurological issues dont cause pain right? I fear this could be some neurological stuff like MS or other bad stuff.
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
1.)When i do the pincer grasp, my index finger pains and have some discomfort. Do you suspect anything neurological or some nerve issue which is manageable?

2.) Can a EMG and ncs study miss carpal tunnel or nerve issue if its like early on?

3.) So there is no progression from the XXXXXXX picture and the recent one right? My pcp told me that's the way my hand is as I have dents on both side my right hand being the dominant is little more pronounced than the left. Also, that i might have a tendon issue as the pain runs all the way to my wrist and sometimes to the top of my arm.
What do you think could this be a tendon issue?

4.) Can a neck doctor like a sports medicine specialist see if thats atrophy or not? Just by physical examination can you rule out atrophy?

5.) So which muscle is that? And what can cause atrophy of that muscle?
I had it during my last neurologist visit and the dr was not concerned by it.

6.) I can easily lift any thing heavy just with the finger alone but then I can pain in the finger and the thumb muscle and wrist and then it spreads to the entire arm, what could be causing it?

7.) Neurological issues dont cause pain right? I fear this could be some neurological stuff like MS or other bad stuff.
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Follow up: Dr. Dr. Erion Spaho (2 minutes later)
"In my opinion, since you report for new symptoms after four months, a new EMG and nerve conduction study is necessary."

I had pain in January too, the neurologist asked me to get physical therapy as he believed it was not neurological. The pain and numbness in January was intermittent and it went away for a month but it has been more or less constant since March.

I am going to see a sports medicine specialist for my neck as my pcp believes my issues are stemming from neck plus i have a history of neck and back issues.

Do you even to the slightest think this is something serious or neurological or something thats extremely common??
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
"In my opinion, since you report for new symptoms after four months, a new EMG and nerve conduction study is necessary."

I had pain in January too, the neurologist asked me to get physical therapy as he believed it was not neurological. The pain and numbness in January was intermittent and it went away for a month but it has been more or less constant since March.

I am going to see a sports medicine specialist for my neck as my pcp believes my issues are stemming from neck plus i have a history of neck and back issues.

Do you even to the slightest think this is something serious or neurological or something thats extremely common??
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Follow up: Dr. Dr. Erion Spaho (44 minutes later)
Attached 2 more images titled ; hands2_may and palm2_may. Just to give you more angles on my hand.
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Attached 2 more images titled ; hands2_may and palm2_may. Just to give you more angles on my hand.
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Follow up: Dr. Dr. Erion Spaho (2 minutes later)
Attached 2 more pics titled: r5_feb and r6_feb these were taken in Feb like 1st week, probably a week or 2 after my neurologist visit and in one of the pics I have drawn out lines where i get the pain. It might help you understand better and probably help in giving me list of things that could be causing this.

Thanks
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Attached 2 more pics titled: r5_feb and r6_feb these were taken in Feb like 1st week, probably a week or 2 after my neurologist visit and in one of the pics I have drawn out lines where i get the pain. It might help you understand better and probably help in giving me list of things that could be causing this.

Thanks
doctor
Answered by Dr. Dr. Erion Spaho (8 hours later)
Brief Answer:
Answered below.

Detailed Answer:
Hello again.

I saw the new pictures that you uploaded.

Since you have pain during pincer gasp, it is more likely inflammation of tendons or muscles that is causing it.

The muscle that seems to be involved should be one of the dorsal interossei.

In my opinion, yours is not a serious neurological condition, I think that a new nerve conduction study is necessary to evaluate a nerve entrapment as a possibility.

Inflammation (tendinitis) also may be a possibility, in such case, the muscle may be atrophied due to the limited usage.

A sports medicine specialist may be of help to evaluate correctly these possibilities.

Hope this helps.

Greetings.

Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Dr. Erion Spaho (0 minute later)
Brief Answer:
Answered below.

Detailed Answer:
Hello again.

I saw the new pictures that you uploaded.

Since you have pain during pincer gasp, it is more likely inflammation of tendons or muscles that is causing it.

The muscle that seems to be involved should be one of the dorsal interossei.

In my opinion, yours is not a serious neurological condition, I think that a new nerve conduction study is necessary to evaluate a nerve entrapment as a possibility.

Inflammation (tendinitis) also may be a possibility, in such case, the muscle may be atrophied due to the limited usage.

A sports medicine specialist may be of help to evaluate correctly these possibilities.

Hope this helps.

Greetings.

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Erion Spaho (42 minutes later)
“Inflammation (tendinitis) also may be a possibility, in such case, the muscle may be atrophied due to the limited usage. “

This is my dominant hand and I use it a lot, so until I see the dr. Can I try something at home to relieve the pain?

Also, is this anything serious?

Is this common complaint?

Do you still think I have atrophy? I am scared as this could be some neurological thing?
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
“Inflammation (tendinitis) also may be a possibility, in such case, the muscle may be atrophied due to the limited usage. “

This is my dominant hand and I use it a lot, so until I see the dr. Can I try something at home to relieve the pain?

Also, is this anything serious?

Is this common complaint?

Do you still think I have atrophy? I am scared as this could be some neurological thing?
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Follow up: Dr. Dr. Erion Spaho (1 hour later)
I just now got a shock like sensation which ran from my index finger all the way to my elbow after i accidently hit my hand on the door.
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
I just now got a shock like sensation which ran from my index finger all the way to my elbow after i accidently hit my hand on the door.
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Follow up: Dr. Dr. Erion Spaho (8 hours later)
Also, there is no progression from the image taken in XXXXXXX to the current one right? I just realized that I showed it to the neurologist while he did the emg and he was not bothered about it and then he did do emg on that muscle which came out normal.

Could that mean, I might have had the dent and I never realized it and only when I started focusing on it I found it out?
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Also, there is no progression from the image taken in XXXXXXX to the current one right? I just realized that I showed it to the neurologist while he did the emg and he was not bothered about it and then he did do emg on that muscle which came out normal.

Could that mean, I might have had the dent and I never realized it and only when I started focusing on it I found it out?
doctor
Answered by Dr. Dr. Erion Spaho (16 hours later)
Brief Answer:
I would explain as follows.

Detailed Answer:
Welcome back.

Tendinitis is not a serious condition and is treated by putting the hand at rest, using anti-inflammatory drugs such as topical diclofenac gel for example.

Shock-like sensation after hitting the hand is caused by direct or indirect nerve pinching and is not linked to any condition.

It is a possibility that the dent was there and you did not notice it since the EMG came back normal.

Hope this helps.

Greetings.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Erion Spaho (0 minute later)
Brief Answer:
I would explain as follows.

Detailed Answer:
Welcome back.

Tendinitis is not a serious condition and is treated by putting the hand at rest, using anti-inflammatory drugs such as topical diclofenac gel for example.

Shock-like sensation after hitting the hand is caused by direct or indirect nerve pinching and is not linked to any condition.

It is a possibility that the dent was there and you did not notice it since the EMG came back normal.

Hope this helps.

Greetings.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Erion Spaho (3 days later)
Thanks for the answer, would like to ask one more thing, do you think this is normal and not atrophy again on my right hand, attached left hand hand picture for reference. Attached images when flexing and when relaxed
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Thanks for the answer, would like to ask one more thing, do you think this is normal and not atrophy again on my right hand, attached left hand hand picture for reference. Attached images when flexing and when relaxed
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Follow up: Dr. Dr. Erion Spaho (1 minute later)
Uploaded 4 new pictures for your reference
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Uploaded 4 new pictures for your reference
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Follow up: Dr. Dr. Erion Spaho (6 hours later)
Also, is my pinky finger normal or is it due to holding smartphone ? Attached another 4 images.
Again this is my right hand.
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Also, is my pinky finger normal or is it due to holding smartphone ? Attached another 4 images.
Again this is my right hand.
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Follow up: Dr. Dr. Erion Spaho (1 minute later)
Attached left hand pinky finger picture for reference
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Attached left hand pinky finger picture for reference
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Follow up: Dr. Dr. Erion Spaho (2 hours later)
I have all the images in the url below, for some reason , I was not able to attach them.

This is of my finger (right hand) marked in green
https://jmp.sh/q68u8AT

https://jmp.sh/YwYLS3s

Image of left pinky finger for reference:
https://jmp.sh/ptersEU

https://jmp.sh/RxdLRCK

This is the image of my right palm where I see these dents when flexed, just wanted to check if they are normal:
https://jmp.sh/punaP0K

Image of left palm when flexed for reference:
https://jmp.sh/8lVnHfT

Image of right and left hand when relaxed:
https://jmp.sh/gawqht5

https://jmp.sh/ORbpOfp
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
I have all the images in the url below, for some reason , I was not able to attach them.

This is of my finger (right hand) marked in green
https://jmp.sh/q68u8AT

https://jmp.sh/YwYLS3s

Image of left pinky finger for reference:
https://jmp.sh/ptersEU

https://jmp.sh/RxdLRCK

This is the image of my right palm where I see these dents when flexed, just wanted to check if they are normal:
https://jmp.sh/punaP0K

Image of left palm when flexed for reference:
https://jmp.sh/8lVnHfT

Image of right and left hand when relaxed:
https://jmp.sh/gawqht5

https://jmp.sh/ORbpOfp
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
YOu can open them in a new browser window
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
YOu can open them in a new browser window
doctor
Answered by Dr. Dr. Erion Spaho (24 hours later)
Brief Answer:
Answered below.

Detailed Answer:
Hello again.

I saw the pictures that you uploaded.

Even if there is some difference between individual muscles of the hands, there is no a serious neurological condition that may cause single muscle atrophy.

Using smart phone, mouse, or minor trauma are most likely causes.

Hope this helps.

Take care.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Erion Spaho (0 minute later)
Brief Answer:
Answered below.

Detailed Answer:
Hello again.

I saw the pictures that you uploaded.

Even if there is some difference between individual muscles of the hands, there is no a serious neurological condition that may cause single muscle atrophy.

Using smart phone, mouse, or minor trauma are most likely causes.

Hope this helps.

Take care.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Erion Spaho (22 hours later)
Ok
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Follow up: Dr. Dr. Erion Spaho (0 minute later)
Ok
doctor
Answered by Dr. Dr. Erion Spaho (8 hours later)
Brief Answer:
Follow up.

Detailed Answer:
Glad I helped you.

Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Dr. Erion Spaho (0 minute later)
Brief Answer:
Follow up.

Detailed Answer:
Glad I helped you.

Take care.
Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4493 Questions

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I Have Pain And Mild Stiffness For The Last 4

I have pain and mild stiffness for the last 4 months or so. it kind of goes away with rest and not using my hand, but comes back after i use it or lift something heavy. Again, I believe there is no loss of strength or any weakness which I am aware of. I think this could be carpal tunnel but the neurologist did do both emg and ncs on that muscle and found nothing. But troubles started after my visit with the neurologist, so i am not sure what to make of it. The finger and the thenar muscles twitch sometimes, but again all random. I used to get numbness in my hands when asleep like couple of months ago but not anymore. I do have pain (on a scale of 10 i would say 2 but bumps up to 4 when i use my hand a lot, especially while playing games on phone or using a controller). I have circled the region in black where i get the pain and also where I feel if there's atrophy or not or just a dent. The 3rd image is also about my right hand. Also, attached image of my left hand for reference. Thanks