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Pain and swelling in hands and fingers. EMG showed no signs of carpal. MRI showed cervical spondylosis. Suggest?

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Orthopaedic Surgeon
Practicing since : 1994
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Hi Doctor, I wrote last week and told HM that I was having pain in my both arms, hands, fingers. I am schedule for a left hand carpal tunnel surgery shortly. I had my right hand done in March 2010 and still have pain to this day. From the beginning I thought my pain was from something else, probably had severe carpal tunnel for twenty years. I just had a test for carpal tunnel, emg, which showed no signs for carpal. My doctor had ordered an MRI on my neck, cervical, which resulted in moderate cervical spondylosis. Last time I had a MRI done it showed straightening of the cervical lordosis in Nov 2010. I am on workmen comp. and I do these tests on my own since I get no answers from my doctor or lawyer. Workmen comp want me to have a surgery on my left hand, want a date of the surgery now or they will drop my case. My case involves pain in both arms, elbows and wrists. My right wrist is still swollen since the surgery. Workmen comp hasn't took any tests on me since May 2008, one year after I had severe carpal tunnel in both hands from my own doctor, that test came out that I had no carpal tunnel. I worked for thirty years in my job, did a lot of lifting, (some were heavy, thirty pounds), bending and always moving my neck and head, always standing and on the go. I kept having pain and my w/c doctor says it is from carpal tunnel, I even went to another orthopedic doctor, because both my elbows were hurting and found out both have tennis elbow, added that to my case. I found out two years ago after having the carpal tunnel surgery that didn't help, so I went to my own doctor, all on my private insurance too, and said it is from my neck all my problems to my arms, hands and fingers, but he wouldn't put that in writing to give to w/c. Isn't that related to my workmen comp case, my neck injury? I am waiting for your opinion on this. Thanks for listening. XXXXX PS I didn't want to do a left hand surgery because I know that is not the problem and why should I do the surgery if my right hand is still swollen and pain on the right side still? They just don't care.
Posted Thu, 26 Sep 2013 in Bones, Muscles and Joints
Answered by Dr. Praveen Tayal 3 hours later
Brief Answer:
It can be due to the neck problem.

Detailed Answer:
Thanks for posting your query.
I have read your problem in detail. The pain and swelling in both the wrists could be due to carpal tunnel, tennis elbow or cervical radiculopathy due to the cervical spondylosis. This needs proper investigations like MRI scan and NCV studies to find out the exact cause of symptoms. All the causes should be covered under workman's compensation.
You can consult a neurologist for proper investigations. Then only you should decide regarding the surgical treatment.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Dr. Praveen Tayal.
Above answer was peer-reviewed by
Follow-up: Pain and swelling in hands and fingers. EMG showed no signs of carpal. MRI showed cervical spondylosis. Suggest? 38 hours later
Hi Doctor, I read your response, thank you for your opinion. I went to see my neurologist yesterday using my private insurance. He did a lower emg test and said come back next week for all the results, both emg, upper and lower and the MRI. I asked him what did that report say and he said it doesn't look that bad, you have some arthritis. I said maybe that is why I get constant pain in my arms and hands, fingers. He said it is coming from your neck. The MRI impression said overall moderate cervical spondylosis as detailed above report level descriptions. Levels of greatest involvement are C3-C4 and C4 and C5. C3-C4: Ventral disc osteophyte complex flattens the ventral spinal cord without underlying spinal cord signal alternation. Uncovertebral ridging with mild neural foraminal narrowing. Mild facet arthropathy. C4-C5 Left paracentric disc osteophyte complex contours the left ventral spinal cord without underlying spinal cord signal alternation. Moderate facet arthropathy. No neural foraminal narrowing. Could any of this be connected to my arms, hands and fingers? Thanks for listening. XXXXX
Answered by Dr. Praveen Tayal 12 minutes later
Brief Answer:
Cervical spondylosis is mild.

Detailed Answer:
Thanks for writing again.
The MRI findings are suggestive of a mild degree of cervical spondylosis. This is not likely to cause the severe pain that you are having since there is no nerve root compression involved. There is only a mild foraminal narrowing.
The pain is more likely to be due to arthritis.
Let us wait for the complete results.
Hope my answer is helpful.
If you do not have any clarifications, you can close the discussion and rate the answer. Wish you good health.
Above answer was peer-reviewed by
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