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Pain in hand, difficulty picking objects. Done nerve study test and carpal tunnel test. Who do I see now?

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General & Family Physician
Practicing since : 2012
Answered : 1038 Questions
Hello Doctors,
I have a problem with my left hand. Lots of pain, lack of movement when I write, use a keyboard.
Try to pick things up & more. It is in the hand & 2 smaller fingers. I had the nevre study test done for the elms nerve & carpool tunnel. Also the evoked study on the brain, but no findings! I am under a rheumatologist. Who have now requested I see a neurologist to.
Also on my recent eye test my left pupil is larger than the right so they have asked for me to go to the eye unit at the hospital. Could it be linked as both are on the left side?
Posted Sat, 6 Apr 2013 in Brain and Spine
Answered by Dr. Achuo Ascensius 3 hours later

Thanks for the query.

From your description, it sounds more of a neural pain though preliminary test you have done have ruled out nerve injury and carpal tunnel. However, tests results are dependent on the technician's know how and ability to interpret the results.

Difference in pupil size warrants detail investigation as it could be an indication of a serious problem in the brain in which case other associated symptoms and signs will be present such as altered consciousness, vomiting, headaches etc which fortunately you have not indicated. Differences in the pupil size could be normal and occurs in up to 17% of people with no underlying disease.

I share the same option of meeting a neurologist for a more detail evaluation including clinical tests such as adson's maneuver and wright test to rule out thoracic outlet syndrome, laboratory tests such as x-rays of your spine and wrist, to repeat nerve conduction and electromyography tests.

Fibromyalgia usually presents with pains as well but it is less likely to be the case in your situation.

Hope this helps and if you have further queries or clarifications, i will be ready to help.

Best regards
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