Suggest treatment for bilateral carpal tunnel syndrome

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Posted on Tue, 3 Feb 2015 in Bones, Muscles and Joints
Question: Dear Dr saheb
i met with an accident 15 years ago through motor cycle. my hand was plastered for 6 weeks but xray doesnot show any fracture.after opening the plaster i was having nerve pain the forearm and finger.i carried this for 4 to 5 years and later solved this by using gabapentin for 2 months.

again the same problem started since 3 months ago after i used big knife to make small pieces of mutton from big sizes in our festival in Bakreeid. Festival of Goat i mean.The day i made the pieces i was ok. but next mroning i wake up with pain.

I went to neurologist in saudia arabia. he gave me tegritol, some antiinflammatory,neurobion..

but it didnt help.then he gave me some cortison in muscular. i was ok for one week and again the pain started.

al together i am in medication since 3 months and i am not ok. Later he transferred me to neuro surgeon. he did my nerve conduction study and told me you have some little problem in motor nerve. i fade up using mediaction and i am not ok.Here Drs are giving medication like we are consuming rice and dal every day.

I am in trouble..Please study my situation and guide me.

nOTE:I have pain in forearm in one of the nerve including pain in almost all fingers..more pain in ring finger and thumb.and pain also there near wrist.The whole hand i am feeling uncomfortable. i cant slap any body .i cannot through the stone.even pain in elbow also there.

Please study my case and guide me properly instead of consuming mediaction without any result.

Is plastering my hand will help.

because morning once i wake up pain is less. after doing my usual work and working in computer in office..upto evening its deteriorated.

please help me.Till now i didnt see Orthpedic Dr. will going to see some ortho would be handy.
I stopped medication since 2 days because stomach getting upset due to taking more medication.Ncs and xray report is attached.





doctor
Answered by Dr. Sudhir Kumar 35 minutes later
Brief Answer:
Having carpal tunnel syndrome, Plastering(below elbow slab) will help.

Detailed Answer:
Hi,
Thanks for choosing healthcaremagic for posting your query

I'm Dr. Sudhir Kumar,

I have gone through your question in detail and understand your concern.You are having bilateral carpal tunnel syndrome mainly of left side.

There are three modality of treatment.

1. Rest to hand and wrist (including below elbow slab in neutral position of wrist) and analgesic such as ibuprofen along with mecobalamine.

2. Local application of steroid( triamcilone40 mg) in carpal tunnel at wrist along with analgesic and Mecobalamine.

3.Surgical release of carpal tunnel by surgery.

You can discuss with your treating Doctor about it.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link:
https://www.bit.ly/askdrsudhirortho

Wishing you good health
Take care


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Sudhir Kumar 23 hours later
Dear Dr

Thank you very much for the advice.

Tomorrow i have an appointment with one XXXXXXX Orthopedic dr.Lets see what he is suggesting on the basis of ur suggestions

and my existing NCS report done by neurologist and neuro surgeon.

please tell me one thing on what basis you said i am having carpal tunnel on the basis of NCS report or as per my details i had told you about my problem.

please confirm if its carpal tunnel then i will talk to orthopedic and take the proper treatment.

Dear Dr ...you had told me three modality of treatment.

How much time will it take to recover if i will follow ur first and 2nd option.

what are the precautions i should take thereby to recover in less time becz i said after i worked on computer for whole day

the pain is increasing and after i wake up in the morning its little less.

taking medicine didnt improve the case becz we are not taking precautions and again we are in the same stage.

what do you mean by mecobalamine...is it b1,b6,b12.

which would be better option to give rest to hand and wrist..either permanent plaster or using splint would be the same.

Is it risky to take local steriod or its easy. Can sr orthopedic doctor will be able to give me this without any risk or i should come XXXXXXX and take it.

As per my NCS report could you please tell me for my case , will i be able to recover without surgery.What precaustions i should take so that i must recover without surgery.

Sorry to disturb you by asking too much of questions.
doctor
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer:
It is carpal tunnel syndrome and You should consult orthopedic surgeon.

Detailed Answer:
Hi,
Welcome back

I have gone through your question in detail and understand your concern.

I suspected carpal tunnel syndrome by reading your question as you have specially numbness in thumb and ring finger and also you have said that numbness and pain increased by computer work and relieved by overnight rest. Your NCV report confirmed my doubt.I strongly think that it is carpal tunnel syndrome and You should consult orthopedic surgeon for it.

To give rest both below elbow slab(plaster) and splint would be same .I generally use splint for persons coming to me for treatment of it.

In 1st option nearly one months time may take however improvement will start immediately. You will have to stop working on computer to recover early as it is aggravating factor.

I generally treat persons coming to my clinic by second method ( weekly triamcilone injections in carpal tunnel) with good results combined with rest , analgesics and Mecobalamine. Mecobalamine is B12. Most of persons improve significantly within a weeks.Most of them are symptom free within 2 weeks.

Local steroid in carpal tunnel is a normal and easy procedure. I think XXXXXXX orthopedic surgeon can give you without any risk.However you are welcome to XXXXXXX if you have some problem there.

Most of persons ( say 90%) coming to me in my clinic recover without surgery. Rest to wrist and avoiding working on computer will help you recover without surgery.

You can discuss with your treating Doctor about it.

Hope I have answered your query.
If you have any further query, I would be glad to help you.
If not, you may close the discussion and if possible you may rate the answer for me, so that I get a good feedback.

In future if you wish to contact me directly, you can use the below mentioned link: https://www.bit.ly/askdrsudhirortho

Wishing you good health
Take care

Above answer was peer-reviewed by : Dr. Prasad
doctor
Answered by
Dr.
Dr. Sudhir Kumar

Orthopaedic Surgeon

Practicing since :1993

Answered : 3338 Questions

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