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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for chronic tendonitis

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Dr. Mahaveer Patil

Orthopaedic Surgeon

Practicing since :2002

Answered : 1209 Questions

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Posted on Mon, 13 Mar 2017 in Brain and Spine
Question: a few symptoms that may be related, wake up several times a night with my shoulders hunched up to my ears, have to consciously lay on one of my hands to keep shoulders from hunching again, and diagnosed years ago with carpal tunnel and chronic tendonitis (sp)--same arm, and carpal tunnel other non dominant hand, once in a while but becoming almost daily I have tremors in hand, grasp and strength ok,coordination ok, fine motor ok, but both hands do this, right far more and seems to get worse depending on the position of my arm and where my elbow is, and in certain sitting positions, my feet will bounce is not flat on the floor (resting on front balls and toes, if you will), used to get relief using inversion board and ibuprofen, now nothing eases the pain that's running along the outside of my right hand including down the pinky finger. Good health, 5'2" 108lbs, blood pressure and pulse within normal limits, no dizziness or clumsiness but the tremor when it occurs will happen whether hand is emply, resting or holding something...
doctor
Answered by Dr. Mahaveer Patil 3 hours later
Brief Answer:
consult a neurologist

Detailed Answer:
Hi,

Thank you for posting the question.
I have gone through your medical history in detail.

The present symptoms do not seem to be related to tendinosis or carpal tunnel syndrome.

The tremors and the associated pain seem to be due to some underlying neurological cause. Microinfarcts or thrombosis of the brain vasculature are the most probable possibilities.

You need to get a MRI of brain (with or without contrast) done to come to a diagnosis.

You should consult a neurologist as early as possible.

I hope the answer was useful.

Feel free to ask me any follow up queries that you may have.

Thank you.
Kind regards.

Above answer was peer-reviewed by : Dr. Kampana
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Follow up: Dr. Mahaveer Patil 26 minutes later
Is it significant that wearing a brace on my wrist stops the tremors? The tremors are not constant, but do seem to have some positional component, such as how high the surface is if I rest my hand on it...the more surface under the hand and arm, no tremors, playing the piano cause the greatest pain and writing or typing causes greatest tremors...I'd say incidence is 2-3 X day, but only if either of my hands/arms are in a certain position. The tongue is the only thing that doesn't seem to tie in and that does concern me and am in the process of getting scheduled with a neurologist. I guess my question is does this sound more orthopedic? I'll need to get the ball rolling to get an appointment before spring...Regards
doctor
Answered by Dr. Mahaveer Patil 12 minutes later
Brief Answer:
Not an orthopedic cause

Detailed Answer:
This is not a problem related to orthopedics for sure.

The positional variation in the tremor intensity seems to be related to the blood / nerve supply of the concerned muscles.

You should definitely consult a neurologist first.

Let me know his opinion so that we can decide further line of treatment.

Thanks
Above answer was peer-reviewed by : Dr. Nagamani Ng
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