Carpal Tunnel Syndrome or Not?

Each one of us has a unique story of how we learned about rheumatoid arthritis and about the immune system which has decided to attack our own body tissue to cause inflammation and damage.  Here is my story.

I am a classically trained pianist who spent her undergraduate years practicing piano 4-6 hours each day.  Lots of repetition, developing great hand strength and finger coordination.  In a very real way, I understood my world through my fingers.

I even knew how words were spelled by the “feeling” of my fingers on typewriter keys.  Yes, this was before I had access to a computer.  I only had to mentally type the words in question to know which letters to use when I wrote.

So when my hands began to feel a bit odd 7 years ago, mostly heavy and thick, I mentioned it to my primary doctor.  Based on my symptoms we looked for possible lupus (my mother has SLE), rheumatoid arthritis, hypothyroidism, and overall inflammation.  My nurse called with the results.

“Everything looks fine.  Your SED rate is slightly elevated, nothing to worry about.  We did find that you are slightly anemic so the doctor wants you to begin taking Iron supplements,” said the nurse.  I went on my merry way.

Two years later, similar complaints, similar test results.  By this point, I had begun to use Aspercreme on my hands in an attempt to find some relief of the growing pain.  Did it work?  Not really.

The next year, I was diagnosed with multiple sclerosis which certainly turned my world on a different axis.  Then just one more year later, I couldn’t use my hands.  Literally couldn’t use my hands.

By this point, I already owned at least two pairs of wrist splints.  Since I was spending extra hours on the computer, I thought that overuse and bad posture were causing symptoms of carpal tunnel syndrome (CTS). 

Eventually, I was waking up in the middle of the night screaming from the pain.  Somebody was shoving my fingers into electrical outlets, at least that’s distinctly what it felt like. 

My fingers had become curled into fists and I couldn’t open my hands, day or night.  The fingertips were so sensitive that the slightest touch was painful.  Consequently, I was not playing much piano and limited the demonstrations I gave during piano lessons.

Thinking that this might be caused by MS spasticity, I saw the neurologist again.  He said carpal tunnel syndrome but I said this was not like any CTS symptoms I had ever felt before.  He order electromyography (EMG) and nerve conduction studies (NCS).

On the left wrist, no evidence of CTS was seen.  Ha!!  The technician said that I should have placed a bet with the doctor.  On the right wrist, very mild CTS was seen.  Ok, so we were both right.  But the mild results did not justify the enormous pain.

We started out with conservative treatment: double doses of Aleve daily, wrists splint worn all of the time, and visits with the occupational therapist for ultrasound therapy.  These strategies did not help and I was eventually referred to a hand surgeon.