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Constant hand pain for 10 years
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Constant hand pain for 10 years

27 year old male, constant pain in both hands and wrists since 2000. No initial injuries.
Initially diagnosed with RSD since the back of my hands were sensitive to touch, disappeared by itself suddenly around 2003 with no recurrence.

Pain is generally equal on both sides, all over the back side of the hands and all around the wrists (it is inside and not on the skin). Palms ok.
Dull, heavy aching with a slow, wave-like up and down intensity, and moves throughout the hand (like smoke swirling around a container)
Activity and vibrations increase pain
Full range of motion
No noticeable sensitivity to hot/cold

Variety of symptoms that occur randomly and unexpectedly:

-shooting/slicing pain through the wrist or a couple of fingers (with or without movement)
-swelling and redness of knuckles
-warm/heated feeling
-joint stiffness
-cold to the touch
-slight tingling/numbness in fingertips, no more than a few seconds
-feeling of a tiny, sharp object within a wrist

Frequent flare ups, usually on one side, lasting from a few minutes to days at a time
Starting from a few years ago the pain can spread across arm to the elbow
Starting from last year it can spread to the shoulder (most recent on July 13th). Feels like my whole arm is being cut and twisted off at the shoulder, elbow, and wrist and lasts at least an hour.

I have seen numerous doctors, specialists, psychiatrists, etc.
Tests including x-rays, MRIs, bone scans, blood work, CT scans with all normal results
Last nerve conduction test showed some slight abnormal signals but nothing conclusive.
3 separate nerve blocks with brief and minimal improvement.
No relief with meds.

No other bodily pains or problems.
Small ganglion cyst removed from back of left hand in 1997, no complications.

Last year I came across the disorder SCN9A Erythromelalgia (http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene&part=etha), which seems to fit a lot of my problems.

I'm just hoping for any fresh ideas. Thank you for your time.
Tags: hand pain
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Avatar_dr_f_tn
HIII Friend,
I would suggest you to go for a 3 phase bone scan and if it comes as normal, then you can be fully assured that there is no problem inside the body, only subjective issues are there, which can be more related to external environment (stress / weather / etc).
Beside this, no other things to do presently.
Feel free to discuss further
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