Aa
When health issues are not MS related
I was diagnosed with MS in 1987 and I have been confined to an electric wheelchair since 2001. I have one arm and hand which has been my only functioning extremity but lately my fingers are not cooperating. I can say that for the past three years at least no one other extremity has deteriorated. I don't believe that it is certain that MS is causing the deterioration in my fingers. I am wondering if it could be carpal tunnel syndrome. The problem is health professionals look to see that I have MS and put that down as the reason for this deterioration. Perhaps they are right but I would like to rule out other possibilities as this is the last remaining functioning extremity.
Can you please advise on how I may proceed or should I simply assume that my problems are all MS related.
Thomas Ramsay
Can you please advise on how I may proceed or should I simply assume that my problems are all MS related.
Thomas Ramsay
That's curious. My providers usually start with the assumption that it's not my MS or that I have a uti if my MS is acting up. At least they used to do that. I've got them trained now
Whether it is, or is not, you should be lobbying for everything to be done for this, as you only have this one arm/hand working for you. Yes, they have been doing everything, so repetitive motion injury is very possible, but if this is mistreated, and you lose them unnecessarily, then what?
Hi, mckernon, and Welcome!
I agree - not everything is MS. Do you have shock sensations when you bend your wrist a certain way? I know numbness and tingling are a regular part of our basket of symptoms, but with CTS, often certain movements trigger symtoms. Repetitive stress plays into CTS, and I'm only guessing, here - do you use that hand to operate your WC? It wouldn't hurt anything to try nerve conduction studies... just a thought...
From the NIH site:
Early diagnosis and treatment are important to avoid permanent damage to the median nerve. A physical examination of the hands, arms, shoulders, and neck can help determine if the patient's complaints are related to daily activities or to an underlying disorder, and can rule out other painful conditions that mimic carpal tunnel syndrome. The wrist is examined for tenderness, swelling, warmth, and discoloration. Each finger should be tested for sensation, and the muscles at the base of the hand should be examined for strength and signs of atrophy. Routine laboratory tests and X-rays can reveal diabetes, arthritis, and fractures.
Physicians can use specific tests to try to produce the symptoms of carpal tunnel syndrome. In the Tinel test, the doctor taps on or presses on the median nerve in the patient's wrist. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs. The Phalen, or wrist-flexion, test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together. The presence of carpal tunnel syndrome is suggested if one or more symptoms, such as tingling or increasing numbness, is felt in the fingers within 1 minute. Doctors may also ask patients to try to make a movement that brings on symptoms.
Often it is necessary to confirm the diagnosis by use of electrodiagnostic tests. In a nerve conduction study, electrodes are placed on the hand and wrist. Small electric shocks are applied and the speed with which nerves transmit impulses is measured. In electromyography, a fine needle is inserted into a muscle; electrical activity viewed on a screen can determine the severity of damage to the median nerve. Ultrasound imaging can show impaired movement of the median nerve. Magnetic resonance imaging (MRI) can show the anatomy of the wrist but to date has not been especially useful in diagnosing carpal tunnel syndrome.
http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm
Good luck in your path. I'm hoping it's not just another part of this stupid MeSsy disease!
I agree - not everything is MS. Do you have shock sensations when you bend your wrist a certain way? I know numbness and tingling are a regular part of our basket of symptoms, but with CTS, often certain movements trigger symtoms. Repetitive stress plays into CTS, and I'm only guessing, here - do you use that hand to operate your WC? It wouldn't hurt anything to try nerve conduction studies... just a thought...
From the NIH site:
Early diagnosis and treatment are important to avoid permanent damage to the median nerve. A physical examination of the hands, arms, shoulders, and neck can help determine if the patient's complaints are related to daily activities or to an underlying disorder, and can rule out other painful conditions that mimic carpal tunnel syndrome. The wrist is examined for tenderness, swelling, warmth, and discoloration. Each finger should be tested for sensation, and the muscles at the base of the hand should be examined for strength and signs of atrophy. Routine laboratory tests and X-rays can reveal diabetes, arthritis, and fractures.
Physicians can use specific tests to try to produce the symptoms of carpal tunnel syndrome. In the Tinel test, the doctor taps on or presses on the median nerve in the patient's wrist. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs. The Phalen, or wrist-flexion, test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together. The presence of carpal tunnel syndrome is suggested if one or more symptoms, such as tingling or increasing numbness, is felt in the fingers within 1 minute. Doctors may also ask patients to try to make a movement that brings on symptoms.
Often it is necessary to confirm the diagnosis by use of electrodiagnostic tests. In a nerve conduction study, electrodes are placed on the hand and wrist. Small electric shocks are applied and the speed with which nerves transmit impulses is measured. In electromyography, a fine needle is inserted into a muscle; electrical activity viewed on a screen can determine the severity of damage to the median nerve. Ultrasound imaging can show impaired movement of the median nerve. Magnetic resonance imaging (MRI) can show the anatomy of the wrist but to date has not been especially useful in diagnosing carpal tunnel syndrome.
http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htm
Good luck in your path. I'm hoping it's not just another part of this stupid MeSsy disease!
Hi mckernon - Welcome to the group.
I don't think that assuming everything is MS related is the way to go. That we have MS does not excuse us from having to deal with things like carpal tunnel.
If I were you I might start with your neurologist. Try and exclude MS right from the start. If your neuro says your hand/arm issue is not being caused by MS, you will be able to start your discussions with other docs by saying so.
Just one mans opinion.
Kyle
I don't think that assuming everything is MS related is the way to go. That we have MS does not excuse us from having to deal with things like carpal tunnel.
If I were you I might start with your neurologist. Try and exclude MS right from the start. If your neuro says your hand/arm issue is not being caused by MS, you will be able to start your discussions with other docs by saying so.
Just one mans opinion.
Kyle
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