Help me diagnose my hand issue, doctor hasnt helped =/.

[chewbacca1]

I will try to be as detailed as possible in my description, hopefully one of you can help me figure out what is causing my issues.  I appreciate any and all suggestions and responses.

Some history:

I am a full time student and I spend roughly 5-8 hours a day on my computer. In early November I started noticing my hand started feeling like it was cramping( see the picture, the shaded area is where it felt like it was cramping).  I ignored it at first.  I hadn't done anything in particular so I just assumed it would go away.  It didnt go away and it kept getting worse.   I started to lose precision in my hand when moving my mouse and it always felt like the pinky side of my palm was tensed when I was using the mouse.   This tense feeling would cause it to ache and I would experience hand weakness after just 20 minutes on my computer.

So, I try splinting and NSAIDs... went thru about 3 different splints until I found one that helped.   Spent 2 months using the splint.  My hand got significantly better but it still never stopped bothering me.  I also tried several different mice, got a new desk/chair.  

So I go to see an ortho roughly a months and a half ago.  First visit I tell him my symptoms and he tells me to come back and get an EMG.   I come back and do the EMG.   Im trying to remember exactly what the EMG doctor said but he basicly said I have moderate problems in my ulnar nerve in my right hand.  The ulnar/carpal/carpal nerve in my hand and other hand were all "mild".

He says he will get the results to the other ortho doctor I saw first and they will do treatment from there.  So, I see the other doctor and I don't think he even looked at the nerve study results.  He comes in and asks me where its bothering me as if he completely forgot about me from the first visit.  I show him again and he says I should try their physical therapy before they do anything else.  I'm a bit annoyed at this point because its my 3rd visit and he wants to give me another 6 physical therapy appointments so I asked him what else they can do.  He says they can try a cortisone shot.  So I ask for that, he he gives me the shot.  The black dot in the picture is where he gave me the shot.  He also signs me up for 4 sessions of physical therapy.

That shot is for guyons canal(i think), but it didn't help much.  So, the week after I go to my 1st physical therapy session.  The guy in charge there says it isnt entrapment at all.  He says its just tendinitis from my repeated mouse use.  After two weeks of physical therapy(ultrasound, electric stimulation, massage) there is not much improvement.  I go for another week and its the same thing.

So thats pretty much where I am now.   Three months and my symptoms are still there.  Some things have helped to reduce them but nothing has made it go away.  Any advice?

[abhijeet v ghosh]

hi,
all the best

[chewbacca1]

Thank you for the reply abhijeetvikram.  I will go talk to the doctor again with the information you have just provided me.

[abhijeet v ghosh]

hello chewbacca1.
i will answer you according to serial numbers

1) Tendonitis / RS will never show any problem in the NCV.
2) Yes, you have the full right to know which disease youare suffering from. So you should ask your doctor. Also your EMG/NCV also should have a diagnosis.
3)  Primary symptom of nerve entrapment are as what you have mentioned. But few cases may have other minor problems also, like what you get.

So just ask your family doctor.
Do not delay.
regards
abhijeet

[chewbacca1]

edit:  for number 3.

I meant to say that numbness/tingling has NEVER been very pronounced.


I didnt see an edit function.

[chewbacca1]

I did a quick lookup on NCV vs EMG.  I beleive they did both.   They placed electrodes and did the electric shocks at varying strenght, and they also put the needles in my arm at different spots.


Just some other information...


It only gets aggravated when im on my computer.  Its always present, but only gets worse when im using my mouse.   I also think the position of my armrest when im using my mouse tends to irritate it as well.

So I have a few questions if any of you can assist me with....

1.   My doctor never gave me a diagnosis.   The EMG/NCV study showed some problems with the ulnar nerve in my right hand.  However the Physical therapist says its tendonitis/repetitive strain.  Can tendonitis/RS cause NCV test to show problems?

2.  Should I ask my doctor if my EMG/NCV showed any entrapment.  WIll these tests even indicate it?

3.  Numbness/tingling has been very pronounced.  Weakness/Aching/Lack of Precision/Stiffness are the primary symptoms.  Does this rule out nerve entrapment?   Whenever I read about Nerve Entrapment it always involved numbness/tingling  as a primary symptom.

Thanks =)

[abhijeet v ghosh]

hello chewbacca1.
if someone like you comes to my clinic, i would prefer to have a NCV (Nerve conduction velocity) study rather than an EMG.
Hence, if possible do a NCV at the earliest.
If you want you can go for another opinion.

regards
and please keep posting,
abhijeet