Test Inconclusive

I'm a 29 year old female who works in the design and communications field of desktop publishing. The onset of my symptoms (sore, aching right shoulder) began approximately 2.5 years ago (or 6-9 months after I began a position where I predominately moused and keyboarded with a nonergonomic work station). Roughly 12-18 months after the onset of my symptoms, the soreness and aching expanded from my right shoulder to include my upper back/neck and upper arm. Concerned my work station was exacting these symptoms I requested this employer make modifcations to my work station; my request was pushed aside (nonprofit industry).

As my work time mousing and typing increased, my symptoms grew worse. (As of early this year I was working more than 40 hours per week predominantly mousing and keyboarding.) I began experiencing tightness from my right shoulder down to my tricep, brachioradialis and into my hand. Along with the tightness was a pulling, an aching and a burning. My elbow felt bruised and the inside of my wrist as if it were going to snap. The hand itself felt numb with coldness; at times it felt tingling, sometimes severe. I became unable to even hold the mouse or keyboard with my right.

I informed my employer and a First Report of Injury was filled out. I was sent to see an orthopedic surgeon specializing in hands, who conducted both a Tinel and Phalen test before diagnosing me with carpal tunnell syndrome. I received a cortisone injection and was ordered to receive an ergonomic evaluation of my work station.

During the two-week period it took for my employer to call in an ergonomic salesperson, my employer asked that I work using my left hand -- the orthopedic surgeon did not excuse me from work for any period of time. My keyboard was replaced with a left-handed a-line keyboard and my mouse was replaced with a WowPen - Joy.

Roughly one month later my symptoms were not relieved. The orthopedic surgeon ordered hand therapy, during which I received ultrasound, graston technique, splinting, paraffin wax, a type of topical TENS treatment, strengthening, and taping. The hand therapist determined while I experienced relief from symptoms, the therapy was not successful in determining and healing the source of the symptoms.

The orthopedic surgeon again conducted both a Tinel and Phalen test, which came back positive, and subsequently ordered an EMG. After more than a week away from work I had the EMG, which came back normal. The orthopedic surgeon then referred me to an MRI of the neck and a consult with a new orthopedic surgeon specializing in that field. (By this time in my treatment, my employer delegated several of my tasks and reduced my work hours to below part time.) The MRI revealed some degeneration of disks, but the new orthopedic surgeon determined this was not the source of my symptoms.

Around this time (July/August) a new symptom began occuring: vibrating in my right chest. I was referred to a neurologist, who felt the symptoms were situational and based upon my work environment. Blood work and a second EMG came back normal. The neurologist will now send me back to an orthopedic surgeon for additional therapy (and possibly place me on medications to treat the symptoms only).

So here I am symptoms still occuring (particularily upon work mousing and keyboarding) with no definitive answers and the insurance wanting to send me to an independant medical examiner and my employer irritated.

Are these doctors barking up the wrong tree? What could be going on?

[Kalvin]

I think it's one of those 2 things, but given your neck, upper back and shoulder symptoms it sounds like a neck problem. What exactly did your MRI show? Just because the Surgeon said that he didn't think your neck was causing the problem, doesn't make so.

It's called Cervical Radiculopathy, and it's caused by a pinched nerve, EMG testing often doesn't pick it up because most muscles are supplied by more than one nerve. Do a search on Cervical Radiculopathy particularly the C6 & C7 levels. I'll give you a link you can check out too. But don't panic, a lot of your problem could be posture related and straightened out with a little time in Physical Therapy.If you have other questions, I can usually be found over on the Neck and Back Forum.

Here's the link:

http://www.neckpainsupport.com/2008/11/neck-pain-resul.html