Never ending wrist pain

[Fluffyseal]

Hello,
I was wondering if anyone could help me.
Since mid march 2015 i have been suffering from wrist pain. It got so painful i had to leave work and go to the emergency doctors who thought it could be tendonitis. I took ibuprofen and paracetemol.. Had no pain relief so went to my GP. I got signed off work for two weeks as they thought i may have sprained my wrist. (I do not do any sports, i just work as an administrator in a very busy office so i do a lot of clicking with the mouse daily). Many more hopeless doctor appointments went by and i was taking 1000mg of naproxen a day. It then went to amitriptyline and naproxen together, with still no difference. Minor injuries will not deal with me as i have not had a recent accident and A&E wont help as its not classed as an emergency. My doctors are not very helpful. I see a hand therapy specialist who has given me exercises to build the muscle but even they are stumped as to what is wrong. In my most recent appointment my doctor told me they think it may be tendonitis and have given me gabapentin, currently on 400mg with no pain relief but have been told to go up to 600mg gradually as i am small.
I am a 23 year old petite female. I had a double fracture and a bone chip on my right wrist when i was about 11 and have noticed over the years my wrist sometimes gets weak.

However this year has been unbearable to the point i cannot hold a cup of tea nor can i use my iphone to write this message out without pain. Then pain is progressing up my upper arm and shoulder area now. Would anyone be kind enough to read this? Thank you and apologies if i have missed anything out, ive had so many appointments and prescriptions it all becomes a blur.

[Fluffyseal]

Hello,

I have had a blood test done recently but not for that reason. I don't think it mentions ESR and uric acid on there. I have a print out and these things were highlighted (i dont know if this helps):
Serum folate low on 4.3
RDW low on 11.5
Albumin high on 51
TSH High on 4.24

I went to my GP again yesterday regarding my pain and she said it is chronic and that I will probably be dealing with this for a long time. She said I have tried literally every tablet possible apart from one which causes really bad constipation. She said I need to go up to 600mg of gabapentin and if that doesn't work I will have to revisit codeine at about 50mg (30mg makes me fall asleep at my desk).
I have had some kind of symptoms with each kind of tablet I have taken.
She said she is unable to refer me for any scans and that it is my physiotherapy who should. However my physio told me they cannot.

She also mentioned cortisone injections and that they are dangerous. She said that my tendon is very small and it would be very painful to go through and that it could rupture my tendon.
She also said surgery wouldn't be good.
She then said i'll have to deal with it and that I should have cognitive behaviour therapy to learn to see it in a positive way. However she never referred me to it.

I have phoned my physio today and pleaded for an earlier appointment this month in which I was able to get an appointment for the 12th.

I do not understand why I am being passed on so much?

All they try and do is get me to take tablet after tablet, to the point in which I am now having slight problems with my stomach so I am now no longer prescribed anti inflammatories.

[AndRynne]

You may be at the point where you need an x-ray and maybe a few blood tests to like ESR and uric acid. This has not really been diagnosed properly yet and that's what needs doing.

[Fluffyseal]

Hello,

When the pain started i was actually using an ergonomic mouse, its one of the ones where your hand is sort of to the side when using.
For 3 months now i have been using my left hand for the mouse and mostly for the keyboard (still need to use right sometimes to use some keys).

I forgot to mention as well that i have had to come off anti inflammatory medicines as its affected my stomach.

I literally do not use my right hand for anything now, its been that way since march; trying to pick up things with left hand only; using fork with left hand only as sometimes pain is so bad i cannot cut my own dinner up.

I havnt found cold or heat really helps although i havnt tried either much as no one has told me which they think would be best.. I dont know if going for the wrong one could make it worse?

I have also been using a wrist splint since about april and was changed to a thumb spica about 2 weeks ago. It helps to some degree but sometimes wen wearing it, the pain builds up and i feel so much pressure around it that i get more relief having it off.

[ScalpMassager]

Pain killers can mask the solution to your injury (and allow you to Worsen the condition as with them, you can work through the pain and subject the injury to a far longer ordeal), but I understand there are times when there's just no other choice available.

So, you use a regular mouse?  

I think it likely you've developed a repetitive overuse strain injury that may have led to swollen injured tissue compressing nerves (very painfully).  We know what hurts or worsens the condition (conventional mouse use, keyboarding's probably not helping matters either).  

What works to alleviate pain?

- painkillers (of course, but those mask the pain, our ability to notice what's helpful to do, and should be seen as the last resort and for emergency coping)

- cold?

- heat?

- rest / inactivity?

- flexing?

- strength building attempts?

- posture?

- a brace / pressure bandage?

Could you (with considerable difficulty at first, certainly on your first day), retrain yourself to use a left handed mouse?   (I assume you're right handed, else reverse my suggestion).  I see this as the IDEAL solution as it allows your injured area to get some semblance of REST from the triggering activity for a prolonged period.  You'd still be keyboarding but at least the major trigger, mouse use, would be taken off the table for that wrist.

Or, could you (with comparable difficulty) retrain yourself to use a Trackman/Trackpad with your left hand as really, we'd like your right wrist to have an extended vacation for six months or more to recuperate properly.

Both of these will include software that has adjustments allowing you to finetune how responsive the cursor is to your movements.  And while you're initially adapting you would set the responsiveness to a low setting (making training far more managable).  Once you approach your usual expert level of competence, you'd steadily reset the responsiveness to higher and higher settings.