Wrist Pain

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I’m a teenage male who has been having wrist pain (both wrists, right hand dominant) for more than a year and a half.  I get a dull pain in my wrist whenever I write.  This pain usually radiates to my forearm, but does not get more than four or five inches.  Typically a dull pain in my elbow corresponds to my wrist pain.  This pain only happens when I am writing by hand, playing the violin, and sitting down on my back with my elbow bent and arms extended upwards (reading at night).  If I extend my elbow in the reading position my pain goes away.  It usually is not very bad until I write for more than five minutes.  The pain gets so strong that I physically have to stop writing.  I run a successful company from home and am typing almost all day.  I type almost everything for school – as much as possible.  I stopped playing the violin for about six months and at the same time I did not participate in physical education (doctor’s request).  I have been to a pediatric orthopedist [many times] (at DePont in New Jersey), a rheumatologist (at DePont in Deleware), a geneticist (director of Marfan’s research at University of Pennsylvania), a neurologist twice, a wrist specialist at a wrist center (New Jersey), a chiropractor, and my local pediatrician.  I have been tested for almost everything possible (MS, Marfan’s syndrome, Lyme disease, Fibromyalgia, etc.).  I had a neck x-ray, spine x-ray, spine MRI, two EMGs and NCVs of arm.  Everything came out normal.  I have gone through five rounds of physical and occupational therapy at three different centers.

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Ibuprofen, acetaminophen, naproxen, heat, cold, wrist and elbow braces – nothing works.  My former occupational therapist (I do not go anymore) believed it was an entrapped, stretched, or twisted nerve in my elbow (ulnar), my orthopedist thinks it is chronic pain, and my pediatrician believes it is growing pain that not can be explained.  I believe that it is some type of ulnar nerve problem.  I have a pretty good basic understanding of the medical field (especially after seeing all of these doctors!), but obviously I am not a doctor.  Does anyone have any ideas as to what is causing this pain and/or how to treat it?

[Sarah26]

Hello :-)

With the risk of sounding a bit stupid, I have to ask if you've been checked for something as simple as Carpal Tunnel Syndrome or a form of Tendonitis? I'm sure with all the extensive testing, surely they HAVE checked or considered such possibilities, but if I know Dr's they can overlook obvious things. Anyways, I was browsing about and come across this case study of sorts of a woman with similar problems and it lists possible diagnosis, if you are interested.

http://coeh.berkeley.edu/ucsfoem/carp7.html

On a side note, have you considered alternative therapies such as acupuncture? It is supposed to have a high success rate in joint/muscular aches. Just a thought!

Cheers!

[sn3]

Yes, they did check for CTS.  The rheumatologist thought it may be tendonitis but it was dismissed by the other doctors, and there was not a lot of evidence to support tendonitis.

The thing about acupuncture is that this pain only comes about when I am doing one of the three activities I've mentioned.  

[Cheeto88]

Hi there,  

I came across your post, and it basically describes my situation perfectly. Every single thing you've mentioned is what I've tried and experienced, it's crazy! Wrist "tendinitis" but also pain in the elbow, ulner nerve tests (2 EMG's), MRI's of neck and wrists, Physical and occupational Therapy, chiropractor, pediatrician saying I'll "grow out of it," Ibuprofen, acetaminophen, naproxen, heat, cold, wrist and elbow braces...

Yes, I am a violinist (well, I've been resting for the last 3 months), and have pain whenever I write and type. I've had this for 5 years (since I was 15), and am really desperate too. I am considering acupuncture and wonder if you tried it and if it helped. I noticed this post was about 3 years ago...has ANYTHING worked??

Thanks so much!

[bugynerd]

I tried to post this a bit ago, and don't think it worked... here's another try.
I struggled with this for a long time.  I am a biology teacher and violinist, and I have done my homework on the ulnar nerve. As you probably know, the ulnar nerve emerges from between several lower cervical and top thoracic vertebrae before making its way through the cubital tunnel (funny bone) of the elbow and then innervating the smallest fingers.  The ulnar nerve is actually dubbed the "musicians' nerve" for frequent inflammation in string-players; it is unlikely that your trouble is carpal tunnel syndrome, which is inflamation (inflammation) of the median nerve which innervates the thumb and first 2 fingers.  I began to develop tingling in those fingers shortly after my family ended our small-scale farming operation, to which I contributed a lot of muscle power.  The problem escalated to cause trouble in playing the violin because of the pain, and also in everyday activities most of us take for granted.  My elbows were very sensitive and all my symptoms generally resemble yours.  No resting on my elbows, or writing on a table/desk, or even swinging my arms naturally at my sides as I walked.  I also was diagnosed with tendonitis of the forearm, but no treatments helped.

After a lot of piecing together for myself, I discovered the root of the problem medically was in my back.  After losing a lot of strength from stopping the physical labour, my back was no longer able to withstand long rehearsal and practise times simply by brute force, as I had done, and as a result, my upper back became a network of knotted muscles, which put pressure on all the wrong places and pinched nerves.  I began to seek out back massages, and that is where a lot of relief came.  The part of the back to work on is the thoracic region, particularly the upper half and into the neck (cervical).  Do not neglect the shoulder-blade regions, especially the muscles beneath the scapula.

Aside from that, get a shoulder rest/chin rest setup that is tailor-made for YOU!  This is a part of violin technique that is most often overlooked and, in my opinion, is of central importance.  If your back and neck is crooked due to gripping the instrument with chin or shoulder, that will throw out the alignment of the vertebrae and cause all sorts of problems.  Don't listen to people who say that one setup or another is the only technically correct thing to do, because it's not worth the pain.

In the meantime, here are my suggestions: 1, strengthen your back.  Anything you do to strengthen those muscles will help them keep your vertebrae in alignment so nerves don't get pinched. 2, try writing on your lap, as this helps eliminate back tension and pressure of the table against the inside of the elbow. 3, try sleeping with a pillow under your arm to eliminate all pressure to the inside of the elbow. 4, watch posture while playing violin and while not.  Don't slouch. 5, and this may sound silly, but women need to wear a brassiere that fits properly and does not ride up in the back, as this puts pressure on those upper back muscles that are already too tense.

Hope that's of help.