924193 tn?1243876373

Chronic Hand Pain, Cramping

I'm suffering from chronic repetitive stress-related pain in my hands, in what I can best determine is my abductor pollicis brevis muscle.  It is brought on by everything from writing to turning valves to cello playing to rock climbing.  It most closely resembles the pain of a cramp, and when exacerbated by intense usage during rock climbing, eventually makes me unable to grasp holds.

History, and notes:

The pain first showed up about 10 years ago when I was playing cello regularly (2+ hours a day).  Minor at first, the pain became more immediate and more intense during manual activities such as cello playing and writing.  

Eventually, I decided to take 3 months off cello to rest, and met with a performance therapist who said he was unfamiliar with the particular symptom, but who recommended I see a PT.  I did so for a few months, twice a week, and he variously stretched my thumb, taught me techniques to avoid using the muscles while writing, and applied an ultrasound to the affected area.  The last treatment caused extreme pain of the same sort I experienced while playing.  I stretched for months, and wore hand braces.

Long story short, the PT didn't work, so I largely gave up playing cello, and the pain decreased (but didn't disappear) until I started rock climbing last year.

My reading online seems to suggest this may be brought on by electrolyte imbalances, or improper circulation. The first seems possible, though I've been unable to remedy the pain much by drinking Gatorade instead of water (I hydrate constantly).  The second seems likely, since I find it hard to maintain warmth in my hands during the winter.  Posts online seem to discount the idea that my 16 years of vegetarianism are directly causing this, though I have considered this possibility.

At this point, I'm hoping someone has experienced or knows of this sort of pain, and might be able to identify an underlying cause, and suggest remedies.  Any help is greatly appreciated!
3 Responses
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666151 tn?1311114376
Sorry for passing this over... I didn't mean to.   I have read about this type of thing, but have not seen it personally-- in some cases where people use their hands to a large extent, they can develop cramping and muscle coordination problems that never resolve.  I think you did the right thing by taking all that time off to rest, but from my recollection there is no solution to the problem once it develops.  I don't think electrolytes are the problem;  it is more a function of the interaction between the nervous system and the small muscles of the hand and fingers.  Anyone else have more info?
Helpful - 1
924193 tn?1243876373
Bump!  Was the question too long, or posted in the wrong forum?  Does anyone have any thoughts?

And, on a related note, I thought about this more yesterday, and I'm wondering if the pain may be an indirect result of my hyperhidrosis.  Excessive sweating seems like a potential reason for low potassium and other electrolyte levels in the muscles, especially of my hands, which sweat quite a lot.
Helpful - 0
924193 tn?1243876373
Thanks for the reply!  I posted a thread in another forum, concerned that I might have posted in the wrong place.  Here is is, with some comments from others, and updates from me:  


A brief summary of the update: after seeing a GP and a neurologist, the consensus seems to be CTS, even though I don't have any tingling, numbness, or coldness.  I'm going in for an EMG Friday, and will send in an update after that.  I'm really hoping that this isn't something nebulous and untreatable, as per your message... And the neurologist I saw also said he thought electrolytes were an unlikely source of the problem.  Blood chemistry and CPK tests confirmed as much.  
Helpful - 0

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