Is this really Carpal Tunnel Syndrome?

[Kotoko]

When I was typing, I noticed that my right thumb strated tingling. I thought the tingling sensation would go away in a couple of hours after I finished typing. But it didn't go away but it's been tingling over a month. I went to see my PCP two weeks after I felt tingling in my right thumb. She told me that I might have Carpul Tunnel Syndrome, Rhuematoid Arthritis (since my grandmother had one), or DeQuervain's Syndrome.

Later I was told to check if I had one or two of these disorders by getting my blood tested and my right hand x-rayed. It took over a week to get the results and I ended up seeing her in two weeks. She told me that the results were negative and I was very healthy.

It was good to hear that I was very healthy. I didn't have diabetes, rheumatoid arthritis, and I didn't have a broken wrist, and I didn't have a thyroid problem.It was good to hear that, really. But by the time I saw her, other than tingling in my right thumb, I strated having a pain in my right and left hands and arms.

I told her that since I saw her last time, I started having a pricking sensation in my right hand including my ring finger and pinky and also my arm. And also I started having a pain in my left hand and arm. She told me that the reason why my ring finger and pinky had a pain was because the way I rested my wrists was bad. I should have rested my wrists on a soft pillow so I wouldn't have had the pain. But anyway, she told me that I should take an EMG test to see if I really have Carpul Tunnel or not. So I took the test and the result was negative.

She told me that she didn't know what else she could do but the only thing she could think of was that I might have an anxiety problem. She told me that when I was typing, the environment I was in was very stressful so my thumb started tingling, which didn't convince me and my husband a bit since I was working on the stuff for helping my mother-in-law's work that didn't have a deadline and it was not definitely in a stressful environment.

But anyway because she told me that I might have anxiety, I couldn't tell her that both of my legs started having the similar symptoms. Since I started feeling the pricking sensation and pain and also feeling sometimes my nerve is pulled in my arms, I strated feeing the similar symptoms in both of my legs.

These days, my knees pop a lot (my husband have heard it many times) and I feel like my legs are getting weak. And also a nerve in the back of my knees sometimes feel pulled and have a pricking sensation in my upper legs and lower legs somtimes and my ankles have a sharp pain from time to time. I didn't know why my legs started feeling like this  so I asked an absurd question to my husband if the nerve in my arms and legs are connected or not.

But anyways, I haven't told these symptoms in my legs to my PCP because I was afraid to hear that that might also be from my anxiety.

But still I wonder why I have this tingling sensation for 24 hours non-stop for over a month in my right thumb. My PCP kinda implied that I am imagining that my thumb tingles. So if what she is saying is correct, I have a constant anxiety for 24 hours because my thumb tingles for 24 hours??? And another qeustion is: Can the EMG test show or prove the tingling in my thumb? I thought that the EMG test I had was to check if my median nerve was damaged because this test was to check whether I had Carpul Tunnel or not. I just want to know if there is some kind of machine or instrument that can prove the tingling in my thumb so I can be convinced that I am imagining things.

And also my PCP mentioned that maybe it's too early to diagnose what I am having is carpal tunnel so she wants to see me in 6 weeks. And if my hands don't get better by then, she might want me to take another test.

Anyway, I really don't know what I have. Maybe I have anxiety. Maybe I don't. Or maybe I have carpal tunnel...Anyway, I really don't know what I have. Please help me.

[Kotoko]

I forgot to ask you this.

You said "EMG results have to corelated with clinical assessment." But I really didn't understand what you meant. Could you please give me more specific information to explain that?

And also I really want your response about my thumb that tingles for 24 hours. I really don't mind that you tell me that I mihgt have an anxiety problem if you think that's the cause of my thumb tingling. I just want to know your honest opinion.

Thank you.

[Kotoko]

Thank you very much for responding to my question.

It seems like I don't have CTS according to your reply.

I also contacted a pyschiatrist to see if the symptoms I have are really from anxiety. But he said " Anxiety would be a remote possibility." So the symptoms I have are not definitely from anxiety,either.

Anyway, if I this pricking sensation in my arms and legs and in the back of my hands won't go away in two months, I am thinking to contact an orthopedist even though my PCP told me not to because I have no reason to see him.

By the way, I am a housewife and I helped my mother-in-law's work just for a month. Her work is a work from home type job and what I needed to do was to just type the content of textbooks for blind kids at my home. It was the easiet job that I ever had. There wasn't really a deadline and I could watch TV and listen to the music I liked...anyways, I didn't really have a stressful environment when I was working. That's why I couldn't be convinced by what my PCP explained to me about why I'm having these symptoms. You explained to me about the psychological and social issues that can affect my body but in my case, it's totally different. I didn't work in a stressful environment, didn't have any  colleagues who could give a lot of stree and so forth. My PCP told me that if I have anxiety, it's possible to have any kind of symptoms incluing the constant tingling sensation in my right thumb. But it sounded to me that because she couldn't explain anything else, what she could come up with was telling me that I have anxiety.  

Anyway, again I want to say thank you for responding to my question.

Kotoko

[DrNavneetMD]

Hi dear,

Carpal tunnel syndrome (CTS) or Median Neuropathy at the Wrist is a medical condition in which the median nerve is compressed at the wrist, leading to pain, paresthesias (altered sensations), and muscle weakness in the forearm and hand.
A form of compressive neuropathy, CTS is more common in women than it is in men.
Most commonly it is idiopathic (without known cause). Repetitive activities are often responsible for the development of CTS.
Symptoms gradually increase over time with typically the symptoms appearing at  night time with a burning and tingling sensation, especially the thumb, index, and middle fingers. These symptoms appear at night because of the sleep posture with bent wrists which further compresses the carpal tunnel. If the median nerve is already under stress, the increased compression of the bent wrist results in numbness and tingling. Difficulty gripping and making a fist, dropping objects, and weakness are symptoms of progression.
Unless numbness or paresthesia are among the predominant symptoms, it is unlikely the symptoms are primarily caused by carpal tunnel syndrome. In effect, pain of any type, location, or severity with the absence of significant numbness or paresthesia is not likely to fall under this diagnosis.
It is concerned with the occupations of assembly line workers, meat packers, food processors, and the like, not general office work. It has been found that discomfort at the base of the neck or in the shoulder or work with their shoulder in elevation (indicators of poor working postures) are more likely to develop a repetitive overuse injury.
Studies have also related carpal tunnel and other upper extremity complaints with psychological and social factors. A large amount of psychological distress doubles the risk of the report of pain, while job demands, poor support from colleagues, and work dissatisfaction also increases in the report of pain, even after short term exposure.
EMG results have to corelated with clinical assessment.
Just relax and meditate to allay anxiety. Develop a comfortable mechanical position while typing and avoid or minimise work which involves repititive stress at the hand and fingers. If the symptoms are still persistent and accelearte over a period of time, consult an orthopedic surgeon.

Wish you all the best.
Take care