Having some left hand problems, I think because of a bad arm break a couple of years ago (in JLC, even). At that time I had damage to the ulnar nerve at my wrist from the bone ends going past, and until they removed the scar tissue some weeks later, I had pretty complete ulnar palsy in my pinky, fourth, and part of my middle finger.
Only lasting effect I noticed ’til recently was trigger-finger on my middle finger. Now it’s on my fourth finger, too. Grab stuff without thinking and can’t let go with out an uncomfortable “pop” or “pop-pop”.
In the last few months, but increasingly, when I use my left hand in a position like holding a single-edge razor to scrape paint off glass, or hold a finishing nail, the strangest thing happens.
With no change in sensation (I can still feel normally, and no buzz like it’s asleep), my thumb and forefinger completely stop working. I mean COMPLETELY.
I can stare at them, and will them to work (I guess the muscles are in the forearm?), but ABSOLUTELY NOTHING happens for 5-10 seconds. Then, they slowly move in the indicated direction, and are back to normal. Once or twice, as I stared, my hand twisted up like I’ve seen on a severely arthritic person – that was scary, though it was only a few seconds.
Seem to drop small things more lately, but can’t be sure.
Checked with the doc today, and have an app. with a neurologist in a few weeks.
What’s bad is that I’m always holding on with my left hand!
Any docs out there know anything?
Forrest – really liking BOTH hands to work
Replies
First off, definitely keep the appointment with the neuro. While it's unlikely, you could be seeing early signs of a serious illness, unrelated to the previous injury.
Unfortunately, hand nerve problems are hard to diagnose. Assuming that the problem is more or less mechanical, due to compression of the nerve, it could be in the neck, the shoulder, the elbow, or the wrist. Plus of course you can have problems with the nerves as they cross the palm.
It's also possible that the problem is not nerves at all, but rather inflamed tendons in the hand/wrist. Or a combination.
Have you experimented with wrist braces? Often that's the best solution. Also consider whether anything you're doing could be irritating the nerves and tendons in that arm. This can be pressure or vibration or simply holding the limb in an awkward position for too long.
Haven't tried a wrist brace yet. Thing is, 99.9% of the time I am doing the exact same things I've done for decades with no problems - THAT hasn't changed.
Forrest
Have you experimented with wrist braces? Often that's the best solution.
It's not good to use a hand brace without a doctor's direction. Hand braces are often self prescribed by people with carpal tunnel syndrome. However, the brace masks the symptoms and leads to irreversible muscle damage.
I'm not a doctor (well, not an MD :-) but that's what several top surgeons have told me.
See my comment about surgeons.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin
See my comment about surgeons.
I can appreciate your skepticism about doctors. Like any other profession, there are good doctors and some less good doctors.
In contrast, it appears that there are more bad chiropractors than bad doctors, in my anecdotal experience. Nonetheless, I'm sure there are good chiropractors out there, but a lot of them are not. The guy on the radio that is very "new age-ish" really scares me. He is always talking about how doctors are out to get you, that medication is always bad, etc.
As a scientist, I value the scientific method, and the testing and demonstrated results from medication and surgery seem valid to me. It's curious, though, that you appear to support homeopathy and other "alternative medical practices", many of which are completely unscientific and unfounded, and yet take the opposite side when talking about evolution. I guess we all have our inconsistencies. I don't mean that as a slight, just an interesting observation.
FWIW, I do know of several people who went to a chiropractor for carpal tunnel syndrome (CTS). The chiropractor "treated" it. Ultimately, they had to have the surgery, the muscular atrophy caused by the delay in treatment was irreversible and significant, and the chiropractors lost the lawsuit.
Yeah, I'm more skeptical of chiros than regular docs, certainly. Much of the chiro dogma is clearly bogus (though I'm sure that many chiros do not subscribe to that dogma).But I've observed both anecdotally and via survey articles that, with back and wrist surgeons especially, they're too often anxious to cut when "conservative" measures would be more effective. Except in cases of actual paralysis, there's generally little harm in attempting conservative treatment for 6 months or so before resorting to surgery.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin
Oh, and I absolutely DO NOT support homeopathy and most other "alternative" medical approaches. Easily three quarters of that stuff (at least) is bogus, with the only positive benefits being psychological. But in addition to maintaining a healthy skepticism about all medical practices, I also try to maintain an open mind with regard to non-standard approaches.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin
Oh yeah. Heard about this before. Sorry to be the one, but....
It ends with me saying, "Send me all of your tools cause you won't be needing them again."
"With no change in sensation (I can still feel normally, and no buzz like it's asleep), my thumb and forefinger completely stop working. I mean COMPLETELY."
You mean they won't move in *any* direction, or just that you can't straighten them out?
"Once or twice, as I stared, my hand twisted up like I've seen on a severely arthritic person "
The radial nerve doesn't have any motor branches near the wrist or in the hand, so if we go on the assumption that this is some kind of delayed fallout from the fracture (which I take it involved the lower end of the forearm), then it won't be the radial nerve.
What it sounds like is that the median nerve-innervated muscles are going into spasm. This can happen when the muscles are weak, which in turn can happen from injury to the median nerve, which has motor branches to the base of the thumb and to the muscles in between the bones of the hand that enable you to squeeze your fingers together or spread them apart. It would also go along with the observation that you are dropping small things more.
On the other hand, if the source of the problem is above the wrist, the radial nerve does innervate muscles on the back of the forearm that straighten the wrist and the fingers, and supinate the wrist (the twisting motion that your right hand makes when you tighten a screw). If your fracture involved your elbow or upper forearm, it could damage the radial nerve. At that level, however, there are both sensory and motor fibers running together, so an injury would usually be painful.
The third neurologic possibility would be something originating in the brachial plexus (a nerve network that passes under your collar bone and through the armpit) or the cervical spine (either the nerve roots or the spinal cord itself). If that is the case, I would expect your symptoms to vary depending on the position of your arm/shoulder and/or your head/neck. So, if using your left hand "in a position like holding a single-edge razor to scrape paint off glass" means holding it up in front of you, but you don't get any symptoms if you squeeze your thumb and index finger together with your hand hanging at your side, then it's something to consider.
Finally, getting away from neurologic conditions and going back to the hand again, there is a scar-forming condition (Dupuytren's contracture) in the hand that can cause trigger fingers and later contractures of the ulnar fingers and the palm. It is generally painless and slowly progressive. Rarely does it affect the thumb or index finger, though.
Best bet: See the neurologist or an orthopaedist; there are physical examination tests that can help narrow down the location of any neurologic impairment or muscular weakness, and if necessary nerve conduction velocity (NCV) and electromyography (EMG) studies can be done. These involve giving you little shocks and then measuring how long it takes the impulse to travel down the nerves, and how the muscles react electrically to the stimulation.
Rebeccah
Yeah, definitely go for the EMG/NCV if suggested. It's a hoot to watch the lights dim every time they give you a jolt.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin
Wow! Thanks for all the learned info.
What I mean is, in these sitiuations, they won't move in ANY direction. I can most liken it to looking at someone else's hand and thinking "move thumb and forefinger" - nothing happens.
One thing you got me thinking about, I believe I can associate this condition with "hunching" my left shoulder, or bringing it close to my neck, as to work in a confined space, like up in a skylight shaft or working through some studs.
Fracture was as "ice cream cone" compound Colles fracture just above the wrist.
Looking forward to my appt.
Forrest
"What I mean is, in these sitiuations, they won't move in ANY direction. I can most liken it to looking at someone else's hand and thinking "move thumb and forefinger" - nothing happens."Inability to move both the finger and thumb in *any* direction suggests either that multiple nerves/muscles/joints are involved, or that something that *coordinates* or *directs* the movement is involved.Most often, that something is the brain. Doctors' terms include things like "supratentorial" or "centrally-mediated." "Supratentorial" means "above the tentorium cerebelli", or originating in the cerebrum. "Centrally-mediated" means caused or brought about by the central nervous system. The central nervous system technically means the brain and spinal cord. Both of these can be doctor-speak euphemisms for the common expression, "it's all in your head." The terms can also mean an actual brain or spinal cord disorder. A couple of anecdotes from my own experience that may (or may not) be relevant:The first is about that sensation of not being able to move.
I do gymnastics. I've done it off and on for over 30 years. I've also had some extreme weight variations over those 30 years. There is a gymnastics maneuver called a back extension roll, that involves rolling backwards and pushing up into a handstand before putting one's feet down. Once you get the momentum and timing down, if you just shove with both hands, you pop right up into the handstand (well, assuming you already know how to do a handstand, which I do). But when I'm heavy and getting back into shape, I just can't do it. It's *not* that I'm too weak, although it's easy to blame it on that. It's that I push, and about 1/3 of the way up as I'm wondering if I'm going to make it or not, my elbows just stop moving. It's that identical sensation that you describe, as though I'm "looking" at them and telling them to straighten, and I might as well be "talking" to someone else's arms. It's a form of "choking" (in the sports sense), I guess. In the same gymnastics session, I'll do passes where I pop right up like I'm supposed to, and others where I freeze part-way up and can't seem to make myself push.Anyway, I don't want to imply that that is what is going on with you, just to relate my experience. The second anecdote relates to a phenomenon called "amplification," where symptoms due to a real injury or just normal sensations are magnified subconsciously, and seem more serious. This can happen, for example, if the patient is afraid of the meaning of the original symptom -- for example, someone who has recently had a back injury and has some fatigue and pain in one leg may be afraid that they have "permanent nerve damage." That fatigue and pain can morph into diffuse numbness, tingling, weakness, and even collapsing of the leg. It becomes self-reinforcing, as the amplified symptoms seem to confirm that there's something "really wrong." The more knowledgeable the patient is about medicine, the more convincing the amplified symptoms can be to the physician evaluating them. I know, 'cause I've done it to myself. Fortunately, a negative MRI that I saw with my own eyes persuaded me that there was nothing seriously wrong and within a couple of weeks, my symptoms completely resolved on their own. This, after I had been suffering for over 6 months.So what's the point? Just that psychological factors can have a big effect as physical ones. Amplification, in particular, is very common, and can complicate a medical problem that itself *does* need attention. In any case, you still need to be examined and evaluated by a professional, and the bad things need to be ruled out.Rebeccah
"for example, someone who has recently had a back injury and has some fatigue and pain in one leg may be afraid that they have "permanent nerve damage." That fatigue and pain can morph into diffuse numbness, tingling, weakness, and even collapsing of the leg. It becomes self-reinforcing, as the amplified symptoms seem to confirm that there's something "really wrong." The more knowledgeable the patient is about medicine, the more convincing the amplified symptoms can be to the physician evaluating them."Yep, this is really apparent with benign fasciculation syndrome -- the more folks worry about the twitching the more they twitch, and they begin to experience other symptoms such as numbness as well. I strongly suspect that anxiety itself causes chemical changes in the body that trigger these symptoms -- largely consistant with organophosphate poisoning.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin
> Rarely does <Dupuytren's contracture> affect the thumb or
> index finger, though.So, if you get trigger finger in your index finger, it's almost certainly nerve damage and unfixable?George Patterson
The body can repair nerve damage. It's just very slow a doing so.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin
Trigger finger has nothing whatever to do with nerves.It is a lump in a flexor tendon, which catches as it passes through one of the pulleys in the tendon sheath. The "triggering" itself is when you bend the finger, and it gets stuck and won't bend any further, but if you keep working at it , the lump suddenly pops through and you can bend it all the way. This sometimes causes irritation and inflammation, which in turn causes further swelling of the tendon and the sheath, worsening the sticking/triggering. Worst case scenario, the lump can't pass through the pulley at all, and either the finger won't bend past a certain point, or it gets stuck and won't straighten back up again.The usual treatment for mild or moderate triggering is a steroid shot into the tendon sheath (not into the tendon itself). This decreases the swelling and stickiness and allows the tendon to glide normally.Severe cases are treated surgically.Rebeccah
I know of what you speak. I had bi-lateral casting for 6 weeks, treating tendosynovitis in both wrists. Not pleasant, but beat the knife option.
Made for some interesting times, haveing a cast on each wrist..if ya know what I mean.
I know exACTly what you mean.It could have been worse, though. Bilateral above-elbow casts are definitely worse.Rebeccah
Funny, when the DR. gave me 3 options ( cortisone, may work, may not last, The dreaded knife, to remove the sheath, or Bilater casting..a sure fix ) I said the casting.
NEXT thing I knew, TWO nurses started to take off my flannel shirt ( my wrist were trashed, bad day with a router for 12 hours duct-taped to my hands, long story), and began padding BOTH wrists, I about DID what would soon be IMPOSSIBLE to WIPE...and said what the HEll?
They smiled and said, " you didn't catch that Bilateral part DID you?"
Lucky me, two weeks before xmas too. I drew a radioactive symbol above where I taped my watch on, and told everyone I asked Santa for Nuclear Arms for Xmas and this is what I got...LOL
Like the Eddie Murphy movie " Clap, clap..."WIPERS!"
Hope things work out. A friend of mine had a similar condition and went to an Orthopod and the Doctor insrted a needle between his wrist and elbow, injected steroids into the tendons. Ira heard a "POP", the pain went away instantly. Been over a year.
Are you still Baching ?
Chuck Slive, work, build, ...better with wood
Baching?
Whazzat?
I was tiling today on a different shower I had built some months ago - client completed all the woodwork in the bath, so it was time for me. I took some pix; should finish the floor tomorrow; grout Tuesday. Shiny glazed cobalt blue 2-1/4" square tiles on both floor and walls; some decorative edging at the top edge and around the door opening.
We put two enclosed lights right above the fixture wall to help the darkness - looks cool!
Forrest
As in "Bachelor". I thought I saw in another thread that your lovely wife and children were on the Patuxent this week.
Chuck Slive, work, build, ...better with wood
Ah. I see. I was thinking classical music.
The job I was working today, I wanted classical, and they just couldn't figure it out. Had one Brahms piano trio CD. Then played that damn "Hearts of Space" music.
Then Seal.
Then Weather Report then who knows what. son, HS senior, wanhts to be a DJ. He's got two turn tables and a micro phone.
Trying to concentrate and make a good layout. Thump thump thump
Man, I like working in empty houses.
Anyway, yeah, family's gone for another week at least. I'm getting a frightening amount accomplished. Kinda' scares me. I realize how much I COULD get done with no distractions, but . . .
Slept on a sofa in the library last night; didn't even take a shower first. Nirvana!
Forrest - conflicted
Thanks. That's what I was told when I first had this problem in 1979. It's just the recent discussion here about nerve damage that got me off-course. My case is with the left index finger. It will contract, but I have to use my right hand the straighten it back out.Glad to hear about the shots - my physician said nothing could be done about it. This is just one of several problems I now have with this guy. My insurance provider changes in a few days, and I will take the opportunity to change doctors.George Patterson
just had a trigger finger release done on my right thumb (the doc said the less invasive treatments didn't do so well on thumbs). I was amazed at how quick the surgery went, and how uneventful the recovery was. Trigger fingers are like leaky roofs--they don't magically heal themselves with time, and only get worse (mine took about a 4-6 weeks between mildly disconcerting to immobilized...).
I'm not a Doc, and I don't play one on TV, but I know more about my median nerve than I ever wanted. I severed it completely, clear through, with a razor-sharp wood chisel back in 2001.
Here is what I learned:
The median nerve (the one associated with carpal tunnel syndrome) is responsible for feeling, circulation, and certain movements of thumb, index, middle, and half of the ring finger (lengthwise, the part next to the middle finger). The ulnar nerve (funny bone) does the pinky and the other half of ringy. The ulnar nerve deals with grasp strength, and the median nerve deals with dexterity. I drop things a lot too, since my hand is numb and tingly, especially the thumb, pointer, and middle fingers, the ones we use for fine motor stuff.
The circulation is weird too. When it's cold, half of my hand will be a lot colder than the other, since the messed up nerve messes up the circulation and temperature regulation.
When I cut my wrist, my hand went numb, and I felt it in my armpit, sort of like I hit my funny bone. Through therapy I did exercises and found out where that nerve goes, all the way from my wrist through my armpit. There's an exercise to do to keep the nerve stretched out and from binding up in its sheath
The median nerve allows you to move your thumb across your flat palm (to the base of your pinky.) It's also responsible for certain grips, like you would grip a car key. I still have weakness in that area, like when opening a bag of potato chips.
I'll get a splinter in one finger, and feel it in my thumb, or somewhere else. Got cross-wired during the repair, I guess.
Hopefully this might give you a little useful info you didn't already have. Hopefully the real docs will be able to help.
One thing I will stress to you is that if they give you exercise to do for rehab, DO THEM DILIGENTLY! There is no way I could have as much functionality in my hand with the injury I sustained without doing the rehab diligently.
Good luck, and fast healing.
Pete Duffy, Handyman
<Pete Duffy, Handyman>
Funny in this context ;-)
Thanks for the info
Forrest
Good one!
I didn't even think of my auto signature there.Pete Duffy, Handyman
The wide variety and depth of knowledge of breaktimers always amazes me!You get out of life what you put into it......minus taxes.
Marv
McDesign,
I have a very similar occurrence.
Mine is extremely painful sometimes however.
The fingers literally lock up and while I can "will " them to relax and open I usually have to literally pry them into doing so .
I started experiencing it about the age of 53 or so I would guess, just once and awhile , now much more frequently . Happens when I am straining the fingers to either push on something or grasp it tightly using just the last part of the finger.
I know I do have damage to the ligaments (maybe tendons, can't remember which it is) that causes them to "jump" out of the tiny "grooves " that they are supposed to run in.
Like a rope jumping out of a sheave is what the doc told me when I was examined. Once out they draw the rest of the finger into a locked position and I have to force them to their normal position.
I have long slender hands and very, very long fingers. Doc told me it was likely from too many finger tip pushups stretching things out too much.
I call it getting old. It's the pits!
McD -
Just my 2 cents worth, at 53 years old, massage therapist (along w/my electrician's license) and son of 2 doctors:
once or if you get a diagnosis from the MD's, don't let them do anything radical until you've checked out the opinions of a couple of good chiropractors or other similiarly-oriented alternatives.
Often the diagnosis is wrong or incomplete. Someone receiving surgery for carpal tunnel will then find out that they really have thoracic outlet syndrome, not carpal tunnel. Doctors too often want to resort to surgery or steroidal injections to try to fix problems involving muscles, nerves and joints. The success rate for such procedures is poor. Then they will often tell you that you simply have to live with it.
So-called alternative practioners have a very different orientation: work with what you've got, the body has natural healing mechanisms that can be stimulated into action, improvement of overall body mechanics can help reduce localized problems. If hunching your shoulders increases the problem in your hand, then it tells me that improving your shoulder functioning might improve the problem in your hand. But no MD is going to see that.
Ed
Edited 6/22/2007 7:39 am ET by edlee
My rule's a bit different: Never accept a diagnosis from a surgeon without consulting a non-surgeon first.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin
<Never accept a diagnosis from a surgeon without consulting a non-surgeon first>
If you're a hammer, you see any problem as a nail?
Forrest
That's about it. A surgeon is only "on stage" when he's in the operating room (and the patient is unconscious) -- everything leading up to that is rehersal time. OTOH, a regular doc is more focused around diagnosis and around his interaction with the patient.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin
DanH,
Curiosity is getting me ... Your medical training is in what exactly?"Poor is not the person who has too little, but the person who craves more."...Seneca
Patient.
So convenient a thing it is to be a reasonable Creature, since it enables one to find or make a Reason for everything one has a mind to do. --Benjamin Franklin