Needing relief from hand pain; Physical Therapy not much help so far.

by Allen
(Oakland, CA)

I'm nearing 50 and have worked on computers all my life. I've also gamed off-and-on for years at a time throughout my life and rarely had any overuse problems. But it finally caught up to me last summer after putting in a lot of extra project hours plus more heavy gaming than normal.

It started with mildly sore hands and tight, localized surface pain across the back of my fingers between the proximal and distal knuckles when I first woke up in the morning.

It didn't impact my ability to type or mouse because it went away quickly after stretching, so work went along normally, but I tried to lay off of games for a month or two to ease it up.

The rest was of little help, so I got a few weeks of PT and that actually resolved the problem in my fingers. Unfortunately instead of moving on to address the occasional, diffuse hand pain I went back to a lot of gaming in October and November.

Several things then happened in rapid succession between late November and December:

* I tried wearing a wrist brace at night and somehow it wreaked havoc on my left thumb. Woke up hurting, subsided after a day or two but it's felt "different" from the base to the tip when I move it ever since.

* The occasional hand pain turned into recurrent hand pain whenever I had to grip a mouse, even a vertical one, for more than 10-15 miunutes.

* I developed another type of diffuse hand pain where the backs of both hands ached constantly for several days at a time.

* I tried on many occasions to use ibuprofen to ease symptoms but it never seemed to help so I gave up on that.

I went to an orthopedic doctor and was told I had mild carpal tunnel along with tendinitis. PT and cortisone was her recommendation. I didn't want the shot but gave in on my last visit two days ago, so had it done to my thumb. Still waiting to see if it makes a difference.

PT has been around 6-7 sessions with a dedicated hand therapist. Mostly it's been ultrasound in the place where it hurts du-jour, teaching me nerve glides, and once or twice did a paraffin bath on both hands.

At work I switched to a split keyboard (which I've used before), and did the same at home. And yet, I can't seem to get on top of this.

Rest from virtually all computer use over the Christmas holiday for two weeks was great but the problems resumed the moment I was back at work.

Most of the problem with pain across the back of my hands still continues to affect my right (mousing) hand the worst.

One interesting bit of good news, I've done weight training for over 20 years and none of this affected my ability to work out. In fact, if my hands are hurting, a weight training session usually brings temporary relief and makes radial nerve glides on my right hand virtually pain free for awhile.

I'm looking for better progress though. The PT doesn't seem to be cutting it this time.

Allen



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Joshua Answers:

Hi Allen.

1. Physical therapy didn't cut it any of the earlier times either. The proof is in the pudding, as they say.

An occasional heat bath, random ultrasound, some nerve glides....that PT was just putting in his/her time and getting a paycheck.

I generally try to be diplomatice, but I've had a lot of coffee today (rare), so guns blazing.

But even then, ultrasound doesn't fix anything, the occasional heat bath has no ability to fix or even help fix anything, and nerve glides, well, mmm hmmm.

Rest doesn't and can't fix anything tendonitis related.

Corticosteroid Injections at best will reduce symptoms for a while, but come with possible risks/downsides, and have no hope of fixing anything.

Wrist Splints And Braces are fine to get you through the day (sometimes the night, depending), but are terrible long term strategies and as you've experienced, can have short term downsides too.


2. You have described the common overall experience of someone with Tendonitis....pain that comes and goes and gets progressively worse (in one or more spots), months and years wasted with doctors and PT's and various 'standard of care' treatments.

That's kind of just how it goes.

Good news/bad news, most people find me/this website after that whole experience.

So here we are. You hurt, you've tried some things, you'll looking for a fix.


Great!


3. So, why do you hurt?

Because of the Tendonitis Dynamic. See: What Is Tendonitis?

On that page is a link to the Pain Causing Dynamic (Those two are kind of the same thing, operating at different levels).

But the moral of the story is, there are various factors that are working together to make things 'worse'.

If you want to get better, you need to effectively deal with all of those factors (not just one).

A tendonitis treatment is a treatment that effectively reverses the multiple factors causing your pain and problem. Anything else is just busy work.


So that's a place to start.

Read the pages the above links point to, then come back with questions etc.




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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com