Trigger Thumbs? Thoracic Outlet Syndrome? Pain Returning After Corticosteroid Injection.

by Carmela
(Texas)

Hello Joshua,

I linked to your site from Ravelry and I'm very interested in getting your opinion on a couple of issues. I'll do my best to summarize.

First, a little about me. I just turned 50 and am in good health. I was laid off from my job 6 months ago so I became a baker and caterer.

I knit, crochet, kayak & fish. I do not take vitamin supplements but am not opposed to doing so if they will help relieve my pain. I have 2 major issues going on here.

1. In 2006 I was diagnosed in the ER with Thoracic Outlet Syndrome. My right shoulder was very painful all the way down to just below my shoulder blade and both my hands were numb and tingling.

I went to see a Dr. friend who said he did not think it was the correct diagnosis and he injected my hands with cortisone.

Instant relief for my hands, but not my shoulder.

After 6 weeks of physical therapy for the T.O.S. I felt much better. Until recently. My hands, especially my right hand, "fall asleep" during the night, while holding the phone and while knitting and the pain in my right shoulder is constant.

2. About a month ago both my thumbs became inflamed and painful, my right thumb more so than my left (I'm right handed).

When I tried to straighten them it felt like they were popping out of the joint and the pain was quite intense. The left thumb is much better but the right is still quite painful.

I have tried to see a specialist but they will not see anyone that does not have health insurance regardless of the fact that I said I would pay. I have an appointment to see my dr. friend next week. Although he is an Internist he is quite knowledgeable and eager to help.

As I mentioned, I am very interested in learning your thoughts and ideas regarding alternative treatments.



----



Joshua Answers:

Hello Carmela!

Jumping right in here...


1. The good news is, you respond VERY well to Corticosteroid shots. The bad news is, they don't fix or cure anything.


2. It's great you have a doctor friend. And, my prediction is, he's not going to be able to help you. It's great he's eager and wants to help, I absolutely appreciate that, and it's predictable that he's going to try to do that with a doctor's education, which, IMHO, does not include knowledge/tools that are going to get you out of pain in a functional, helpful way.

You have symptoms for a reason. Taking away the pain (like with cortisone injections) does not at all deal with the reason.

I'm certainly not saying that doctors have no idea how to fix Thoracic Outlet Syndrome or Tendonitis, but it can be a little bit like me performing heart surgery. Probably not the best choice of surgeons. :)

Unless you have had a recent level, DO have him do a Vitamin D level for you.



3. I suspect you have a long history of keyboard work and knitting and/or crocheting?

Thoracic Outlet is a function of your body conforming to long term poor posture and use.

Thoracic Outlet Syndrome is not a disease.

Your structures and tissues have just changed over time. With the right know-how and time and effort, it's totally reversible.

We will need to deal with Inflammation and the Pain Causing Dynamic you have going on, and investigate how much of the problem is from your shoulder/neck area, as opposed to how much is happening in your lower arms and hands.


4. I'm not worried about the TOS or the symptoms that show up when sleeping. We can deal with that.

I might be worried about the thumbs. Let's investigate.


QUESTIONS:

1. Have you thumbs ever hurt before?

2. Describe the thumb pain in more detail. Sharp? dull? Arthritisy? Muscle pain/tightness? The more detail the better.

3. Describe any wrist/forearm symptoms.

4. What exactly were you doing at PT? Did you stop, and now it's feeling worse again?

5. General description of diet.

6. On any meds? Any thyroid issues?


Let's start with those questions.



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