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Arthritis and Rheumatism

What is wrong with my hands

03/08/2007

Question:

I have been experiencing hand pain for far over a year now. I have all of the signs and symptoms of carpal tunnel. So, I saw an orthopedic surgeon and when I explained my symptoms, he immediately said that it was carpal tunnel, without hesitation. However, I had a nerve conduction study done, and everything came back normal. I was also given blood tests that came back normal as well. I was then treated for Tendonitis of the wrist, by wearing an imobile splint for over a month and given several cortisone shots in several places in my hand along the tendon under the thumb, and in the wrist joint. The shots seamed to help slightly, but only temporarily. I didn`t notice any permanent improvements. I was then referred to see a rhuematologist for further treatment. There, xrays were taken of my right hand, and the Doctor said there were little to no signs of swelling, damage, or arthritis. He told me to use hot/cold water treatments and take alieve daily. These at home treatments provide a little temproary relief, but I am not satisfied with this. I am a graphic designer, and use the computer all day, everyday as a career. I am 26 years old, and to have this amount of pain, I am worried that it may progress to the point that I can no longer use my hands for work. Most of my pain worsens as the day goes on, and by around 8:00-9:00 in the evening, I am in severe pain, and have trouble doing anything involving the use of my fingers. I am constantly rubbing and grinding away at my hands in the evening because they hurt so bad. When I do anything extensive involving my hands such as scrubbing something, painting, sewing, drawing, typing, etc..., My hands are extremely stiff and sore for a day or more after. My symptoms are: I have a lot of soreness/achyness in the muscle between my thumb and index finger. This is the most irritating and painful of the symptoms. I also have pain in the wrist under my thumb, and on some occasions, in my forearm. I also noticed recently that I have a sore and achy spot between my index and middle fingers on the back of my hand. When I wake up in the morning, I feel like my fingers are swollen and stiff for about an hour after I wake. This makes it very difficult and painful to dry my hair and put on my makeup, etc... After an hour or so, they eventually get a little tingly, and then it seams as if they wake up. All of the above symptoms are in both hands, however, it is far more severe in the right hand (which I use to operate a mouse all day.) I also have a clicking noise in my right index finger when I move it a certain way, and also in my right wrist when I move it in a circle. I have been to about 8 Dr.s appointments, and several tests, and no one has come up with a solution for me. I apologize for the lengthy description. Do you have any ideas? I would greatly appreciate some advice, or a push in the right direction. Thank you.

Answer:

Some of your symptoms may be consistent with rheumatoid arthritis despite negative blood tests. About 15% of patients with rheumatoid arthritis do not have positive blood tests. You also need to be evaluated for connective tissue disease such as lupus if not done so already. I would encourage you to continue to see a rheumatologist to figure out what's going on.

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Response by:

Johnny  Su, MD Johnny Su, MD
Formerly, Assistant Professor of Medicine
School of Medicine
Case Western Reserve University