[48F] With severe hand pain and numbness upon waking
Patient Description
A 48-year-old female presents with severe sharp pain in her left hand, specifically in two fingers extending to the wrist, occurring every time she wakes up and lasting for about 2 to 5 minutes. This pain has been present for a week. She also reports numbness and a pins-and-needles sensation in her fingers, which has been ongoing for about two weeks. The numbness and tingling improve when she puts her arms down above her heart. Additionally, she experiences some weakness in her left hand and difficulty gripping objects. Similar symptoms are present in her right hand but are less severe. Her symptoms are worse upon waking. She has no history of diabetes, thyroid disorders, or rheumatoid arthritis but performs repetitive hand movements, such as typing, every day. Her past medical history includes having had 100 kidney stones over the past 25 years. She has no known drug allergies. Current medications include Zoloft (100 mg), Hydroxyzine (50 mg three times a day), Gabapentin (300 mg three times a day), and Buspirone (15 mg three times a day) for depression and anxiety, which she has been taking for almost three months. Additionally, she takes Ibuprofen (800 mg twice a day) and some vitamins once a day.
Show More
Arora's Assessment
What might be happening
Based on the information you have provided, a possible diagnosis is:
- Carpal Tunnel Syndrome (CTS): This condition occurs when the median nerve, which runs from your forearm into the palm of your hand, becomes pressed or squeezed at the wrist. Symptoms often include pain, numbness, and tingling in the thumb, index, and middle fingers, which can be worse at night or upon waking. The fact that your symptoms improve when you put your arms down above your heart and that you perform repetitive hand movements like typing supports this diagnosis.
- Treatment: Initial treatments often include wrist splinting, especially at night, to keep your wrist in a neutral position. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation. If symptoms persist, a doctor may recommend corticosteroid injections or even surgery in severe cases.
What you can do
While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to help alleviate your symptoms:
- Wrist Splinting: Consider using a wrist splint at night to keep your wrist in a neutral position. This can help reduce pressure on the median nerve.
- Ergonomic Adjustments: Make sure your workstation is ergonomically friendly. Adjust your chair, keyboard, and monitor to reduce strain on your wrists.
- Take Breaks: Take regular breaks from typing or other repetitive hand activities to give your hands and wrists a rest.
- Stretching Exercises: Perform gentle stretching exercises for your hands and wrists to improve flexibility and reduce tension.
- Pain Relief: Continue taking ibuprofen as directed to help manage pain and inflammation.
- Symptom Tracking: Use MDandMe to journal your symptoms, track your progress, and share your notes with your healthcare provider. This can help in identifying patterns and triggers.
What you should look out for
Reasons to see a doctor more urgently include:
- If your symptoms worsen or do not improve with initial self-care measures.
- If you experience severe pain, weakness, or loss of function in your hand.
- If you notice any new symptoms, such as swelling or changes in skin color.
Remember, while these suggestions can help manage your symptoms, it is important to seek care from a real health professional to receive a formal diagnosis and appropriate treatment.
Show More
1
Hugs
0
Comments
Save
3 mo ago