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Dr. Mark
Dr. Mark, Physician / Surgeon
Category: Medical
Satisfied Customers: 11946
Experience:  U.S. Surgeon / Neurological Surgery
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I have extreme pain in my hands, it hurts to close them and

Customer Question

I have extreme pain in my hands, it hurts to close them and re-open. Lifting things is difficult. They are swollen Sometimes if I bump them on something I have pain enough to send me through the ceiling. My DR. says it's not arthritis, lopus blah blah, He tells me what it isn't but not what it could be , I have had several surgeries on my neck fussing a couple of dics and my DR's next step it possible another nerve test to see if something is pinched. What are your thoughts. This has been going on for months
Submitted: 4 years ago.
Category: Medical
Expert:  Dr. Mark replied 4 years ago.
Do you have weakness in the hands as well?

What about pain in the forearms? Or upper arms?

Do you know what levels in your neck were fused or operated on?
Customer: replied 4 years ago.
Yes there is some weakness. There is pain up the arms, not all the time but occassionally and the fussion was at levelc-5 & 6 I believe
Expert:  Dr. Mark replied 4 years ago.
OK.

Well, certainly if your doctor has evaluated this and ruled out arthritis of the wrists, that is important.

And weakness in the hand muscles can come from "pinched" nerves -- both within the neck, and as these nerves travel out into the arms.

For the hands -- common causes for weakness and pain can be "carpal tunnel" -- which would affect mostly the thumb, index, and middle fingers, or "ulnar neuropathy" -- which would affect the pinky and ring fingers.

These nerves can get compressed at the elbow (ulnar) or wrist (both carpal tunnel and ulnar).

So the test called the nerve conduction velocity test is helpful in this situation, as it can diagnose nerve compression at these areas.

In addition, given your history of cervical fusion surgery, it would be helpful to evaluate your neck as a potential cause, since a "pinched" nerve there, lower in your neck than the previous surgery, could cause similar symptoms as well.
Customer: replied 4 years ago.
I have had carpal tunnel surgery on both hands and the DR doesn't think, from his examine that this is the problem. He has tapped on both wrists and elbows with no noticeable reactions according to him. So everything you have told me has been told me by him so far
Expert:  Dr. Mark replied 4 years ago.
OK.

But the nerve conduction test can still see if there is a problem in the wrists (as scar tissue can form after surgery, and cause compression again) -- as well as the elbow (where the ulnar nerve runs).

The elbow is particularly important, because this nerve compression can also cause pain in the hands, as well as cause hand grip weakness and muscle wasting in the hands.

The nerve conduction test is a more accurate way of diagnosis, more so than "tapping" on the wrist and elbows. EMG testing can see if there is a nerve irritation somewhere in the arms. And MRI of the cervical spine can see if the issue is with the nerves in the neck.

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