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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5355
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I have pain in my hand across the top of my hand back from

Resolved Question:

i have pain in my hand across the top of my hand back from the knuckles of my two fingers that feels like a burning pain - especially when i use my hand. i also get pain in the middle of my palm and around my wrist area but my electrical nerve study did not show up carpal tunnel. is it possible for the study to show up negative and still have carpal tunnel? the symptoms are agravated when i type - my hand can also get very sore and very cold and when aggrivated the blood vessels on top of my hand (back from the knuckle of my first and second fingers) seem to swell up.
Submitted: 5 years ago.
Category: Neurology
Expert:  Dr. Bob replied 5 years ago.

Hello. If you had Carpal Tunnel Syndrome sufficient to cause these symptoms, something should have shown up on the nerve study (assuming it was done and interpreted correctly). In addition, one would expect some involvement of your thumb and possibly forearm, with some weakness as well.

Other possible causes would include Tendonitis, which can affect the tendons that run from your forearm muscles into the palm and fingers. (Repetitive strain from computer use is a common precipitating cause). OR Arthritis, either osteoarthritis from wear and tear of the joints or rheumatoid arthritis from an inflammatory reaction in the joints. These can also flare intermittently.

Treatment is similar for all these entities, and include rest (with splinting of wrist in most cases), avoidance of repetitive motions and heavy lifting ( > 5#), ice 3-4 x per day, especially after work, and non-steroidal anti-inflammatories such as ibuprofen or naproxyn. If you feel you need a work up for arthritis, your family doctor can do this with simple blood tests and possibly x-rays.

Customer: replied 5 years ago.

Sorry I should have mentioned that I have had hand x-rays which were fine and tests for RA which were fine as well. I also get major aching in my forearm if i use my hand too much. I also get a stiff feeling in my hand where it feels swollen but it isnt. My massage therapist thought it was muscle related so i tested the theory and had a hot bath which tended to aggrevate the area just down from the wrist as well as the pain across the top of my and - i got out of the bath and used ice which tended to help settle it down... i also have soreness running from my elbow along the muscle or tendon that runs along that part.

if it is tendonitis who should i see to treat this conditions?

Expert:  Dr. Bob replied 5 years ago.

Some people are very vulnerable to tendonitis, for reasons that are not well understood, but probably relate to an over exuberant immune system. This might actually help you in some ways (e.g. fighting infections, removing cancerous cells), but not in terms of aches and pains and such. For this you have to counter the immune system with ice and medications.

Tendonitis would fall under the perview of orthopedics, possibly rheumatology. Some ortho docs specialize in hand problems. Similarly some sports medicine specialists have particular expertise in tendonitis and other activity related disorders of the hands and arms.

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