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If both of your hands are affected, you would have to have 2 pinched nerves (one on each side) or a pinched spinal cord. Have you had an MRI of the cervical spine?
So you've lost strength in both hands? Have you had nerve conduction tests (NCV/EMG)?
The important questions, Peter, include is there nerve damage and if so where is it originating from?
If it's originating from the cervical spinal cord (i.e cord compression, or spinal stenosis) you need to see a neurosurgeon to assess whether the cord is at risk of further injury and if the compression can be fixed surgically. The MRI should show this. In such a scenario, chiropractic adjustments of the neck could be dangerous. If it's originating from peripheral nerves, either at the neck region (i.e. radiculopathies) or further down the course of the nerves at the wrists, for example, (e.g. carpal tunnel) you would need to see either a neurosurgeon or a hand specialist to see if the nerves can be released from the pressure that is causing the weakness. If surgery was not needed, physical therapy might be helpful.
Let me know if you have any follow up questions. I would be happy to help you further.
Corticosteroid injections are used to reduce inflammation leading to pain. They are not generally helpful in terms of weakness, especially weakness that comes and goes.
In such a scenario you would have to consider other diagnoses such as myasthenia gravis, a condition in which muscles fatigue with repeated use, then regain strength slowly with rest. Your family doctor can look for this by ordering a blood test.
Do you have any additional questions? Let me know if there is anything else I can help you with.
Yes, I would suggest you see a neurosurgeon or a neurologist if the weakness is affecting both hands. If you can get an MRI first that would be very helpful. If not, see if you can get nerve conduction tests done on the upper extremities (i.e. NCV/EMG). This test will tell you if there is nerve damage and if so where it is coming from.
It depends on what is causing the nerve damage and how severe it is. Nerve conduction testing can be very helpful in this regard. Surgery is usually the last resort for nerve damage that is worsening or for spinal compression that puts one at risk for other complications.
If an MRI shows no cord or nerve root compression, you would likely not need surgery. In this case, physiotherapy and medications would likely be the best approach.
Ibuprofen is sometimes helpful. If not, you might need to use a cox-2 inhibitor such as celecoxib or meloxicam. If there is evidence of a lot of inflammation, you might need to be on a course of prednisone. Your doctor can help you decide the right medication based on your exam and the results of testing.
If the compression is mild, the medications are more likely to be effective and you might not need the tests we discussed...so that would be a reasonable place to start.
That would be ideal. Weakness is not something you want to wait too long to address...especially if it is getting worse.
Hi there. Were you able to be evaluated by your primary doctor for your hand weakness? Has it gotten any better or any worse? Let me know if there is anything else I can help you with.
That's great. This is a first important step in getting the proper diagnosis and treatment before things progress. As for the meloxicam, it is an excellent anti-inflammatory and you should begin to see improvement within a couple weeks if there is an inflammatory component to this.
In terms of possible interactions, it is generally considered to be a safe medication. If taken with meloxicam, certain antidepressants, particularly the SSRI class, can increase the risk of stomach and gut bleeding.
Yes. Sometimes, inflammation can affect motor neurons. This affects their ability to function properly. If the inflammation recedes with anti-inflammatories, the symptoms often gradually improve. Your neurologist should be able to determine if there is nerve damage, where it is located, and whether there is an inflammatory component. Similarly, if you begin to improve while taking the anti-inflammatory, this is pretty good indirect evidence of inflammation.
I agree. I think you will do well once you get the diagnosis pinned down and start on treatment. Be sure to ask the neurologist if nerve conduction testing (i.e. NCV/EMG) is warranted. This may be more valuable than an MRI at this point.
You're welcome. Hope all works out for the best for you.
Do you have any additional questions?
That's terrific. Give it a couple more weeks if tolerated, and continue with the physiotherapy as this should help you regain the strength you have lost.
Hi there. How are your hands today? Did you have any follow up questions for me?
Let me know if you do and I would be happy to help further. If you have no additional questions, please don't forget to provide a rating. This is the only way I get credit for helping you.