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Do I have Carpal Tunnel Syndrome (CTS)?

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Do I have Carpal Tunnel Syndrome (CTS)?

Old 10-01-17, 02:48 PM
  #26  
sumbikerguy123
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Originally Posted by OldTryGuy View Post
diagram of affected fingers CARPAL TUNNEL SYNDROME - ┬ ┬ ┬ ┬
R. Thanks for the pic link.

I use these handlebar grips: https://www.amazon.com/Weanas-Genera...andlebar+grips

And that's about where the palm of my hands rest on where the median nerve is and takes most of the road shock. So could likely be the cause of my CTS? But I'll let a doctor diagnose or confirm that one.
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Old 10-01-17, 03:02 PM
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Originally Posted by roccobike View Post
OP, Without a nerve conduction study it is almost impossible to tell what's causing your pain. I have Carpel Tunnel issues. I had NONE of the typical problems associated with that condition. It was found out because I had a problem with my elbows that required further evaluation. At the completion of the nerve conduction study the Doc informed me I had Carpel Tunnel issues and they were at least moderate, one step shy of an operation.
With neck pain I would be setting an appointment with an orthopedist ASAP. You're probably a candidate for a neck MRI and a nerve conduction study.
Been there, done that.
R. Thanks. Hopefully a specialist will conduct the necessary tests you mentioned for proper diagnosis.

I do feel its more of a nerve issue causing the muscles to be painful and weak or CTS symptoms. Rather than soft tissue injuries which I thought initially. We shall see?
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Old 10-01-17, 03:08 PM
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Originally Posted by elocs View Post
Check out http://highperformancesports.blogspot.com/2006/03/cyclists-palsy-cyclists-palsy-or.html

Cyclist's palsy includes CTS. It's just part of the price you pay for riding a DF. But it must be worth it though.
R. That's a dead link?
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Old 10-01-17, 03:54 PM
  #29  
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Originally Posted by sumbikerguy123 View Post
R. Thanks OTG. Was your CTS the result of bike riding or some other form of repetitive movement, ie; typing every day, or both, etc?

So your Ortho referred you to a Neurologist. When I was looking at a list of doctors in my area I got Ortho, Sports Medicine Specialists, Neurologist's, etc. and wasn't sure which one is the most preferable? This is all new to me?

An orthopedic surgeon (orthopedist). A neurologist. A hand surgeon. A plastic surgeon. A rheumatologist. A physiatrist?

Seems like Ortho Doc's specialize in a certain area's they feel more proficient in. If not, then makes sense to refer a patient out to someone with more expertise and knowledge in that specialty.

I just started experiencing these CTS type symptoms about 6 weeks ago. My VA Doc gave me some Voltaren Gel (diclofenac sodium topical gel 1%) the other day. Only tried twice, but don't see any decrease in pain yet?

Just have to wait to see whatever Doc I chose has to say?
Not a clue as to why???? For years before diagnosis I rode mostly on aero bars because right shoulder was bone on bone and aero position was more comfortable.

The neurologist was schooled in testing for nerve issues where-as the ortho was schooled in repair to eliminate the issues.
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Old 10-01-17, 03:56 PM
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Originally Posted by VegasTriker View Post
If you choose a doctor, maybe an orthopedist (not orthopedic surgeon) would be a good choice. I've had bicyclist palsy for years and so I switched to recumbent bikes and trikes a long time ago. In spite of that I developed trigger finger in one hand. Typical in our modern health care system I had to undergo 12 months of tests including nerve testing (mild electrocution!) to finally get a referral to an orthopedist. The orthopedist mentioned surgery as a last choice option but suggested trying a cortisone shot. It was probably the most painful shot I have ever received but cured the problem in a couple of days. Start with the simple things and then work to the more invasive if it doesn't work.
R. Cortisone shots work sometimes to help break up calcium deposits formed during the healing process. For me it was the calcium deposits that was causing the inflammation and pain.

I had several cortisone shots in my shoulder for inflammation caused by calcium deposits. The first couple shots weren't to bad, but the last one I got did. It felt like a hydraulic pump pressure when he was injecting the Cortisone into my shoulder. It looked like 5cc or more of Cortisone fluid.

But the Ortho doctor said the x-rays showed the cortisone did break up the calcium deposits.

I was recently offered a shot of cortisone in the arch of my foot for plantar fascia tendon pain. But I said no thanks, I'll think about it. The foot arch is a super sensitive area. The needle was like 1.5", no thanks. But I may have to reconsider that, if no other remedy.
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Old 10-01-17, 04:06 PM
  #31  
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Like to thank all those who have replied. Lots of good info here.

I will take all ideas into consideration and discuss same with whoever I choose for a consult.

Hopefully, things will work out. No one likes to be in constant pain, taking painkillers and being limited to what you can do physically.

Hopefully, it won't interfere too much with my bike riding as that's all I got for daily transportation.
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Old 10-02-17, 12:01 AM
  #32  
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Originally Posted by sumbikerguy123 View Post
R. Right now, I'd say mostly in the smaller end fingers, wrist, forearm, elbow and in the shoulder blade in my back.

I started having what I thought was a muscle/tendon/soft tissue injury in my right shoulder blade back area. Then it progressed to my whole right arm. I haven't been working out or doing any home related exercises since then hoping it would heal on its own.

But right now it seems to be more CTS related. Hopefully a Doctor can give me an accurate diagnosis?
If it is your little finger and the ring figure, that's the ulnar nerve and not CTS.

But yes, go to a Dr, and if your Dr says CTS, get a second opinion.

How do I know?

I went to a Dr when my little finger and ring finger went numb ... she was about to book me for CTS surgery, and I practically sprinted out of there. Went to another Dr, was correctly diagnosed with ulnar nerve issues and was given some appropriate ergonomic advice ... problem solved.

But go to your Dr.
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Old 10-02-17, 06:52 PM
  #33  
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Originally Posted by Machka View Post
If it is your little finger and the ring figure, that's the ulnar nerve and not CTS.

But yes, go to a Dr, and if your Dr says CTS, get a second opinion.

How do I know?

I went to a Dr when my little finger and ring finger went numb ... she was about to book me for CTS surgery, and I practically sprinted out of there. Went to another Dr, was correctly diagnosed with ulnar nerve issues and was given some appropriate ergonomic advice ... problem solved.

But go to your Dr.
R. I hope it becomes that simple for me?
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Old 10-03-17, 07:24 PM
  #34  
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Originally Posted by sumbikerguy123 View Post
R. Right now, I'd say mostly in the smaller end fingers, wrist, forearm, elbow and in the shoulder blade in my back.

I started having what I thought was a muscle/tendon/soft tissue injury in my right shoulder blade back area. Then it progressed to my whole right arm. I haven't been working out or doing any home related exercises since then hoping it would heal on its own.

But right now it seems to be more CTS related. Hopefully a Doctor can give me an accurate diagnosis?
Just my experience, but I have yet to find an injury that responded to rest. Everything that's ever gone wrong with me, and there's a decent list, responded best to carefully targeted exercise, sometimes very hard exercise, sometimes just stretching.

Things I'd try at the gym: hanging by the hands as long as one can, lat pull-downs, horizontal rows, back machine, seated dumbbell presses, dumbbell front and back wrist curls, all the various standing dumbbell raises, say 3 sets of 12 starting light, and 3 one minute hangs. Twice a week for a couple weeks should make a difference.

I doubt it's CTS. I notice you didn't try the bike fit advice.
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Old 10-03-17, 11:44 PM
  #35  
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Originally Posted by Carbonfiberboy View Post
Just my experience, but I have yet to find an injury that responded to rest.

R. Have to agree with this part and what makes it more frustrating.

Things I'd try at the gym: hanging by the hands as long as one can, lat pull-downs, horizontal rows, back machine, seated dumbbell presses, dumbbell front and back wrist curls, all the various standing dumbbell raises, say 3 sets of 12 starting light, and 3 one minute hangs. Twice a week for a couple weeks should make a difference.

R. That's what I would normally do, but considering my injuries, the inability right now to do that, my age (70), the pain and haven't seen a specialist yet for treatment makes it hard to do that right now.

I doubt it's CTS. I notice you didn't try the bike fit advice.
R. Once I get to see a specialist for treatment I will go over the bike fit advice.

I appreciate the bike fit advice, but personally I'm not too keen on uploading pictures of myself on the world wide web for privacy reasons.

Last edited by sumbikerguy123; 10-03-17 at 11:54 PM.
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Old 10-04-17, 07:18 AM
  #36  
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I visit my son-in-law for stuff like that. He's a Chiropractor. Has always worked for me.
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Old 10-04-17, 07:33 AM
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Originally Posted by sumbikerguy123 View Post
R. That's a dead link?
Try this:

Sports Injuries and Performance
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Old 10-04-17, 08:00 AM
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Originally Posted by sumbikerguy123 View Post
R. Once I get to see a specialist for treatment I will go over the bike fit advice.

I appreciate the bike fit advice, but personally I'm not too keen on uploading pictures of myself on the world wide web for privacy reasons.
Cut your head off if you're worried about it.
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Old 10-04-17, 08:32 AM
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Originally Posted by Carbonfiberboy View Post
Cut your head off if you're worried about it.
Cut off your head and that will be the end of your worries.
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Old 10-04-17, 09:15 PM
  #40  
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Originally Posted by elocs View Post
R. Okay thanks, got it. Sounds about what I am experiencing, although I'm not yet familiar with all the nerves in the hand area. Working on setting up an consult with a specialist in that area.

I haven't done any long distance riding since Jan. 2017, so must be my around town bike or a combination thereof?

Have to look into some of those tips also. I could make a few adjustments on those alone.

Sounds like I could use a nerve conduction test also? See what a doctor says once I get an appointment set up.

Thanks for the link.
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Old 10-04-17, 09:16 PM
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Originally Posted by Carbonfiberboy View Post
Cut your head off if you're worried about it.
R. Before or after?
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Old 10-04-17, 09:23 PM
  #42  
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Originally Posted by elocs View Post
Cut off your head and that will be the end of your worries.
R. A factual statement right? But I got CTS in my right arm have to wait to cure that first.
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Old 10-05-17, 07:17 AM
  #43  
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[QUOTE=sumbikerguy123;19908296]R. Okay thanks, got it. Sounds about what I am experiencing, although I'm not yet familiar with all the nerves in the hand area. Working on setting up an consult with a specialist in that area.

I haven't done any long distance riding since Jan. 2017, so must be my around town bike or a combination thereof?

Have to look into some of those tips also. I could make a few adjustments on those alone.

Sounds like I could use a nerve conduction test also? See what a doctor says once I get an appointment set up.

Thanks for the link.[/QUOTE

Near the bottom of that link it does say: "Furthermore, it has been found that cyclistĺs palsy can be brought on by a single day of mountain biking." So evidently it doesn't always require a long time of long distance riding. I ride a recumbent, so I have no problems with my hands but last summer I had my bike in to get tuned up and they kept it for 2 weeks (they were very busy and evidently free tune ups didn't rise to the top of their list) and I had an old Giant DF to ride and after just 10 minutes of riding I would get a shocking pain from my hands because my weight was on them on the handlebars whereas with my bent my fingers rest lightly on the handlebars. This motivated me to buy a second recumbent off of CL which I paid just $130 and it's the same year and model as my regular bike, just ridden less. So no more hand pain for me.
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Old 10-06-17, 12:58 PM
  #44  
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I have been dealing with low level CTS for a few years now, and also with forearm tendinitis. The tendinitis comes from mountain biking and typing all day. I have Jannd pant leg straps wrapped around my forearms and it helps enormously. For CTS I no longer do century rides and limit myself to 60 miles or less, and usually less! Seems to be working for now. You should try the pant leg straps or even old school toe clip straps, which is what I started out with.
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Old 10-07-17, 07:11 PM
  #45  
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If you have numbness and tingling in the firsts 3 and 1/2 digits, that CTS. As pictured in post above
Look up Phalens test and do it. If your symptoms are reproduced by this maneuver, then you very likely have it. But you might also have other problems, pinched nerves and trigger points too.

Many people think they have CTS when the hand symptoms are caused by trigger points in the elbow muscles.
People with hand numbness, whether CTS or not, often have symptoms in their arm, shoulder, upper back and neck.
CTS can refer and cause secondary problems up the arm to neck, and neck problems can work their way down the arm, eventually leading to CTS.
A simple stretch, which is a real help, straighen arm out, pull straight down on knuckles, then do opposite stretch, pull up on fingers.
Different things work for different people. You can get different opinions from different "competent" doctors.
I'm a Chiropractor and have helped and cured many people with CTS. But others I've treated, no help whatsoever.
I've seen people get perfect results from surgery, others no help and a certain small percentage worse.
Sometimes, shows in the wrist help. Medication probably wont' give you lasting relief.
The neck is very often involved and part of the problem. Many people have tendonitis of the supraspinatus shoulder tendon.
Then there is thoracic outlet syndrome, which even after 35 years of "practice" i find to be a murky concept, but certainly possibly a factor.
For sure, cycling won't help it! I get CTS numbness almost every time i ride, but it always passes.
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Old 12-02-17, 09:07 PM
  #46  
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Thought I would give an update on my progress since my 9/29/17 OP.

I don't have health insurance, so I have to rely on VA healthcare. Sometimes its okay, sometimes its a major accomplishment just to get a simple message to your PC Doc or nurse. I also have been using Veteran's Choice Program (VCP) when the appointment dates are beyond 30 days. I have used this program a few times and its been okay.

But my last two times has been a constant pain in the ass (CPITA). Taking way more than 30 days just to get me on the VCP list. When it should be an auto thing, but someone forgot to do their job putting me on that list. Then it took another 3 weeks just to get approval.

Then the VCP failed to setup the initial appointment, a 5-10 minute phone call. I had to call the VA Patient Advocate several times in order to get the VCP people to do their jobs.

Long story short, I just had an appointment with an Ortho Doc's assistant yesterday, Friday, 12/1/17. So it took Oct. and Nov. or 60 days, just to make an appointment w/Ortho.

The Ortho's assistant did some basic hand manipulations of my wrists/arms trying to duplicate a temporary nerve, muscle weakness reaction. But that didn't work. But I do have pain in both arms severe enough at night for me want to reach for an take Tramadol and Ibuprofen in order to sleep. Although the Tramadrol helps with the pain I don't like taking it as it makes my brain not work very well the day after.

I told the assistant this and she said she would prescribe me a Methylprednisolone 4mg dosepak. I never took this stuff before, but it calls for 6 pills the first day. 5 the 2nd, and so on, until you finish with one pill on the 6th day of the medicine.

I'm on my 2nd day and it does make me sleepy and all I want to do all day is lay in bed. No motivation or energy and feel too weak to do anything. I just feel like **** all day and out of my normal realm of normalcy. I don't like it and am thinking of stopping it, but also thinking I'll just have to suck it up and finish the dose pak regardless of the sides?

I feel less pain in my arms, but the sides make you wonder if its worth it? Anyone here ever take Methylprednisolone 4mg dosepak? If so, what was it like for you?

I'm not sure what the mechanism of action is, something to do with the immune system? Supposed to lessen nerve inflammation somehow?

I told the Ortho assistant from the beginning that I didn't think I had a soft tissue or Ortho/joint/ligament/tendon problem. Rather that I had some kind of nerve dysfunction going on in my arms as a result of riding my bike as my sole means of transportation. She said we don't consider a nerve conduction test at the beginning of treatment.

But after talking to another worker in the Doctors office he agreed that I should see a Neurologist for a nerve conduction test. Apparently he talked to the Ortho assistant and said she would refer me to a Neurologist for a nerve conduction test and that was the extent of my visit.

I did try to set up an appointment with a Neurologist's Office, before doing so with the Ortho appointment. But the VCP gave me a hard time, claiming my GP's initial consult was for an Ortho Doc, not a Neurologist. Then the VCP only allowed treatment on the right arm and shoulder.

When I initially saw my VA PC Doc my whole right arm, shoulder and back was hurting. He initiated a consult with Ortho for this. Then after that my left arm, shoulder and back started acting up, so have to negotiate my left arm side into the consult.

So its a long way around the boat just to get approved for and make an appointment with the Neurologist that I previously attempted do so unsuccessfully? Looks like more calls to my local Veteran's Patient Advocate to get this done?

On another note, I did bring my bike to a local shop to have the handlebars moved up and back some more toward me. Had to change a few cables to do that. Also had the stem moved up to max height. All in all it took some of the pressure of my hands, arms, elbows and shoulders.

I also cut a small sponge in half and put the sponge in my bike gloves to absorb some of the road shock. I run the sponge halves under warm tap water and squeeze out the excess water and towel tamp each one before inserting same into my gloves. Seems to help some or its more comfortable that way.

Kind of hard to find bike gloves with adequate gel or sponge in the correct areas of the glove. Like right where the bundle of nerves runs in the heel of the palm. And that is exactly where I placed the sponges.

So I'll have to wait some more until I can get an appointment approved with a Neurologist to get the nerve conduction test done. To see where the problem is? My VA PC Doc thinks its my Ulnar nerve which runs from just under the elbow to the wrist. Could very well be as that is where the majority of the pain area is.

Thanks for all the replies.
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Old 12-03-17, 06:44 AM
  #47  
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That Methylprednisolone has kept me up all night despite taking 20 mgs of Melatonin. Not good!
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Old 12-03-17, 06:55 AM
  #48  
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Originally Posted by sumbikerguy123 View Post
So I'll have to wait some more until I can get an appointment approved with a Neurologist to get the nerve conduction test done. To see where the problem is? My VA PC Doc thinks its my Ulnar nerve which runs from just under the elbow to the wrist. Could very well be as that is where the majority of the pain area is.

Thanks for all the replies.
Huh ... imagine that. Who would have guessed.


Originally Posted by Machka View Post
If it is your little finger and the ring figure, that's the ulnar nerve and not CTS.

But yes, go to a Dr, and if your Dr says CTS, get a second opinion.

How do I know?

I went to a Dr when my little finger and ring finger went numb ... she was about to book me for CTS surgery, and I practically sprinted out of there. Went to another Dr, was correctly diagnosed with ulnar nerve issues and was given some appropriate ergonomic advice ... problem solved.

But go to your Dr.
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Old 12-04-17, 01:06 AM
  #49  
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Machka: Went to another Dr, was correctly diagnosed with ulnar nerve issues and was given some appropriate ergonomic advice

R. What was that ergonomic device like...some kind of brace you wear around your wrist?

My VA PC Doc knows I ride a bike everywhere, so I guess he was just speculating, but he may be right? You may be right? Once I get a nerve conduction test I'll hopefully have a better idea or confirmation of same?

I watched some nerve conduction tests on YouTube trying to get an idea if those tests have any pain associated with the test? Some YouTube replies said it was painful, others said it was tolerable...whatever that means?

Anyone here ever have a nerve conduction test, if so, what was it like?
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Old 12-04-17, 01:18 AM
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Originally Posted by sumbikerguy123 View Post
Machka: Went to another Dr, was correctly diagnosed with ulnar nerve issues and was given some appropriate ergonomic advice

R. What was that ergonomic device like...some kind of brace you wear around your wrist?

My VA PC Doc knows I ride a bike everywhere, so I guess he was just speculating, but he may be right? You may be right? Once I get a nerve conduction test I'll hopefully have a better idea or confirmation of same?

I watched some nerve conduction tests on YouTube trying to get an idea if those tests have any pain associated with the test? Some YouTube replies said it was painful, others said it was tolerable...whatever that means?

Anyone here ever have a nerve conduction test, if so, what was it like?
Ergonomic advice ... not device. Like how to position my hand, shoulders, etc. when I cycle or use the computer.

No, I haven't had a nerve conduction test.
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