Help with hand pain
08-08-23, 03:49 PM
#26
Newbie
Don't know if this will help, but I had a bike fit session today for the same reason. My hands were going numb. He basically put me on a fit machine thing, tried various positions, and ended up moving my saddle back and dropping the seat post quite a bit. That's going to take some getting used to. I sure hope it helps. It did change the relationship between my upper body and the bars. Oh, and he sold me some gloves with much thicker padding than the ones I had been using.
08-09-23, 08:24 AM
#27
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Long time lurker here, first time poster.
I hereby summon the Sages.
I need your advice on a hand injury, maybe you've experienced a similar situation, or know someone/read about it. I'll really appreciate any leads on the diagnose, the right professional to approach, tests, etc.
For the past week I've been suffering from pain in my right hand. It started while cycling up a mountain trail (light gravel), as a shooting pain starting in the bottom of my wrist (center) and going right to my thumb/index/middle fingers (I suspect nerve-related as it shoots up like through a pipeline). It was triggered by weight/pressure/effort on my hand, as soon as I was on the hoods or hit the brakes, it would kick in (9/10 pain). If pain wasn't triggered, there was a constant pain in a specific spot (middle of the union between the wrist and the forearm) but at a lower intensity (3/10). I aborted the ride and at one point on my walk home, all my fingertips went numb (I can't pinpoint what triggered it), it stayed like that for 5-10 min and then it went away (haven't had numbness since). While off the bike, weight, pressure and effort on the right hand triggered the pain. One week after the incident, pain hasn't gone away, though triggering sensitivity has decreased.
I'm 38, 100kg, I've been cycling for 10-15 years now, but long-ish distances (40-70km) for only the past year (I'm planning for long bikepacking trips), and I had wrist pain in the past year on those long rides (numbness), but they went away after a bike fit setup optimization. There was no gradual pain leading to last weak.
Post bike fit, I did mess with the hood position and I'm probably throwing my weight on my hands as I haven't been using my core; both could be our main suspects, I guess
I'd like to get a diagnose to figure out what the damage is and what the recovery options are, and then back to a bike fit (no messin' around this time) and training to have the right position on the bike.
I live in Quebec, Canada, and while (most) health care is public, waiting times are insane and getting referrals from a GP are a pain. Unless I want to spend 3-4 months to get all the correct forms and authorizations, I really need to know the full roadmap to the right test/specialist by the time I meet my GP.
Any leads on what this thing could be?
Focalized tests? (EMG/Ultrasound/MRI?)
Does this sound like I'd need to check the spine? Other areas?
Would diagnose for this be something for a neurologist to assess? Physiatrist? Other?
I hereby summon the Sages.
I need your advice on a hand injury, maybe you've experienced a similar situation, or know someone/read about it. I'll really appreciate any leads on the diagnose, the right professional to approach, tests, etc.
For the past week I've been suffering from pain in my right hand. It started while cycling up a mountain trail (light gravel), as a shooting pain starting in the bottom of my wrist (center) and going right to my thumb/index/middle fingers (I suspect nerve-related as it shoots up like through a pipeline). It was triggered by weight/pressure/effort on my hand, as soon as I was on the hoods or hit the brakes, it would kick in (9/10 pain). If pain wasn't triggered, there was a constant pain in a specific spot (middle of the union between the wrist and the forearm) but at a lower intensity (3/10). I aborted the ride and at one point on my walk home, all my fingertips went numb (I can't pinpoint what triggered it), it stayed like that for 5-10 min and then it went away (haven't had numbness since). While off the bike, weight, pressure and effort on the right hand triggered the pain. One week after the incident, pain hasn't gone away, though triggering sensitivity has decreased.
I'm 38, 100kg, I've been cycling for 10-15 years now, but long-ish distances (40-70km) for only the past year (I'm planning for long bikepacking trips), and I had wrist pain in the past year on those long rides (numbness), but they went away after a bike fit setup optimization. There was no gradual pain leading to last weak.
Post bike fit, I did mess with the hood position and I'm probably throwing my weight on my hands as I haven't been using my core; both could be our main suspects, I guess
I'd like to get a diagnose to figure out what the damage is and what the recovery options are, and then back to a bike fit (no messin' around this time) and training to have the right position on the bike.
I live in Quebec, Canada, and while (most) health care is public, waiting times are insane and getting referrals from a GP are a pain. Unless I want to spend 3-4 months to get all the correct forms and authorizations, I really need to know the full roadmap to the right test/specialist by the time I meet my GP.
Any leads on what this thing could be?
Focalized tests? (EMG/Ultrasound/MRI?)
Does this sound like I'd need to check the spine? Other areas?
Would diagnose for this be something for a neurologist to assess? Physiatrist? Other?
The pain distribution, as described, is median nerve and far and away the most likely cause is entrapment in the infamous carpal tunnel. See a neurologist or a physiatrist who does neurodiagnostic studies for a diagnosis and a course of conservative treatment (splinting and anti-inflammatories). Then, if necessary, a hand surgeon.
Carpal tunnel is not a pressure, so much as a positioning, issue, but can come about simply from wear and tear degenerative changes and swelling in the other things the nerve shares that tight space with.
Last edited by MoAlpha; 08-09-23 at 08:30 AM.
08-09-23, 06:37 PM
#28
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Therefore, when I agree with @MoAlpha ("The original Alpha Mo"™) it carries weight.
I'd bet you are holding the bars in a way which presses in a way it shouldn't.
The pain distribution, as described, is median nerve and far and away the most likely cause is entrapment in the infamous carpal tunnel. See a neurologist or a physiatrist who does neurodiagnostic studies for a diagnosis and a course of conservative treatment (splinting and anti-inflammatories). Then, if necessary, a hand surgeon.
But also, try being really careful about where you rest your weight. You always want a direct bone line or a fleshy/muscular pad on the bars, and never between pads or bones. Cheaper to change your holding habits than to see a doctor (though probably harder.)
08-09-23, 07:14 PM
#29
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Somewhere in my attic I have an old piece of paper saying I'm board-certified as a neurologist, so I'll chime in with some informed speculation.
The pain distribution, as described, is median nerve and far and away the most likely cause is entrapment in the infamous carpal tunnel. See a neurologist or a physiatrist who does neurodiagnostic studies for a diagnosis and a course of conservative treatment (splinting and anti-inflammatories). Then, if necessary, a hand surgeon.
Carpal tunnel is not a pressure, so much as a positioning, issue, but can come about simply from wear and tear degenerative changes and swelling in the other things the nerve shares that tight space with.
The pain distribution, as described, is median nerve and far and away the most likely cause is entrapment in the infamous carpal tunnel. See a neurologist or a physiatrist who does neurodiagnostic studies for a diagnosis and a course of conservative treatment (splinting and anti-inflammatories). Then, if necessary, a hand surgeon.
Carpal tunnel is not a pressure, so much as a positioning, issue, but can come about simply from wear and tear degenerative changes and swelling in the other things the nerve shares that tight space with.
It was triggered by a skiing injury, where I managed to catch my hand just right in the pole loop (we still used poles with leather loops for downhill back then), in a fall. Hyperflexed my wrist, and it never did completely repair itself.
I had some very tedious job where I needed to write out stuff in longhand, all day , every day. So eventually I got tired of the pain and dysfunction, got one of those nerve transmission studies, and found an ortho surgeon.
He did the release operation, which is supposed to make more room in there for the nerves to run about. I wish I could tell you it worked, but it was only a partial fix, and I didn't really overcome the issue until I changed jobs to one that was less hand motion intensive.
But without seeing some sort of neuro guy who will do the studies and give you a diagnosis, it's too soon to lose hope. I can remember a couple of direct to the joint cortisone injections, and a course of anti-inflammatory meds before we gave up and opted for surgery. You might well be able to overcome this with rest, some other sort of cross training activity, and a reevaluation of exactly how you fit on your bicycle. And if you don't already use them, corked bar tape and gel padded gloves are standard equipment for me. One of the reasons I love downtube shifters is that they enforce the moving my hands around thing, that was mentioned earlier.
Nobody ever mentions that in the ergo brifter wars.
08-09-23, 10:58 PM
#30
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I agree with MoAlpha about seeing a neurologist or hand surgeon to accurately diagnose and find a treatment protocol
I was having issues with my left hand going numb or intermittent pain. Like you, I primarily had my hand on the hoods with most of my weight on my hands. After reading several threads and web sites, I
1. raised my stack dramatically,
2. double wrapped my handle bar tape,
3. got a shorter stem and
4. bought gel padded gloves.
5.I also worked on strengthening my core so my weight wasn’t thrown forward.
6. I also got off the hoods as much as possible and on the tops (not the drops). I only ride the hoods if changing gears or need to be prepared to brake.
I made quite a few changes and aye chi wa wa, I am riding pain and numbness free.
Best of luck.
I was having issues with my left hand going numb or intermittent pain. Like you, I primarily had my hand on the hoods with most of my weight on my hands. After reading several threads and web sites, I
1. raised my stack dramatically,
2. double wrapped my handle bar tape,
3. got a shorter stem and
4. bought gel padded gloves.
5.I also worked on strengthening my core so my weight wasn’t thrown forward.
6. I also got off the hoods as much as possible and on the tops (not the drops). I only ride the hoods if changing gears or need to be prepared to brake.
I made quite a few changes and aye chi wa wa, I am riding pain and numbness free.
Best of luck.
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08-10-23, 11:14 AM
#31
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08-10-23, 11:26 AM
#32
Junior Member
I had carpal tunnel release surgery last year in both hands and it changed my life.
But I wouldn't just jump to the conclusion that is what it is.
You need to get a nerve conduction study to diagnose the problem.
But I wouldn't just jump to the conclusion that is what it is.
You need to get a nerve conduction study to diagnose the problem.
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08-10-23, 12:16 PM
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