I'd like to ask a question on carpal tunnel syndrome management here as I know some have experienced it and some have clinical knowledge. Sorry for the length; I hope it's clear. 12 mths ago: symptoms began to worsen markedly (after 18mths of milder ones), with significant sleep disturbance from dead or tingling hands. Was waitlisted for surgery (public, in Melbourne, no PHI). Tried (competent) physio without benefit. Tried a course of prednisone 25mg which helped greatly, but only for the time taking it.
7 mths ago: Middle finger tendons started catching in the wrists, leading to ultrasounds, steroi_ injections, and updated referral for surgery. Still triaged as "routine". The injections mainly made good sleep possible, with gradual (perhaps unrelated) fading of the tendon-catch problem.
Last four mths: increasing sleep disturbance again, plus daytime "buzzing" in the hands (very strong after exertion), occasionally dropping things, some difficulty gripping hard, then recent occasional jolts of nerve pain with certain movements and strong morning stiffness of hands. I have tried taking a single 25mg prednisone about every 10days just to give me a night or two of full sleep. The GP reluctantly agreed to this approach.
Fortnight ago: I've been on the hospital waiting list for 11 months. I went back to the GP to get referred for repeat steroi_ injections. GP also updated referral to hospital given established functional impairment. As there usually has to be a gap between steroi_ injections and surgery ( the literature indicates more than 30days is clearly advisable, but various surgeons/services seem to say anywhere between two and six months), GP told me to wait until triaging was clear, then call the hospital to talk about the necessary injection-to-surgery gap. Alas, the hospital does not appear to have completed triaging in the fortnight since.
In the intervening fortnight I've had two new symptoms: (1) one morning where an attempt to close my hand caused intense tendon pain across one hand (became milder over the day and abated by evening). No obvious unusual use in the day prior. (2) The following night I was woken by excruciating nerve pain across the fingers of the same hand, lasting perhaps 30minutes (I didn't quite reach full alertness, but by the end of the doze/dream state I was contemplating whether I'd need to go to Emergency if it went on much longer). Thankfully this has not yet recurred.
I'm seeing the GP in a few days' time, but I feel I need to be better prepared for various planning and symptom management scenarios. AND I'm travelling for three weeks from late August, so the window for (hypothetical) surgery-plus-travel-safe-recovery is now effectively closed.
If updated triaging means I might actually get surgery in the next, say, four months, then injections may be unwise, leaving me with no previously-tried management options, and some clearly more serious symptoms popping up occasionally. If I'm still a "routine" case, then the injections would presumably give me a few months' amelioration (and make travel more pleasant). To be clear, I do still have reasonably good use of both hands most of the time. Any suggestions/thoughts welcome.
