By Joshua Tucker

burning veins/right wrist tendinitis

by Brian V.
(Sacramento)

 marking of pain on right wrist/hand

marking of pain on right wrist/hand

 marking of pain on right wrist/hand  marking of pain on right wrist/hand 2

Since roughly January 2009 I have had problems with my right arm. I do not know what the cause of the problem is directly, it seems to have been a perfect storm of computer classes, a new computer job, and a genetic disposition for weak wrists.

The problem started as just a soreness and a tightness in various parts of my hand, beginning with the outer edge of my pinky side right hand. I believe this to be from using the trackpad on my computer. Switching to the other hand caused the same pain but much more quickly, presumably since my left hand was not used to that kind of operation.

The pain spread and I did seek treatment within a couple of months, but all I was told was use my computer less and I was given a brace. Nobody told me how to use the brace or what to do with it, and after a while I stopped using it.

I've never been seriously hurt before, and tend to bounce back from injuries pretty quickly. I've always had some sort of nagging injury, a sore ankle or something (my physical therapist says that I have a propensity for lax joints and extra flexibility). I am 23 years old.

Slowly but surely my hand got worse and I did nothing about it because it was so gradual. One night I hurt my right hand in a different spot, in the soft tissue between my thumb and forefinger on the back of my hand. I think this was because I was drumming too hard (I am not a drummer). The pain in my hand did not go away no matter what I did, though admittedly I did not try much. After a couple of months I saw an NHS doctor in London who naturally prescribe me two weeks of high dosage ibuprofen (about 1800 mg per day). I was very skeptical but I stuck to the regimen, and after about 10 days the pain that I associated with the drumming stopped. It never came back.

The pain in the rest of my arm continued, however. Consistently for as long as I can remember having this injury the pain tends to follow my veins, which are almost constantly engorged. At its worst, the pain would travel down my forefinger and middle finger, parts of my thumb, and up my forearm towards my elbow. It makes me wonder if I have a problem with my veins…

For much of the issue early on, resting/not using my computer seemed to help a lot. This wasn't always an option. At this point it is also worth noting that I have always had very warm extremities. I don't know if this is just good circulation or what, but have always had very hot hands and feet. Putting my hand in cold water always felt good, so when it felt good to do it post injury I probably did not take it seriously enough.

After one last paper for college and the abuse that came along with typing for two hours straight I decided to get aggressive about my issue. I have two different kinds of ergonomic mice (one that suits my 10 inch hands and that has an arch support, and one that is actually sideways so that my hand does not pronate and I click with my thumb), an ergonomic keyboard, and dictation software, with which I am actually writing this letter. I thought if I minimized my typing that I would heal to 100% like any other injury I've had before.

By this point I'd seen a couple of doctors casually, and one finally suggested that I wear my brace at night when I sleep so that I don't bend my wrist. For the last six months or so I have not missed a night. It was also about six months ago, about February 2010, that I started physical therapy.



Under my PT care I started with isometrics, pushing my hands together in different positions for 10 seconds at a time in five sets. When I showed improvement in strength in testing, I was moved on to upper body strengthening to take the pressure off my wrist. This involved an exercise band with two loops, in the middle of the band jammed in a doorway so that I could pull away from it in different methods to strengthen my back and shoulders. Additionally I was told my posture needed to change (I have a tendency to hunch my shoulders forward, especially when I sit). A few weeks prior to physical therapy I had also taken a regular exercise on a stationary bike, which is something that I did not consistently do before. I was hoping it would improve my circulation and help my healing process. On that note, I generally have a very healthy 3000 calorie a day diet, and appear slim/fit.

Admittedly, I was not very consistent with my physical therapy, save for wearing the brace at night when I was sleeping and doing the isometrics every day. Nevertheless, I did show improvement, which I attribute mostly to less activity and wearing the brace at night.

Eventually my physical therapy consisted of many more things:
-one exercise had me put my wrists over the edge of a table and while gripping an exercise band and stepping on the other end of it, I would “lift” my wrist with resistance to the band, pushing my hand backwards, upwards, or in, much like curling a free weight.
–I progressed to holding a 5 pound weight over the edge of a table with my right hand, lifting my right hand with my left, and then lowering it slowly. It did not take long before I was comfortable using my right hand to lift as well.
–with my physical therapist I designed a device consisting of a large wooden dowel with a hole drilled through its center so that I could pass a rope through it vertically. On the other end of the rope I tied a 1 pound water bottle, and I would use my hands and forearms to twist the dowel until the water bottle reached the top, and then I would lower with just my right hand. This exercise in particular was very difficult, but also made me feel like I was actually doing something to heal my hands the most.

----



Joshua Answers:




----------------------
Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.
-----------------------




Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















Subscribe to The Tendonitis Expert Newsletter Today!

For TIPS, TRICKS, and up-to-date Tendonitis information you need!


Email


Name



Then



Don't worry -- your e-mail address is totally secure.

I promise to use it only to send you The Tendonitis Expert Newsletter.



























Comments for burning veins/right wrist tendinitis

Average Rating starstarstarstarstar

Click here to add your own comments

Dec 16, 2010
PART 2 - burning veins/right wrist tendinitis
by: Max

My hands tend to appreciate activity, and because of the injury they have not gotten much, beyond the computer use that irritates them further. On that note, they tend to feel good when I do things like play baseball, even though it makes sense that this would hurt more. I've been told that it is adrenaline and endorphins that are masking the injury.

?the final step that I made it to in my physical therapy was placing my palms on a countertop and rocking back and forth and side to side adding pressure. This was a big step, because previously it would hurt to do things like push-ups on my palms. Previously I had used things like handgrip strengtheners, push-up bars, and bench press machines to strengthen my forearms, but it is likely that these exercises only hurt me more.


Dec 16, 2010
PART 3 - burning veins/right wrist tendinitis
by: Max

Whew, that was a lot, sorry if it's too much information. I said final step in my physical therapy because about three weeks prior to writing this note I re-injured my wrist in a more serious manner. I was moving a bed and I put too much pressure on my wrist.

My pain has always tended to radiate from the space in my wrist between the bones behind the hand itself on the back of my wrist. I felt a very definite sprain in this spot. I stopped what I was doing immediately and the pain went away immediately, but when I went to cut a piece of meat that night for dinner I felt a sharp pain. I did not wear a brace when I was moving the bed because my physical therapist had told me that I was at a point where I needed to start using my hands normally in order to maintain strength. I am afraid that I will begin to permanently favor my hand as habit.

At this point I went to see a doctor that evening who prescribed icing 20 minutes on 20 minutes off a few times and 1800 mg of Motrin per day for 10 days. I ceased all physical therapy and did what she told me to. The sprain itself did go away, but the general pain in my hand remained. I started light physical therapy again, beginning with the isometrics, and I have not progressed to anything else yet (I hope to this week, with permission).

In the interim, I saw an orthopedic surgeon at Boston's MGH, and he told me what all the other doctors told me: there doesn't seem to be anything wrong with you. As usual, I had full range of motion and no pain as long as my hand was not activated (he could bend it any way he wanted to). At my request, he gave me a cortisone shotCorticosteroid Injection in my wrist, as I recall my father having a trigger finger issue that was permanently resolved by a cortisone shot.

My father also has abnormally large spacing in the same area of the wrist that causes me pain.

The shot seemed to work at first, decreasing the swelling of the veins and relieving some pain. The pain is not terrible right now, although often it feels like I am injured without pain, a sort of weakness. As usual, the pain seems to follow the path of my blood veins and subsides some when I elevate my hand. Icing always feels good. Is it part of both the ice too much and become attached to it permanently?





Dec 16, 2010
PART 4 - burning veins/right wrist tendinitis
by: Max

I am still icing with bags of ice for 20 minutes at a time about four or five times a day. I recently started elevating my hand above my heart while icing. Often the greatest relief that I feel is holding my hand up to my shoulder so that the blood can drain out. Most of the pain I feel comes from my engorged veins, save for the consistent pain I feel from the space between my bones behind my wrist. I have had x-rays and MRIs on my hand and wrist and while the MRIs may have shown some sort of injury they were inconclusive.

Lastly, if I place my hands on a tabletop and lean forward there is a visible puffiness in my wrist on my right hand that does not exist on my left. This may be coincidence, I never thought to look before it hurt. The most recent development that my hand has had is that the area between my thumb and forefinger close to my wrist has felt tight when I make a fist.

I started my own ice dip regimen yesterday (Tuesday the sixth). I filled a 5 gallon bucket with water and put in about a gallon of ice, then submerge my hand for about 20 seconds before bringing it back out. I did this every minute or two for about an hour and 15 minutes, when the ice melted. Aside from feeling very good (it has always felt good to put my hands in cold water), the engorged veins on the back of my hand slowly but surely shrunk. They had always done this when I iced with an ice pack, but grew again after a few minutes.

After an hour and a half of ice dipping, the veins took quite a while to grow back, and the biggest difference that I noticed was that when I elevated my hand the blood tends to drain out much more quickly now. Maybe it is just a hope that I have acquired from reading your website, but I have at least accomplished one days worth of therapy successfully. Do you think it is too early to start massaging with ice in a Dixie cup? I am very eager to have my hands back?

Please let me know if there's anything else you need to know, and thank you so much for taking the time to educate me on the healing process.

Best regards

Max

Dec 16, 2010
PART 5 - Joshua Responds - burning veins/right wrist tendinitis
by: The Tendonitis Expert

Hi Max.

What you describe is pretty much the common experience of people that end up on my site. Some people have less pain, some more, but the progression and doctor/pt experience is pretty much the same.

1. Yes, absolutely, ice dip. As much as possible for a full 7-10 days. This is not a fix, but it is a pain reliever and makes other good things happen.

2. Not to early for ice massage. Never too early.

3. Magnesium, my friend, Magnesium for Tendonitis. Anything but oxide. Start at that link, then follow the 'magnesium dosage' link at the bottom.

I'm going to be out for 5 days heading to the 2010 Crossfit World Games working on the finalists. Hit the ice dip hard, get as much mag in you as possible (watch out for that tolerance level, too much is no fun), and massage/ice massage. Just get in there and gently/firmly squeeze/stretch everything with your hand/fingers etc. Let me know what happens after a week of that.

Point being, you're in pain, but you're experience exactly what I'd expect you to be.



Dec 16, 2010
PART 6- burning veins/right wrist tendinitis
by: Max

Hi Joshua

So I have been ice dipping, for 15 seconds at a time usually over the course of one to two hours (every minute or two). I have done it for eight days now, and I am experiencing some mildly positive results. It is certainly better than using an ice pack for 20 minutes on 20 minutes off. I told my physical therapist, and she recommended that I dip my hand in warm bath water for two minutes before my 10 second ice dip.

I have not tried this, mostly because I am wary of what it says on your site, that heat can make inflammation worse. My PT does not feel this way, nor does she think that an ice massage will work for my issue. I decided to just do the ice dip without a hot water bucket in order to see how that felt. I have tried an ice massage once, and I don't think it did much for me. Maybe I was doing it wrong.

I have been dosing 500 to 900 mg of magnesium every day. The first 100 mg comes from my daily vitamin. I get another 400 from a dietary supplement that also gives me 1000 mg of calcium and 15 mg of zinc. Should I be dosing more? I am a 6 foot two, 23-year-old, 180 pound male, and my diet is usually about 3000 calories per day. I probably get a lot of magnesium from my diet as well, since it often consists of dark cooked vegetables.

Finally, I am back to doing my physical therapy. Right now I use the hand bicycle at the gym for 10 minutes every day with light resistance, and I also twist a stick with a rope and a 1 pound weight on the end for two sets of 10. I'm also lowering 3 pounds off the edge of a table by holding a weight in my fist.

All of these things combined seem to be helping. I am doing my best to be careful. Thanks again for your help.

Regards

Max

Dec 16, 2010
PART 7 - burning veins/right wrist tendinitis
by: The Tendonitis Expert

Hi Max.

500-900 Mag is probably plenty good. In general, Mag is good for you on a variety of levels, so once you're out of pain you may or may not want to keep those levels. Even if it's supplementing that much for a month, then a month off, then another month, etc.

Having said that, find your tolerance level, and stick there for a while.

Warm before cold, sure. Don't need two minutes, just run them under hot water for a few seconds. Depending on the situation, heat doesn't necessarily make inflammation worse, but it doesn't fight inflammation. Hot cold hot cold is great, but I would ALWAYS finish on cold.

I would give the ice massaging another whack. Frozen water bottle, and use it as a tool. Pressure, and push at different angles. Basically a massage tool, but also you're getting specific stretch to the tissue in there. Work the entire muscle structure, not just the tendon. And like most things, keep at it for a while. Once just isn't enough.

Things still getting better?



Click here to add your own comments

Join in and write your own page! It's easy to do. How? Simply click here to return to Wrist Tendonitis Q&A.