Please help my severe right wrist pain tendonitis

by Joe
(California)

I have had right wrist pain for almost seven months now. I am not faking.


No history of injuries. 32 yr old male.

Injured at my job and went on Modified work at 24 hours. My work put me at full time (40 hours) and forced me to use my right arm after specific instructions from the doctor not to.

After that work week, I experienced complete right side paralysis. Unable to move my entire arm, neck, head. It subsided after a Tordol injection. I have been unable to work since then.

I had two X-rays, an MRI and an EMG test done. All were negative.

They have continued to classify it as wrist tenosynovitus and used the "wait and see" approach. All of my doctors now say I'm faking and try to clear me for work.

My hand surgeon said he found tears in my ligaments that other doctors did not see. He has tried to request exploratory surgery but it has been denied.

My physical therapist thinks it has something to do with the sheath that allows the tendon to slide in and out.

I am in extreme pain all day long. The average pain level is 6-8 out of 10. I cannot twist my wrist or lift any type of weight with it. I have to be laying down for most of the day because of the pain. There is no sign of distortion, swelling or inflammation.

I cannot sleep, and if I do, it is only for a couple of hours. I have been in a cast for about 90% of the time because without the support the pain skyrockets. The 10% is for when I'm actually asleep.

I've had 8 tordol shots, a steroid injection, have been on naproxen, gabapentin, tramadol, norco and maloxicam. The injections provide one day of relief. The medications do nothing at all.

I have no other option than surgery. But nobody has a clue what is wrong with me and therefore they go to the default medical evaluation.

No attorney will help me because they say that it is just a really bad wrist strain and in the eyes of California, it is not a permanent disability and therefore I won't be awarded any settlement.

Have you heard of anything like this before? It's not tenosynovitus anymore. It's not carpal tunnel. It's not tendinitis.

Hypothetically speaking, if I were to sprain my wrist, but overuse it with repetitive motion for 40 hours straight (checking and bagging at a supermarket) what injury would that yield?

Nobody wants to entertain the idea because the doctors I'm sent to work for the company I work for as well. So they don't want to admit fault and they are trying to prevent any type of lawsuit.

Any type of information or experience will help. I need to figure out my next step soon.

Thank you.



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Joshua Answers:

Hi Joe.

1. "I experienced complete right side paralysis."

What does that mean, exactly? You couldn't move due to pain, or you had/have no motor control over your arm etc?


2. "Nobody wants to entertain the idea because the doctors I'm sent to work for the company I work for as well. "

Yeah....that's problematic.


3. "All of my doctors now say I'm faking..."

"My hand surgeon said he found tears in my ligaments that other doctors did not see. He has tried to request exploratory surgery but it has been denied."

Welcome to the workers comp system. I don't have anything nice to say about all of that.


4. Where was the Tordol injection? Neck? Hand? If neck, why did they do it there?


5. Any history of whiplash, falling down the stairs, boxing?


6. What ligament did a doctor think he saw tears in? And how? On an MRI?


7. "what injury would that yield? "

Except for the 'can't move neck/arm' thing, it sounds like really bad Tenosynovitis.

The tendon sheath gets inflammed, constrictive and VERY VERY irritable and painful.

Then long story short you get stuck in that pain dynamic.

It's reversible, but your doctors don't know dick about it and at best could do surgery to cut the inflamed/swollen/constrictive tendon sheath.

The complication there of course is that there are multiple factors at play, and surgery ignores almost all of them. It may be helpful to destroy the tendon sheath, but it's not a magic bullet that solves the entire problem because...it ignores the factors that got you to where you're at.

Which is, the Tendonitis Dynamic and it's Pain Causing Dynamic.

Basically, that's:

- Muscle and connective tissue tightness (hand and forearm) that causes tendon sheath problem.

- Process of Inflammation which causes tightness and a lot of pain.

- Nutritional insufficiency: Your body doesn't have what it needs to work correctly, thus you're stuck in a pain dynamic and can't get out of it (and resulted in the original pain/problem as well).


Make sense so far?







See Related: Tendonitis Is Pain In Wrist After Carpal Tunnel Surgery Workers Comp Hassle

See Related: Severe Tendonitis How To Prove It Is From Work?


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






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Nov 13, 2017
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Update
by: Joe

Thank you for your response. I wanted to wait until I got the arthrogram results before I continued. Worker's Compensation had approved it promptly a month later.

Unfortunately, it showed everything intact and normal. They could not determine the source of the pain and continue to not have any answers.

To answer your questions:
1. Right side paralysis
I awoke to my right arm, neck, head completely frozen. Unable to move any such part: fingers, elbow, shoulder. No motor control, a lot of pain when trying to move. It was as if I slept on my neck incorrectly (which I didn't, just an example of the feeling), but so bad that I was paralyzed. It did not return after the doctor's visit.

2. Tordol Injections
It was because of the paralysis that I started to receive Tordol shots in my buttocks. It alleviated the paralysis but severe pain replaced it after only half a day. Sometimes even sooner.

They said that the buttocks was the only place to receive the amount administered.

3. History
Only history of trauma is a concussion about 12 years ago. I lost my sense of taste and smell but it did not physically impair me in any way.

4. Ligament Tear
After I got denied for surgery, I asked my hand surgeon to be my representative for the appeal. He declined. I guess he just wanted the free money from workers compensation. The arthrogram also found no tears.

I have read what you have written about tendonitis.

My big questions are; if the tendon sheath is irritated/inflamed/constricted/painful, why can no doctor locate or even verify that there is a problem? (Two X-Rays, MRI, EMG, Arthrogram) Basically, I'm looking for something to give me proof of injury and a definitive time table. What test is next to actually show that? With all the technology, there has to be one last option besides exploratory surgery?

I am seeing my pain management specialist on the 15th and I had hoped the arthrogram would give answers. My physical therapist is dumbfounded. He has no idea what to do next. I have researched online and I can't find any other test I can take. Medications don't work. Marijuanna doesn't work. Alcohol doesn't work. Sleep aids don't work. Therapy doesn't help.

I have lived in constant pain and without full use of my right arm for eight months. It wasn't by my own doing, and the prolonged severity indicates something major is going on. I refuse to accept it as a mystery or that I did this to myself or that this is my new life. Which is what they are trying to tell me.

So how on earth do I convince them that I am literally being tortured every day with the pain, when all of the tests say otherwise? Even if surgery isn't the magic bullet, how do I get them to at least realize that it needs to be considered? What would you do next Mr. Tucker?


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Joshua Comments:

"My big questions are; if the tendon sheath is irritated/inflamed/constricted/painful, why can no doctor locate or even verify that there is a problem? (Two X-Rays, MRI, EMG, Arthrogram) "


If the tendon sheath is inflamed/heavily inflamed, it will show up on an MRI.

If it's not, it won't.

IF a tendon sheath is compressed/constricted (pulled compressively tight from elsewhere) it won't show up on anything.



"Basically, I'm looking for something to give me proof of injury and a definitive time table. What test is next to actually show that? With all the technology, there has to be one last option besides exploratory surgery?"

You'd think so, wouldn't you. But unfortunately, some even disabling problems are too subtle to be imaged, depending on what it is.

Injury means rip/tear. But lots of problems come just from compression. Potentially anywhere.


"So how on earth do I convince them that I am literally being tortured every day with the pain, when all of the tests say otherwise?"

When the tests don't show anything obvious, that's the end of their ability to believe. No positive test must OBVIOUSLY mean there's nothing wrong, right? *eyeroll*


"Even if surgery isn't the magic bullet, how do I get them to at least realize that it needs to be considered?"

Surgery is unlikely to be a magic bullet, especially if they don't have any idea where to start other than 'well, how about right here'?

What is exploratory surgery going to find that an MRI can't? (They should be able to answer this definitively.)

I'm not a fan of exploratory surgery, no matter how desperate the patient is, because it often just results in more pain and desperation.

If there was some kind of educated guess about what they might find exactly where, then maybe maybe.

I'm not sure how you can convince them of anything.....a doctor's office is a tough place to try to do something like that.


"What would you do next Mr. Tucker?"

1. What is your vit D level?

2. How much if any magnesium are you taking?

3. Where exactly did they do mri imaging? What areas?

4. "It did not return after the doctor's visit."

What did not return after the doctor's visit? Feeling/movement, you mean?












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