Join 3,376 readers in helping fund MetaFilter (Hide)


My hands and wrists hurt. Help?
December 12, 2013 3:38 PM   Subscribe

My hands and my wrists really hurt doing any activity that engages them, I don't see my doctor for until December 29th, and I have things I need to get done involving my hands. Looking for some ideas/short term solutions to keep functioning until I see the doc next in a couple weeks.

Diagnosed with fibromyalgia after I started having widespread pain 2+ years ago. Under regular pain management care. Wrists/hands started hurting in the spring, but peaked mid-summer and that's when I brought it up to my doctors. We're unclear how much is related to fibromyalgia or if it's something else entirely.

It's very limiting. Any activity engaging the hands hurts, (typing this hurts, but hoping to get some useful information out so pushing my way through it.) Typing, holding book, paper or tablet, writing, drawing, opening things, scrubbing, all things that make it worse. But sometimes it is only a little pain with a lot of activity, sometimes a lot of pain with a little activity.

I don't think it's related to the fibromyalgia, but I don't know. Two pain doctors have said the same thing, but my pain doc that specializes in fibromyalgia wanted to wait and see if the course of treatment I'm on now would help. I'm basically taking muscle relaxers at night, and doing physical therapy, but the physical therapy doesn't involve my hands.

The pain runs from my hand up my arms to the elbows, though most of it is in the hands and wrists. Both the pinky side and the thumb side are affected, but the thumb side is worse.

Previously I had not been able to tell if there were actual swelling or warmth from the painful areas. I thought it looked a little swollen but it was hard to tell. Last night and today, I can tell that the thumb side is warmer on both hands, which I assume means there is some inflammation.

Two pain doctors have looked at my hands, and didn't find anything specific. They did strength tests and pressed various parts of my hands. My strength was normal in those tests, though last night I couldn't unscrew top off a bottle of soda. Pressing various parts mostly didn't hurt, though one doctor did find the part of the palm near my thumb that was somewhat sensitive to pressure in both hands. Not as significant as the pain alone is.

I find myself massaging my forearms, wrists and hands a lot when the pain is bad. The tendons or muscles, or whatever they are seem really tight.

I have tried a number of braces and those make the pain worse. Two doctors suggested it didn't matter what kind, just so it immobilizes the wrists, but I've read online that it does matter. If I try sleeping with them (another suggestion from one of the doctors) I wake up within an hour and need to remove them.

It's gotten really bad out of the blue again, and it couldn't come at a worse time. Not only that, but I can't get in to see anyone sooner because everyone is trying to get in to the doctor before years end. I could possibly get in with my Primary Care Physician, but not sure what she could do.

I have a number of things I am trying to complete in the next two weeks that involve typing and using the mouse. The longer I use my hands, the worse the pain ramps up. I do have tylenol 3 to help with the fibromyalgia pain, but it barely takes the edge off.

I'm also having some of the worst fibromyalgia pain the past couple weeks, it's possible it is related.

I know you're not my doctor, but I'm out of ideas. If anyone has any suggestions about how I can manage the next couple weeks with some functioning before I see my doctor, I would greatly appreciate it.
posted by [insert clever name here] to Health & Fitness (16 answers total) 2 users marked this as a favorite
 
I would see an acupuncturist if I were you.

You can also try Zyflamend, and/or take additional ginger, turmeric, and boswellia everyday. These are potent anti-inflammatories. Don't be afraid to use large quantities. A capsule or two won't do anything. If you take turmeric take bioperine (black pepper extract), or your body will not absorb it. I believe bioperine may also increase absorption of pharmaceutical meds so be careful.

Maybe try relaxation techniques like guided imagery, meditation, and breathwork.
posted by Blitz at 3:45 PM on December 12, 2013


Talk to whoever is prescribing the Tylenol 3 and ask for something else. You may benefit from a painkiller that is more anti-inflammatory or a combination of drugs. If the Tylenol 3 is not resolving a significant portion of the pain, it's not the right drug for you right now. They have other options. You should be able to get this done without seeing the doctor. Frankly, be aggressive if you need to, being in that much pain and losing that much function cannot wait until your appointment on the 29th.
posted by quince at 4:11 PM on December 12, 2013


Sorry you're going through this.

Did you try if cooling or warming helps with the pain?

You could also try some topical pain relievers, there are gels and ointments geared towards athletes. But ask the pharmacist is there are any side effects when mixed with your existing meds.

If there is someone else to help you, definitely ask them to help you. Even a neighbor or a school kid you pay $10. Small hacks like filling drinks in a jug or into a bottle with a straw could help you out not to use your hands so much. Try to avoid all the things that make your pain worse and ask them to prepare simple meals, change the bed, take items out of cupboards, put your papers and electronics in place so it becomes easier for you to use them.

Would it be possible for you to record your work and have someone else type it? Or you could use a pen to type (slow I know, but holding a single object might put less stress on your hands than typing with 10 fingers).

Could you learn to use your mouse with your foot? There even is a footmouse.

There is more info on disabledhands.com.
posted by travelwithcats at 4:12 PM on December 12, 2013


Damn, sorry to hear you're going through this. You say you're taking muscle relaxants, but you don't mention anything about painkillers. Maybe this is just too obvious since I imagine that as someone with fibromyalgia you have more experience with pain management than most, but could you try an NSAID like ibuprofen or naproxen? It's unlikely to make severe pain actually go away, but it might make it bearable in the short term. An NSAID will also reduce the inflammation some, which will help even more if the inflammation is itself causing some of the pain. My favorite OTC pain remedy is actually to take ibuprofen and acetaminophen together, at the maximum safe daily dosage. Be careful about maxxing out your acetaminophen dosage though (especially if you are on other medications, many of which are combined with acetaminophen) because acetaminophen poisoning is awful and even if it doesn't kill you can do real damage to your liver. It's OK to take the maximum recommended dose, and it's OK to combine it with Ibuprofen (they are different classes of drug and do not interact) but do not exceed the maximum dosage.

Other than that, I'm not sure. There's a whole bag of tricks you might try, though I imagine you've already heard of most of them. If you can see or talk to your physical therapist before your doctor, she or he might be able to recommend some simple exercises you can do that are at least unlikely to do any harm (hopefully after you've talked to the doc your PT will be able to give you more specific recommendations). There's also the old "pain-free activity" treatment, which is sort of the most basic and least dangerous type of PT; rather than keeping your hands and wrists still, try to use them as much as you can do without making the pain worse, to keep them limber and facilitate blood flow. That said, you should try as much as possible to avoid tasks that aggravate your pain.

There are also a variety of trackballs, ergonomic mice, and ergonomic keyboards out there that might be of help to you. Perhaps a keyboard and pointer that puts your wrists in a more neutral (or even just a different) position would help you to avoid putting stress on whatever parts of your hand and wrist are complaining. I can't recommend a specific one, but you could look at a few and choose one that you think would work well for you.

You might also experiment with hot and cold compresses – heat will help relax your muscles and tendons, while cold will reduce inflammation. One or the other or both might help you. Long hot baths with Epsom salts are also an option as a muscle relaxant, and Epsom salts can be used in compresses as well.

Additionally, you could visit a massage therapist who specializes in pain management. There's a mountain of research supporting massage as a viable pain-reduction therapy (much more than for acupuncture or herbal supplements, both of which I would avoid as they are unregulated, unsupported by research, and potentially dangerous). It might seem odd to you to go get a massage specifically for your hands, wrists, and forearms but I guarantee it won't seem odd at all to an experienced massage therapist.

The final thought I have is that you might try one of those OTC capsaicin ointments. Capsaicin is used clinically (usually at higher concentrations than are available OTC) to treat pain caused by peripheral neuropathy. I don't know if an OTC version would be strong enough, or if your pain would respond to capsaicin at all, but it wouldn't do any harm and there's a chance it might help.

Good luck. Chronic pain is no joke. I hope you can get through the next few days (you will, one way or another!) and that your doctor can figure out what's going wrong and prescribe you some effective treatment.
posted by Scientist at 4:15 PM on December 12, 2013 [1 favorite]


Oh, sorry, I missed that you are already taking (or at least have access to) Tylenol 3. I still stand by my painkiller advice above though. Look into whether it's safe to combine NSAIDs with the codeine that's in Tylenol 3, but if it is then I would try stacking some ibuprofen on top of it. If it's not safe, I would try taking regular acetaminophen and ibuprofen in combination, to see if that helps you any more than the Tylenol 3 does. The anti-inflammatory effect of the ibuprofen might do you more good than the narcotic effect of the low-dose codeine.
posted by Scientist at 4:18 PM on December 12, 2013


Note to self: I really need to stop with the serial answering.

I would really like to echo the sentiment that if you are having severe chronic pain that is impairing your ability to function (which is what you describe) you should push your doctor to give you an appointment earlier than the 29th. What you are dealing with is serious, and you shouldn't have to wait that long. If nothing else, she/he might be willing to give you a non-refillable prescription of a stronger narcotic that you can take until he/she has time to see you for a full appointment. It's also possible (I can't say how likely, but possible) that what you are experiencing is a symptom of some kind of underlying degenerative condition, and waiting three weeks might make the difference between recovering or not.

If there's any way that you can get your doctor to squeeze you in earlier, do so. Emphasize that you are suffering severe, chronic pain that is significantly impairing your daily function and that it is urgent that you see the doctor as soon as possible.
posted by Scientist at 4:27 PM on December 12, 2013


Only a minor thing, but it took me about a week to get used to sleeping in a wrist brace, and I only had it on one hand. This is obviously just an off-chance thing, but basically I have a bone spur or something in my wrist, developed after an injury some years ago, that is seriously aggravated by my sleeping on it at bad angles... different enough that I'm not saying this is necessarily going to help you, but generally, it took a bunch of time to adjust to and I would have sworn it wasn't working at first, I just needed to give it more time. Even now, when I stop, the pain eventually comes back and it takes a few days of keeping it immobilized before it really eases up.

So there's just a possibility that actually wearing the braces more regularly for a more extended period, especially at night, could have an impact even if more occasional use hasn't, if the pain really is from something related. That, and I never got nearly the benefit from Tylenol that I did from Aleve or ibuprofen, since mine at least is very inflammation-based.
posted by Sequence at 5:23 PM on December 12, 2013 [1 favorite]


I wear this, and it is pretty much the best thing ever. The only thing that works as well as this to control my pain, when I have a flare-up, is a steroid shot (which I hate.) The key bit is the thumb spica. I wear it all night long and as much as I can stand during the day. If you find the velcro difficult to tolerate, it helps to wear a trouser sock underneath it. I cut out holes for my fingers and thumb so that the entire inside of the brace is lined with it, and then I fold the long part up over the brace so the velcro doesn't catch on anything.

BTW, if you're experiencing numbness/tingling that shoots up your arm, and it's really hard to grip a pencil or turn a doorknob, and the base of your thumb hurts, look into De Quervain's Tenosynovitis. That's what I have (which is why the thumb thing is so important.
posted by SMPA at 6:19 PM on December 12, 2013 [2 favorites]


Also, I hate every other brace I've tried - I have a ton of them. That particular brace is one of the best things I have bought in my entire life.
posted by SMPA at 6:20 PM on December 12, 2013 [1 favorite]


Good advice here. Fellow fibromite, have had hand difficulties for more than 30 years (woe):

1. While you identify the pain in your hands/wrists/forearms, the problem may be closer to your spine. In my case it's shoulders. Changing the angle of my keyboard then permitted my arms to hang differently from my shoulders and relieved the pain greatly. Wearing a cock-up splint while you are using your hands can create total havoc, because your shoulders attempt to substitute for the frozen wrist motion.

2. Ice may be the best painkiller ever (limit to 20 minutes on then 20 minutes off to prevent frostbite).

3. "Joint protection techniques" can make a big difference by minimizing painful motion while still getting things done. You'll get the best advice on this from occupational therapists, who figure out how to get the job done without pain. But here are some samples: Whenever possible, avoid making a grip. Don't point your finger to press the microwave buttons; make a fist and use an extended knuckle. The flattened part of a knuckle can push a sponge around. Get a book stand so you don't have to hold the weight of the book and spread the pages open. Put a big eraser on the end of a pencil, hold it loosely in your fist, and slide a page from right to left instead of making the exquisitely precise motion of pinching the page.

4. Rheumatologists routinely track the size of finger joints. Enlist someone to note the sizes of two joints on ten fingers — if you're having an RA flare, then they may enlarge by that 29th appointment. I sure hope not.

Best wishes.
posted by Jesse the K at 6:29 PM on December 12, 2013 [1 favorite]


I had very sore hands, wrists and sometimes ankles and feet for a while, I consistently tested positive for 2 markers of infection but not for arthritis which mystified the doctors. Was on meloxicam for a while but made me feel worse than the pain, also got fingerless gloves that hold heat-pads that helped a bit, tried the capsaicin cream and it was awful (but heard you need to build up a tolerance) and then prescription voltaren gel which worked the best. Then got my gallstone-ridden gallbladder out and all is fine now, I guess that was the infection they couldn't find before. You could also get some general tests when you go to the doctor, especially non-intrusive ones like an ultrasound to make sure nothing else is going on and causing your hand pain to flare.
posted by meepmeow at 9:16 PM on December 12, 2013


Something rubbed in like Aspercream might help the pain. There are others that might be more effective, but any relief from pain would be helpful. Isn't it awful how long one needs to wait to see a doctor?
posted by Cranberry at 1:02 AM on December 13, 2013 [1 favorite]


You sound like me. A lot. Meloxicam works so-so. So did Celexa. But without insurance and the fact Meloxicam is like four bucks, well you can figure out which I chose.

When my hands and wrists get really bad, I found generic Ben-gay cream helps some. Keeping my hands warm help because I also have Reynaud's Syndrome.

Tramadol and Gabapentin are what I take for the generalized pain. I'm thinking of trying to get back on Cymbalta again.

I used to have a thumb spica, and found it somewhat helpful.

You might want to visit a rheumotologist to help rule out things like RA or other inflammatory disorders.

Sorry for the spelling, brain fog and the such.
posted by kathrynm at 8:35 AM on December 13, 2013


i don't know anything about fibromyalgia, so maybe you won't be able to tolerate this, but i've had success in the past for my wrist/hand/elbow pain with ice dipping. it sounds stupid, but it does help.

go here and scroll down to "If You Have Carpal Tunnel Syndrome How To Reduce Inflammation". it's not just for carpal tunnel. i know the site looks spammy and all SEO, but the guy is actually helpful on another site i'm on.
posted by misanthropicsarah at 10:35 AM on December 13, 2013


Thank you for the suggestions everyone. I had physical therapy today and told them about the hand/wrist issue flaring up; they said I should call the doctors office to see if I can get in sooner just as you all have suggested. Unfortunately I didn't get out done until the doctor was closed, so I'll try Monday.

Ice was really effective in helping with the pain, surprisingly so. After 20 min on, 20min off (I just went back and forth between hands/wrist) for about 2 hours, the pain was significantly reduced, and today it's minimal. I mean, I'm surprised just how much an improvement it was. Pleasantly surprised, but surprised none-the-less.

As for medication, I am taking tylenol 3 which is tylenol with codeine 2 every 4 hours. I can't take NSAIDS since a prescription of Celebrix chewed my stomach to hell. I've tried zyflimend in the past, and it didn't do anything, but I'll give it a try when my wrists act up again as I tried it for fibromyalgia, not inflammation.

I have ridiculous medication sensitivities which I didn't think to list in my qustionI've had bad experiences with Tramadol, Gabapentin, Cymbalta, Lyrica and Savella. Gabapentin and Lyrica made the fibromyalgia pain worse (that was fun). I don't deal with opioids well, though tylenol 3 I do okay on. Most make me nauseous to the point of vomiting. I recently did try a single Vicodin when my husband had some dental work done, and surprisingly, it didn't seem to affect my pain, so I don't know what's up since I thought Vicodin was stronger than tylenol 3.

I'll also try icy-hot, probably later tonight because the pain is minimal but not gone.

Thanks everyone, you're input really really saved me. I have more to do so it will likely flare up again, but at least I have some things that work and some more things to try.
posted by [insert clever name here] at 4:18 PM on December 13, 2013 [1 favorite]


Just a quick update, I could not get into the doctor any earlier. Between his schedule the holidays in my schedule it just didn't work out. The good news is icing my hands and wrists has helped considerably.

When I did finally see my doctor, he agreed that the fact that using ice made them feel better was probably a sign of inflammation and therefore not likely related to fibromyalgia. I have an order for xrays, I just haven't set it up yet. But I should get that taken care of fairly quickly. Will post a resolution, assuming I get one.
posted by [insert clever name here] at 8:26 PM on January 2


« Older Where do I begin looking to hi...   |  I sent my resignation a few da... Newer »

You are not logged in, either login or create an account to post comments