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08/02/2009 10:53 PM

Negative EMG's & Nerve Conduction - Still CTS?

itsmeamyk
 
Posts: 6
New Member

Hi Folks,

I'm looking to communicate with anyone that has been diagnosed with CTS BUT has had multiple negative EMG's and Nerve Conductions. I'm right hand dominant.

I'm 31 years old and have had right wrist pain since I was a senior in high school. I used the chat lines a bit too much-lol.

1995 - Onset of wrist pain, went to hand specialist and the Nerve Conduction was negative. Told to quit typing so much and wear a brace. Didn't help.

2005 - Still continuous pain. Saw another hand specialist and had EMG and Nerve Conductions. Both normal. Also had Xray which was normal. Cortizone shot and anti-inflams. Didn't help.

Present - Just had yet another EMG and Nerve Conduction. Normal. MRI was abnormal and notes swelling and fluid around carpel areas. Hand specialist said "you don't have carpal tunnel, the EMG and nerve conductions are negative" and sent me to a Rhematologist. Rhem looked at history (have all records) and said I absolutely have CTS and that the MRI confirms it. Am presently on a gel and an anti-inflam, told to wear brace every night. No improvement. Going in tomorrow to get cort injection directly into carpal area using ultrasound to see if it helps.

I have electrical shock type pain, numbness in my fingers and a constant ache in my wrist. I drop things and have great difficulty gripping. I feel like I constantly need to shake my hand due to the pain. Heat and ice do nothing. This Rhematologist is the ONLY person that has listened to my history and genuinely understood the pain I'm in. Should I stay with a Rhematologist or go see another hand specialist? Any advice? I live close to the Mayo clinic in Phoenix, but who knows how long that wait could be.

Just interested to see if anyone has had surgery or seen improvement when the EMG and Nerve Conduction were normal.

I'm so tired of being told I don't have CTS...but darnit, what's wrong??

Any advice/suggestions/support? I'm getting really frustrated!

Thanks,

Amy

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08/02/2009 10:55 PM
itsmeamyk
 
Posts: 6
New Member

oops...forgot to mention that I also have tendonitis. The MRI showed inflamed tendons.

08/03/2009 09:58 AM
mammy
mammy  
Posts: 7217
VIP Member

Amy welcome to our group. We're so glad to have you with us but sorry you are suffering so much. I personally have never heard of negative nerve testing with CTS, that doesn't mean it's not possible.

Your symptoms all sound like CTS that's for sure. It would be a neurologist that would diagnose the CTS under normal circumstances. Although your rheumy says you have it I think it would be difficult for you to find a surgeon to agree to perform CTS surgery. How many doctors did you say you've been too? I would definitely consider the clinic or another doctor and bring all your records. It may be there is still something that can be fixed surgically, you just need to find out for sure.

The other thing I wanted to add is that I have RA in my hands and some of the symptoms do mimic the CTS. I still get the shocking feeling ( but I'm waiting on other test results too), I get the severe pain, shaking and they both swell up really bad.

I don't think I actually have been too much help to you but our other group leader, Tina will be along and she is much older and wiser than me (lol Tina, beat you to the punch this time)

I hope that you will stick around, maybe we can all figure this out together and please, please keep us posted as I am very curious now.

Connie

Welcome  bears


08/03/2009 09:59 AM
mammy
mammy  
Posts: 7217
VIP Member

I did want to also mention that I have had the CTS surgery on both hands and while I did get tremondous relief, I still suffer due to the RA.

hugs and prayers,

Connie


08/05/2009 08:28 AM
aTinaL
aTinaLPosts: 11832
VIP Member
I'm an Advocate

Amy! Welcome to the group it's a real pleasure to meet you!

I agree with the rheumy, that's for sure! Your symptoms are undeniably CTS!!!

I have never heard of normal conductivity tests yet still having the condition. Sounds like you could be a anomaly! How cool is that?!

Is the rheumy advising surgery? It would make sense to me. Although you might have a hard time finding a surgeon because of the test results. I would think that the rheumy could help you with that.

So you only have it in one hand? You're very fortunate in that respect.

I'm very interested to hear more about your case. Like if the ultrasound works or not.

I really do think that if I were you I would stick with the rheumy. Because he obviously gets it, where as the other doctors don't.

If you're interested, we can suggest home remedies that may give you some relief. Just let us know.

Absolutely fascinating!

Tina


08/05/2009 08:37 AM
aTinaL
aTinaLPosts: 11832
VIP Member
I'm an Advocate

No, according to this you're not an anomaly after all! It says that about 30% of "clinically certain" patients have negative nerve conduction tests!

Here's the link. I hope it helps Smile

http://www.carpal-tunnel-symptoms.com/abnormal-nerve- conduction-test.html


08/05/2009 08:34 AM
aTinaL
aTinaLPosts: 11832
VIP Member
I'm an Advocate

Not fair! I just made a long, eloquent post and hit the wrong button and POOF! GONE!

Anyway, welcome to the group, Amy! It's a real pleasure to meet you.

Sounds like you might be a anomaly! How cools is that? Personally I've never heard of anyone with negative conductivity tests who has the condition. However, your symptoms undoubtedly sound like CT.

If I were you I would absolutely stick with the rheumy. At least he gets it! I'm sure he can help you find a surgeon who would do the surgery, too. Is he recommending surgery?

I have a stupid question. When you had the tests, were you experiencing symptoms or no? I'm not even sure if that would make a difference, but there has to be some reason that the tests were normal yet you have the symptoms and the pain.

I hope you stick around and keep us posted. I'm VERY interested in your case. I'd like to hear how the ultra sound goes, too. I hope it gives you some relief.

BTW, if you're interested, we can suggest home remedies that might give you a modicum of relief. Since we've all been there and done that.

Tina


08/05/2009 03:25 PM
aTinaL
aTinaLPosts: 11832
VIP Member
I'm an Advocate

AHA! I also found this! While it's definite science speak, I take it to mean that negative nerve conduction tests can happen in cts patients when only standard positioning of the hand is used!!!!!!

http://www.sciencedirect.com/science?_ob=ArticleURL& _udi=B6WJK-4MK14RY-F&_user=10&_rdoc=1&_fmt=&_orig=search& _sort=d&_docanchor=&view=c&_acct=C000050221&_version=1& _urlVersion=0&_userid=10& md5=ea3bbb49036aa5980b7688dfb55e7995

Tina


08/05/2009 03:28 PM
aTinaL
aTinaLPosts: 11832
VIP Member
I'm an Advocate


08/05/2009 09:26 PM
itsmeamyk
 
Posts: 6
New Member

Thanks so much for the posts!! When I last posted, I was going to the Rheum. Well...once I reported that the gel and anti inflams didn't work, we did decide to do a cort inject using ultrasound. It was pretty cool. I don't know how he found the spot, but whoa, did he ever. I did ask if he saw a baby, but alas, no baby growing in my wrist. LOL. I've had a cort shot (no ultrasound) before and I remember it being painful, but HOLY COW!!!!! It was like sticking my pointer finger in an outlet and holding it there for 10 seconds. That aside, after a day of electrical shocking pain and lots of discomfort, it does appear to be helping a bit. The dull numb ache feeling isn't there as much. I'm starting OT tomorrow at a hand specialty center and will do OT 2xs a week for 4 weeks and then we'll re-eval again. I'm guessing that the OT will talk me into a custom splint, which I've never had, but willing to try.

To answer a few questions, yes, each time I had the EMG's/NCV's, I was having pain. The times that I've seen hand/wrist ortho specialists were the times when I just couldn't take the pain anymore. The last hand ortho guy (a couple of weeks ago) ended his note with "There isn't much more I can do to help her." UGH! I was so mad. Thank GOD for this Rheum - I'm getting somewhere. My hope is that the cort shot will be the trick and then we'll be sure that it is indeed CTS. Between the CTS and the Tendonitis, my whole arm is like a lump! I teach Special Education (k-3) and trying to set up my classroom is proving to be very challenging. I hired two teenage helpers for Friday or I'm afraid I'll look like a moron for open house next week! Smile

Thanks ladies and I plan on updating regularly. Aside from sawing my wrist off with no anesthesia, I'll try anything!

Thanks again for the support.

Amy

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