HELP ME, this injury is taking over my life, RSI injury, minor peripheral

[james_leo]

My name is james , i'm 22 year's of age, and i have been receiving treatment from the NHS for 8 month's with no answers and no treatment plan. I injured both forearm's early september time of last year "2009" from weight lifting, the injury is very much affecting my life.

My story.

I've been weight lifting for the past 3 and half year's, had a minor injury through weightlifting, I damaged both rotator cuff's through lifting weight's which was treated, and now is healed.
10 month's ago I started to isolate the forearms alot more through weight lifting, and
noticed a a sudden tingling/burning sensation throughout both forearm's, with dull sharp triger point's throughout both forearm's, I also noticed both elbow's seemed to flare up and was tender to touch, but that settled down after a month. Both forearm's feel very weak, typing seems to bring on the symptoms right away, both forearm feel's tight, as if the the muscle is being squeezed, also front of hand*knuckle side* and wrists, skin feel's tight. symptoms overall feel's like a hand grasping both forearm's, chinese burn sensation? I have completely stopped training, and have stopped all activities which falre up my arm's.

I've already had physio treatment for the first two month's of the injury, then i was sent to see a plastic surgeon who deal's with nerve compression release, I was given two sterriod injection's which didn't work ect.. i've currently had nerve conduction studies done which showed no nerve compression, but as you know minor peripheral nerve injury's tend to fall of the radar. I never saw the same consultant,which added to the confusion of the situation. the last consultant i saw was convinced the next step was to see a rheumatology consultant, because "the NCS showed no nerve damage or compression, therefore it's not a nerve related injury"

I think i have a minor peripheral nerve injury's, RSI, Or non specific arm pain.. but no one seem's to no what it is, and i'm being passed round like a football......

I have no idea what to do, or what action to take. i don't know what type of treatment i should be looking for. this is affecting my work life, and every aspect of my day to day life

apologies for this poorly constructed email, it really hurt's when i type
is there any info, or advice you can give me? any good uk NHS based clinics or clinical trials for this?

I have listed my referral's

My nhs My referral


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[gcoe]

Hi James Leo

Thanks for your detailed post. Firstly you may want to repeat your post in the musculoskeletal outpatients discussion as the neurology post deals with problems such as stroke etc. You may be more likely to get a member's attention who specialises in this area.

However here are a few points that come to my mind:

• Looking at your description and the letter's it is quite hard to recognise a clear pattern of what is going on. for example it is hard to say it is definitely one particular nerve as the symptoms and signs seem to confuse matters. I think it would be very hard to get a diagnosis over the internet so I agree going back to a clinician would be the best.
• I agree that it just because the nerve conduction tests were negative the overall symptoms do sound neural in nature. So I suspect a rheumatologist may not be able to help you, although it may not be any harm in having this checked out
• The fact that you have bilateral symptoms is significant and that you had a previous neck and bilateral shoulder injuries could be important in sorting this out. There is a phenomena known as the "double crunch". That is you have some restriction of the nerve course much more proximal. then the forearm exercise you were doing at the time of the onset of symptoms may have caused more distal irritation/compression whatever. the idea behind the double pinch is that the sum is worse than the parts. One site isn't enough to cause problems but two sites really set things off. I say this because it would seem coincidence to develop bilateral symptoms at the same time, even on dining the same exercise. Has the physio conducted detailed set of tests that look at the nerve course right down the arm (called the upper limb tension tests). Here is a presentation on the ULTT. http://www.physio-jahra.com/data/lec...BILIZATION.pdfThese can be informative. By the way you need a clinician to do the tests -trying to do them yourself usually doesn't work.
• The alternative is trigger point problems in your forearm muscles. However trigger points and process injury/RSI things where there are minor neural problems can go hand in hand
• You are at the stage where a chronic pain syndrome could really be setting in. Chronic pain syndromes don't follow prescribed patterns and have more to do with the way that the nervous system is processing pain.
• AS I don't work in the UK I can't give you a recommendation. However look for a physio who holds a post grad qualification in manual therapy.

[james_leo]

thank's for the post gcoe, I share your doubt's about the rheumatologist.. It's due to the nhs.. making me see random people each time i have have a check up.. i will post this thread in musculoskeletal outpatients
thank's!

[JON 77]

hi James,

Sorry to hear that you're having a rough time. I thought I would get in touch because I have been having a very similar problem for the last 18 months. I am 33 years old and previously entirely healthy and very active. I had been doing a lot of Intensive weight lifting and no stretching along with a lot of computer work, guitar and piano in the run up to my injury. After doing way too many chin ups from a stairwell the Christmas before last I developed pain which was initially diagnosed as acute flexor tendinitis in both forearms, I had insanely reduced range of motion in my wrists and a very weak grip. after trying to ignore the pain and carry on weightlifting and playing the guitar for a week or so my hands practically seized up.

The issue seemed to go away with rest and anti-inflammatories but when I started trying to do isometric rehabilitation wrist curls about eight weeks after the initial injury in an attempt to get myself strong enough to go back to the gym it flared up terribly with all kinds of bizarre sensations; deep cramp, pins and needles, non-existent grip strength and hands that felt like cotton wool, burning sensations .... I was left unable to type (I'm currently using voice dictation software) wash up, drive a car, lift a bag of shopping, swim or play guitar and over a year later still haven't got close to recovery.

The NHS has been no help at all. For the first six months I was told to rest my arms when I flared up, wait until the pain had gone before trying isometric exercises again, each time with a lighter weight. Each time the exercises only served to make things worse and during all of this time I barely had any real ability to use my hands.

A few months ago I came back from a three-month trip to Australia where I saw a number of physios who expressed doubt that I had anything wrong with my tendons Saying that they felt it was much more likely given my symptoms that it was a neural problem. On returning to the UK I saw another orthopaedic specialist on the NHS who said he felt I had non-specific pain syndrome or RSI type 2 as it is also known. I'm going to be receiving MRI scans in the next month or so on the NHS. In the meantime I am left with no course of treatment and no real explanation as to what is wrong with me.Being diagnosed of RSI type 2 is basically the same as being told that you are in pain but that they don't know why as the symptoms don't fit with any recognized, easily detected injury. a neurophysiologist at Sussex University is currently conducting a study into the possible pathology behind RSI type 2 symptoms, I've been in contact with him and he is interested in finding people who are suffering from these conditions to take part in clinical studies. The theory he is working on is that it is to do with damage and/or inflammation in the median nerve. If you are interested I can forward his details.

Two weeks ago I attended the RSI support group meeting in London and got some really useful information from them. The NHS really does seem to be pretty useless when it comes to these problems despite the fact that RSI can have a massive impact on otherwise entirely healthy people's lives . There is a dedicated RSI clinic in India and another in Philadelphia in the States which I'm considering getting in touch with. In the meantime I'm continuing doing next to nothing with my arms apart from light stretching and light day-to-day activities which don't irritate them.

Sorry this is such a long message, I just thought you might like to know that there are other people out there experiencing the same frustration that you are. You should get in touch with Stephen at who could give you advice and information. he is also putting together a bunch of case studies in order to put pressure on the Department of Health to pay more attention to these debilitating conditions. I'm sure he would like to hear from you

Let me know how things work out who you and if you find anything or anyone that helps your condition

Take care, stay positive. jon

[james_leo]

john i have sent you a message