Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Hand pain anyone?

this all started quite suddenly in 1998. the first thing was a rib thing, but that only lasted a week or so. then a few months later, horrible dq tendonitis started. first in the left hand in july, then the right hand in september. in between, an upper back (rhomboid) thing happened. and for the first few years it was only the dq tendonitis and the upper back / neck. my dq tendonitis got so bad so fast that i was afraid i'd have to go on disability and maybe even lose the new academic position i had worked so hard for.

went to a hand (physical) therapist (they are awesome by the way and i highly recommend that you ask your doctor to see one) unless the doctor thinks its worse and thinks you should go to a hand orthopedist / hand surgeon. but at least go to the PT. a good one will send you to the hand orthopedist / hand surgeon if its bad enough.

first the PT did a lot of ultrasound and contrast baths and exercises with me. got me to a certain point, then sent me to the hand orthopedist who gave me a cortisone shot in the left wrist. we tried it with just the PT first, but it needed the shot. i save those for only when it won't heal with more conservative treatments.

the right hand never got as bad, and so PT and home contrast baths got it over the hump.

it was a real problem for about 4 years or so. then got better. now it flares now and again. but i can go for months to years where its hardly a problem.

a few things that i think have helped it:

the contrast baths (1-2 minutes hot water, 1-2 minutes ice cold water, back and forth for ~15-20 minutes total, repeated several times throughout the day. have found that just ice sets up scar tissue pretty bad. just heat increases the inflammation and makes things worse.)

my muscle relaxant zanaflex which i started ~2001. the physiatrist (dr of physical / rehabilitative medicine) gave it to me more for my back / neck / SI / butt issues, but the nice side effect was with the muscles pulling on the tendons less, helped my tendonitis as well.

LDN (low dose naltrexone) which i started in 2009. my tendon and ligament issues have improved dramatically since i started it. have not had any serious pulls or tears since. and any more minor pulls heal up so much faster. much less tendonitis too. though i still do get it some.

being careful not to overuse tendons that are inflamed. when my hands are flaring, i use a mouse vs a touch pad on the computer, i limit page turning of books and magazines, ask hubby to peel and chop the fruits and veggies when we prepare meals, have hubby open jars (or i'd buy one of those electric jar openers - same with cans). i only use gel ink pens, uniball are the easiest i've found on the hands and with nice smooth ink; they're my favorite. the hand therapist gave me some of these ideas, and over the years i've learned to compensate. like when the left wrist was very flared, had my students staple the right hand corner of their work instead of the left so i could limit page turning with the left. though an odd request, it made a huge difference, just need to be creative sometimes.

in 2006, i tore a ligament in the left ulnar wrist, pouring water into the sink from a pot. it was just too heavy for my flaring tendons and ligaments and i felt it snap (well, partially snap, as it was torn but not ruptured). hand PT (ultrasound, ionophoresis, and cold laser) after a cortisone shot got it over the hump. then another 2-3 years of not using it and now its about 99% (only bothers me if i push it). the next few years, the right ulnar wrist would get a twinge now and then, but never as bad as the left.

and through the years. have gone through periods of time where its the base of one of the thumbs. that comes and goes.

and lately, its like the joints of my fingers are loose. cause when i go to use them with any force, they crack and hurt when doing so. more annoying than anything else. the pain is very temporary and no damage thus far.

so for me, yes, the hands have been an issue. sometimes all by themselves.

but like most spondy enthesitis. moves around. locations come and go. does lift as mysteriously as it starts.


PS: also tore a ligament in my index finger. and couldn't even tell you how i did that. just woke up one morning and couldn't bend my finger well. as the month progressed, it got worse and worse. then it just got better and better. the hand surgeon told me it was a torn ligament when he evaluated it.