Knuckles sound more like to OA, thumb and finger tips sound more like CT and of course with some tingling. (I have both the OA and CT both hands.) You prob wake up in the morning with hands all numb and having to 'shake' em awake? That is usualy a sign of CT. Holding a book for any length of time, fingers go numb or holding the telephone...ooohhhh, very numb!
Tests. One is to bend the wrist towards you, bend it tight, keep bent, if you get the tingling in the palm then the finger tips, then CT. Another one is to strike the inside of the wrist with the edge of your other hand, does it tingle? If so, CT. Another one is to strike the outer edge of the wrist, if it tingles then CT. Another one is to press the thumb down the little finger, starrting from the top, then the middle then the base of the finger, do all four fingers, if they tingle at all then considered a sign of CT. Called the Phalens test and the other the Tinel test.
Pain in finger tips and numbness is CT 'or' can be radiating down from cervicals 'or' can also be caused from ulna nerve (elbow). Yes, the dominant hand will usually be the worst affected.
Fess up to rheumy and no doubt she will send you for nerve conduction tests - no, they don't hurt.
Try a brace - any good pharmacy should sell em. Must get the right size, and if you do get one, ensure that don't overtighten, should be comfortable and supportive. The brace is to keep the hand in a neutral position, so as to stop fingers curling and bunching and fisting. Can also sleep with arm supported by, resting on, a soft pillow.
Might find this website useful:-
http://www.ninds.nih.gov/disorders/carpal_tunnel/detail_carpal_tunnel.htmAs for cortisone injections - injection is painful and does not do much for the wrist and 'can' severely damage the nmedian nerve *unless done by a very skilled operastor and preferably under ultrasound guidance needle.
Surgery. Open mini or arthroacopy. Arthroscopy 'can' be problematic due to the fact that the surgeon cannot 'see' the nerves - which have been known to be damaged during arthroscopy. So, arthroscopy is controversial... They can still damage in an open surgery! IF you ever do go the surgical route ensure that your surgeon had done hundreds of em, so much so that he can do em in his sleep! It is a simple surgery with horrible potential to go very wrong indeed.
Read up everythng you can find. (Follows separate pot with surgical information - that I put together for my s-in-l).
