- CASE FILE
Chronic bilateral hand and arm pain four over 4 years with no diagnosed causes, that has terminated by career. Can't use my hands for work.
ABOUT THIS CASE FILE
For the past 4 years, I have been suffering from an unidentifiable bilateral hand condition that has eluded over 12 doctors, including Dr. Shawn Bird at University of Penn Medicine. My symptoms are varied, come in bunches, and can sometimes be hard to describe, but essentially the problems are:
• Aching & throbbing in the joints of fingers;
• Aching and throbbing deep in the muscles of the hands and fingers;
• An itchy, burning sensation in the hands that I don’t consider to be tingling, but more of a sandpapery feeling. This symptom makes me want to scratch my hands or forearms when I feel it.
• Hands are rapid to fatigue from medium to heavy exertion of my hands (like digging a hole with a shovel, using a wrench, or cooking), but gradually fatigue over light dexterous work (like using a pencil, computer work, light repair);
• A partial cramping feeling, like the muscles of the palm are contracting, but not completely, so it just hurts instead of freezing up;
• When typing at a computer, but when especially using a mouse, my hands gets tired (including my arms and shoulders), the sandpapery feeling increases, and I have to work harder and harder to complete the motions like it’s a tractor pull. The pain and mental stress skyrockets during this, and it is a frequent symptom;
• When sitting, standing, or otherwise not using my hands, aching, throbbing, and partial cramping are still prevalent.
• In the forearms, it feels like the tendons hurt (like they are straining, or scraping), but this may be a more recent symptom that has worsened in the past few months. I’m not sure if the forearm is related to the hands, but the problem is there.
• Another symptom might be chronic stiffness in the shoulders and neck that stretching just can't seem to improve. It feels good, but it doesn't actually help.
This condition has forced me out of my career as a design engineer, which is entirely computer work. One week into my first job, I had to see a doctor because the pain was so bad. It felt like shards of glass were in my hands and forearms. Those symptoms never returned, but gradually the condition worsened to where I am now. I left my job 2 years ago due to the pain and now live with my parents working for their small company at a reduced work load until I can figure things out. I basically can’t use my hands in a normal job’s capacity; the pain and mental stress become so severe that I can’t meet anything close to a normal work day.
I have tried Gabapentin, Amitriptyline, and Nortriptyline, but my body developed a tolerance to them years ago and no longer work. They did help, mostly the two anti-depressants, but only provided relief for half of the day for a span of 2-3 months. Blood works has not shown any endocrine problems, inflammation, or joint calcification. An MRI of my neck yielded nothing, and neither have X-rays of my hands. Dr. Bird from Penn Medicine personally performed one of three EMGs and had no idea what’s wrong with me. Neither exercise nor stretching help; they might feel good, but the symptoms are unchanged. No doctor I have seen has encountered anything like what I describe.
The first instance of this problem occurred was when I was 14 years old. I had been using a computer so much, so intensely that one day it felt like ice cold knives were piercing by hands when I went to type. I don’t recall any treatment or diagnosis for this and doctors seem to ignore this story. I stopped using computers until I recovered, but never went that hard again (e.g. I was typing with a pencil while I recovered). Since then, I always felt like I was susceptible to hand pain when using a computer. The problem flared up again in college from intense computer work, but only in my right hand, and using an ergonomic mouse (the Orthomouse by Orthovia) fixed it. However, when I started my first job and ever since, nothing alleviates the symptoms. I believe the ergonomic mouse and using an ergonomic work setup keeps my wrists healthy, but they do nothing for my hands. In total, I have had problems of varying severity with my hands for 12 years, but it has been the past 4 years that have been life altering.