Carpal tunnel & trigger finger -- where to get treatment?

[caradow]

Best treatment between St. Thomas and Florida?

That limits you to CUBA!!!! not kidding

Otherwise would recommend an Orthopedic Surgeon that does Hands or a Plastic Surgeon in the States, not necessarly Florida.
Contrary to what you have been told by some it is surgery that is needed if it is severe. The "inflamation" that is spoken about becomes fibrotic in it's final statges.
Just make sure you have the right person.
In the interm may try splinting both wrists so they do not flex while sleeping and take something simple like motrin.
Motrin has been around a long time and taken for a short peoroid of time with food is just as good as the more expensive anti inflamatory meds out there that have the same side affects. I would start at 600mg 3x day after meals.
good luck

[twoblocktom]

Constant pain is a lot to deal with. I can't help you with cost comparisons but I can endorse the relief offered by the marvelous concoction known as the "painkiller"
If you are in USVI I say get one there.
BVI.....get one there.
I wish I were there, I would buy the first round!!!

[capngeo]

My dad had the surgery at age 70.... He's 83 now and has had a numb hand since the surgery! Seems the surgeon cut the nerve for all sensation in his hand; he still has motor function, but is just as likely to knock over something as pick it up.

[FSMike]

I was just about to get surgery for my carpal tunnel syndrome whem my ex recommended her acupuncturist in Palm Coast, Fl. After a series of treatments I was good to go and have not had a problem in the ensuing six +/- years.
Liked it a lot more than surgery.

[FSMike]

As far as trigger finger, when I was suffering from that I located a traditional doctor in The Villages, Fl. who specialized in hand and wrist ailments. She gave me two shots, telling me that one would hurt and one would really hurt.
She was right, I actually yelled at the worst one (and I like to think I'm tough). Be that as it may, that was years ago annd I haven't had a problem since.

[GalleyWenchTale]

twoblocktom I also am a fan of drinkable painkillers; the best is at Saba Rocks, BVI (not Soggy Dollar!)... 2nd best... mine.

Thanks for all the great feedback, all.

Since I'm stuck in St Thomas with a dead diesel, I went to a recommended GP here. Interestingly, her theory is I may have really bad tendonitis. In any case, she gave me a steroid shot, which is helping and suggested Ibuprofin, rather than a more expensive prescription anti-inflammatory.

FYI the Dr. visit + 2 shots cost $140 -- much less than the 1 shot in Antigua from an Orthopedic specialist who though I had carpal tunnel.

When I'm someplace and insured long enough, I will get it checked more thoroughly and am definitely open to acupuncture or whatever makes sense.

Years ago my dad had surgery for carpal tunnel. The first wrist, he recovered quickly and completely. The second time, with another doc, it healed slowly and he didn't get nearly as much relief as he did with the first wrist. I believe a good doc on a good day makes all the difference and unfortunately, the reverse is true as well.

Again, thanks.

And yes, I do believe Cuba would be great for care, but not planning on going there until next year and hope to have this issue resolved before then. I wish I'd checked it out when I was in the French territories (Martinique, Dominique, French St. Martin, etc.) as I've heard good things about their care and cost.

[Seaworthy Lass]

Originally Posted by zeehag

resting the wrist by using splints works...

This simple technique is often overlooked and can be extremely effective (even if just used while asleep). Splints for carpal tunnel are avaiable from many (most?) pharmacies.

Originally Posted by caradow

Contrary to what you have been told by some it is surgery that is needed if it is severe.
Just make sure you have the right person.
In the interm may try splinting both wrists so they do not flex while sleeping and take something simple like motrin.

Good advice.

Yes, surgery is needed if it is severe as permanent nerve damage (and therefore loss of function) may result if numbness is not controlled. Severity can be judged by how long it takes to induce the numbness if the wrist is deliberately flexed fully.

Complications can, however, arise with surgery. It is not a quick or guaranteed fix as Zee and Capngeo have pointed out. Choice of surgeon is critical to increase chance of success. Although it often works well, you could be worse off after surgery. It should be a last resort, not a first option.



GalleyWenchTale, have you tried a splint like this yet?

[bill cartwright]

Browns Hand Center in Houston. Go in the morning walk out the afternoon, no restrictions and just 3 small holes with a butterfly bandage across it. Virtually no pain and they take almost every insurance. 100% satisification!
Good Luck!

[GalleyWenchTale]

Seaworthy Lass -- I did try some splints which didn't help. Not sure if they were the right kind.

In any case, the last doc said if it's tendonitis, the splints won't help. Stretching -- arcing my fingers and wrist up rather than down -- will though. Doing that now.

[Thomashay]

I know this isn't exactly your question:
Don't know Carpal Tunnel from the Holland Tunnel, but have had trigger finger. Middle finger would not close -- or would lock closed painfully not to straighten. Learned to keep it straight and dread the day someone took offense at seeing me flip them a vulgar finger.
Famous local sports physician gave me cortisone shots for two years and said it was just the way I had to learn to live.
During a massage one day, masseuse began to apply pressure to a pressure point in my wrist about 6 inches down, opposite the thumb. Not an intuitive spot. Instant help.
But 3 years with no problems. When it gets stiff, I apply pressure myself -- easy to find the spot because it hurts.
So go for the acupuncture or try to massage yourself for the trigger finger is my experience.

[DeepFrz]

Finger exercises everybody, finger exercises. And for tendonitis, heat and cold and light exercise, massage and gentle stretching. Tendonitis heals very slowly so be patient, and wearing wrist braces at night sure wouldn't hurt.

[zeehag]

galley wench--welcome to my world--i have bilateral tendonitis,both thumbs. some days are fun some days sukk. the splints hurt like hell and didnt work. the injections sent me to the moon with bad pain. and i had one of the best rheumatologists evaah.
the only thing that works is resting the part with the tendonitis. yes the thumbs , if those are the affected tendons, will atrophy, as no exercise will help, only hurt. i do some anyway as i really dont want my right hand disabled any more than it is already.
best of luck and do use ibuprofin -- i had to use 1600 mg every 12 hours, which is about the way they were prescribing it--not 600 three times daily with food-- should be 12 hours between dosings. with food--not just a cracker or apple.

[GalleyWenchTale]

FYI
I did get some cortisone shots in St. Thomas USVI. Thanks to a good recommendation (Dr Elizabeth Flowers, Ambulatory Care -- a drop-in clinic), it was $140 for the Drs visit including the shots (vs $400 in Antigua for 1). The first visit took care of the trigger finger but did not provide relief for my other hand's fingers (numbness in all but pinky).

Doc offered a second visit and a repeat shot for free -- normal followup for her to check in. Not 100% recovery after 2nd shot but definite, worthwhile improvement.

She thinks it might be tendonitis not carpal tunnel. Suggested both for that and the plantar fasciitis (those teak & holly floors are HARD! for a true Galley Wench) taking ibuprofin and doing stretches, watching rotator cuff and using icy hot on it. Again, definite improvement.

By the way, she's a live-aboard which helps her understanding of what's hard to totally avoid.

Back in the States, when insured again, will focus on getting to its root cause & best options for the long haul. That includes finding ways to do things with less "gripping" -- not always easy on a boat and long dinghy rides. Working on it though.

Again, thanks for all your thoughts and life experiences on what to consider.

[Nicholson58]

I had carpel surgery about 8 years ago. It was done by scope. Only two stitches each wrist. I hardly noticed except it stopped bothering me. I see no loss in strength at all. The same surgon did my right tirgger thumb a year later in only a few minutes. totally successful.

Dr. Dehann in Grand Rapids.

[feelsgood]

Originally Posted by GalleyWenchTale

December 2012, after 6 months of persistent numbness in my fingers, then the added pain of "trigger finger" in my right thumb prompted me to get diagnosis and treatment in Antigua.

The doctor's visit for diagnosis, cortisone shot and Voltaren together cost $400 -- all out of pocket as I'm uninsured. It helped.

But now, it's back. I'm stalling for time until June when I have medical insurance in Florida. Figuring I can get a max of 1-2 more cortisone shots and then likely get surgery if it reoccurs. I will also consider alternative such as acupuncture when in Florida.

Can anyone recommend whether it's more affordable to get cortisone shots in St. Thomas, versus Puerto Rico, Turks and Caicos, the Bahamas or if I can tough it out until covered in Florida, to just wait?

Thanks!

Had the same problem. Although we live in France for the price you paid you could get a cheap flight to france and have the job done for about £200 or about $300 I had 4 fingers done and they have never given me a prob since but as another person her said if you dont have surgery it can get realy bad