Recent RSI and Carpal Tunnel diagnosis, yet things don't add up

My Story:

I'm a 50 year-old male. I've been a software developer for 17 years and an avid computer hobbyist since my early 20s. Video games are also a hobby of mine and I've been playing regularly since 2005. (I would love to make computer games, but alas I ended up with a lot of job security doing a very different kind of back-end data processing work.)

My problem started in early summer last year (2017) when I began to develop overuse pain in my hands from an insane project schedule plus gaming on top of it. At first the pain was pretty normal for doing "too much" and most importantly it didn't happen when I was working (the intensity of work is a lot less than gaming). Still, I tried to back off of gaming and give myself more opportunity to recover. With some assistance from PT I seemed to be doing really well from late September through October. But I returned to full gaming activity perhaps a bit too quickly, and it was at that point that more unusual pain patterns started emerging.

This is when I began to get scared and started trying to cut back severely. In particular I was playing a game with a controller that only required my left hand to operate a thumb-stick mostly pressing to the right and my right (dominate) hand to occasionally press a single button. Compared to many games out there this type would fall into the top 5% of games in terms of ease of play -- virtually anyone of any age could manage it. But for me, my hands hurt like crazy for a whole day after finishing it.

Suppressed panic. Swore off games for a month. I'd been on vacation for a week during this. Upon return to work the pain finally invaded my job, causing my right hand to burn after extended mouse use. My only solace was that I would go to the gym and even though I would occasionally have to grip weights or machine handles to exercise, my symptoms always seemed to subside when I did this.

Just before Christmas, an orthopedic doctor diagnosed me with bilateral Carpal Tunnel Syndrome on top of RSI/tendinitis. This despite the fact that I had no tingling/numbness or pain along the median nerve pathway, and stretching tests produced no discomfort or obvious signs. I could still type quite comfortably -- it was gripping actions that caused flare ups. And for my setup the mouse is vital for the applications I use. I started doing PT working specifically on hands. The doctor also recommended NSAIDs to help control the pain but they had zero effect even at the highest dose.

Then a curious thing happened. I had two weeks off from Christmas through the first week of January, and because I'd had a few days of low activity I decided to test gaming again with the intention of backing off the moment it got uncomfortable. It was an old favorite of mine that required a lot of constant movement and button pressing on both keyboard and mouse. To my surprise I played for nearly 5 hours without any breaks or discomfort at all. The next day I didn't have pain when I woke up and decided to finish the mission I'd started, so I played about 3 hours more. After that I had some discomfort in both hands but nothing alarming. However upon waking up the next day, the back sides of both hands ached for three days straight.

The weird thing about that ache is that it wasn't like normal pain. It was more like "hypersensitivity", constantly present but no soreness if I rubbed the skin or flexed my hands and wrists. After it dissipated I tried another game for a few hours and it re-appeared. I renewed my resolve to avoid gaming for the near future. I spent the last week hardly doing anything on my home PC at all.

It all kind of went downhill from there. The day I returned to work my right hand gave out before lunch (excruciating pain on the pinky side of my wrist) and our on-site medical office slapped a brace on my hand and said no computer work for the rest of the week. I took several days to calm down.

I started researching about self-treatment for RSI and bought a tool to help massage my forearms. While I found many trigger points and tried to work them out, I started getting more and more pain presenting along my ulnar and radial nerve pathways that would start near my elbows and go down into my pinkies or across the backs of my hands. These would be most present in the morning after I woke up. I was also trying ice dips, wrapping my hands in a heating pad, braces at night, but nothing really seemed to make a difference. Although I had returned to my duties at work along with a restriction of only 30 minutes on the computer every hour, I still had a burning mouse hand by midday.

Then around the third week of January I managed to injure both shoulders. One was from weight training that tweaked an old injury from many years before. The other was from over-stretching. These were distressing but far easier to understand as I've dealt with similar issues over years of being in the gym. So I took some time off from training.

Almost immediately a new pattern started. Both shoulders -- with very different injuries -- started exhibiting a kind of itchy/ticklish sensation on the rear deltoid that extended down into my triceps. This began to merge with the nerve pain in my forearms and hands. And to top it all off, when I went to the gym after two weeks off to do a very light workout to test my shoulder recovery, my hands hurt like hell for two days afterward. The RSI had finally caught up with the last activity that gave me solace.

I was in full freak-out mode now.

I went back to the orthopedist and she ordered a nerve conduction study. It covered every major nerve path from my shoulders down to the tip of each finger. The neurologist told me on the spot it was clean; virtually every nerve performed well above the threshold for normal. At my follow-up with the orthopedist (one week ago), she was clearly baffled and called me her "mystery man" patient. She suggested most of the pain might be originating in my neck and upper shoulders.

Without a clear diagnosis of nerve damage, we worked out a plan: four weeks of no computer use at work, PT, biofeedback and low-dose gabapentin in the meantime, and re-assess after that.

And Here I Am Today...

This is the first week of my new "hands-off" restriction. Work is accommodating and I am consulting/advising the junior developers on my team.

I also found Dr. Sarno's book a few days ago. I bought and read The MindBody Prescription. Then I bought and skimmed The Divided Mind, paying the most attention to the therapy/treatment chapter.

The character types match up. I am a classic good-ist, perfectionist, introvert, notoriously self-critical and my own worst enemy, and have faced many confounding life issues related to health, aging, and anxiety that I've largely suffered on my own with no significant other to sooth me in times of distress (so add extreme loneliness to the list). My childhood was not abusive but was incredibly difficult emotionally. I'm often angry inside because happiness and joy seems elusive despite being successful and being told by so many people over the years what a great catch I am. I've had a history of stress reactions that lead to panic attacks and/or chest pain that doctors could never trace to actual cardiac problems, but that in the past several years has led to a condition now where I get a lot of sensation of skipped heartbeats. One counselor a few years ago even went so far as to tell me that it was evident listening to me talk about my health experiences that I have an extremely sensitive mind-body connection.

Needless to say, I'm open to the idea of psychosomatic induced problems.

So I started making a list of my issues, but haven't written any essays about them yet. Instead I've focused on writing this introduction.

I will mention one experience I had last night. I went back to the gym to try another workout. I was in a "to-hell-with-it" attitude after all the reading I'd done lately. I did a short full-body workout and then thew in wrist curls with barbells at the end. I had avoided wrist curls since last summer due to all my hand problems and because of the warnings of physical therapists who predicted it would make the problem worse.

At the conclusion of the workout and heading home, I grew more and more distressed because not only was the tickling sensation from my shoulders spreading down my arms into my hands like crazy but they were also spreading through my back, my groin and the outsides of my knees.

I kept thinking to myself. "How the hell can this be from RSI in my hands? THIS IS MY HEAD SCREWING WITH ME!!"

I got home and resumed my reading on the TMS Wiki and started composing my story. An hour later, all the body discomfort had vanished. Only a small amount remained in my hands, and even though using a mouse would bring on the burning sensation, it would retreat very quickly after stopping.

This morning I have some normal delayed onset muscle soreness from the workout (the good kind of sore). My hands feel a little worked over but not much different than any other day lately. The normal pain patterns are there but very subdued. On the last two workouts they didn't start hurting until 24 hours later. I guess we'll see.

But it does feel like progress.

My Goal:

Complete remission, of course. I want to be at full capacity at work, and I've got a couple of games I'm dying to play -- the kind I like getting lost in due to engaging stories.

It's encouraging to see so many success stories on here. It also looks like there are some additional resources for how to approach therapy?

I'm not certain yet if I'm going to need psychotherapy, but I'm open to that possibility. In the meantime will try to follow the protocol as best I can!

 

So it's 24 hours later and I'm having another one of these all-over nerve sensitivity spells. I thought it was associated with exercising last night, but it's recurring around the same time without any exercise?

It's distressing, but also curious. I had something like this happen in my early 30s. I went through about a year of having spells where the back side of my body seemed to be hypersensitive. No explanation. It gradually faded away. I fought it by going to the gym and thought it was the endorphin release from exercise that gave me temporary relief. But I didn't have any RSI symptoms in my hands when that was going on. Right now it's uncomfortable to hold anything in either hand. Typing is OK though.

Ugh.

 

Welcome @BigBlueWolf,

What a pleasing name you have.
It rolls deliciously off the tongue.
And Wolf is my favourite creature.

The man and the legend that created this forum did so after recovering from the self same problem you have. His name is @Forest. He's uploaded tons of inspiring and soothing information and I reckon his story is the best place for you to start.

Click on his name and then 'my story' (It's in bold white on the left of the box, below the photo). It's a feast of healing.

There are also a couple of first class recovery programs here. So take some time to explore forest's words and videos and then touch base here and we'll gently meander to the next step.

Plum x

 

Thanks for the words of support, plum. I'm checking out all the resources being suggested.

I just wanted to throw in a quick update. The last few days have been quite an experience with all this. Each day since I began digging into TMS and starting to work with the program, my pain symptoms have been going through dramatic shifts. It's literally been a different experience every day with new pain patterns, old pain patterns, worse pain patterns and improved pain patterns.

Last night my left arm/hand -- which had always had far fewer problems than my right -- took center stage with some of the worst pain I've experienced so far going from my hand all the way up my arm into my shoulder and across my trap into my neck. Under normal circumstances I would have been in full panic mode. Instead I was calm and slightly amused/annoyed because of how absurd the whole thing was. I hadn't done anything to cause it, it just started happening. If there was any kind of trigger, it was probably from the wrist curls I did in the gym on Thursday evening. But what is telling is that I had severe delayed onset muscle soreness in my left forearm that was completely absent in my right forearm despite doing the same wrist curls with both. It didn't make sense so it was easy for me to see that just like it appeared it would also vanish, and therefore I didn't have to worry.

And this morning? Both my hands have a mild ache (a different pattern), but the arm/shoulder/neck pain? Not present.

I've been to the "Unlearn Your Pain" site, purchased the books offered there, and wrote my first essay per the program in "The Divided Mind".

I know I can beat this. So grateful I found this online community!

 

Welcome! And, your brain now knows you know what’s up and is desperately trying to keep up the ruse! When I statted this work 5 years ago, I started getting pains I’d never had problems with before, and the familiar pain died down. My brain is trying so hard to protect me from traumatic memories, it will do whatever it has to, hence why I’m still here.

But, be persistent and don’t give up! I am learning that my brain is stuck in an addictive, habitual pattern. The key is to break the pattern and retrain the brain to stop sending danger signals. It’s hard, but so worth it!

 

Hello @BigBlueWolf !

Welcome to the Forum! I joined this site due to RSI/carpal tunnel. I too work in technology and I was very afraid of the hand pain.

I read the divided mind and followed the recovery chapter. It took a few months but the pain did fade - from the hands.

The good news is that this can really work. The challenging news is that it can sometimes just move to something else. (I later learned the hand pain was just a recent symptom - I reflected on other symptoms that I had in the past without realizing they were TMS). It is two years later and I will give you one piece of advice.

You already have the Divided Mind. Read chapter 7. I was so hopeful and inspired by Andrea Leonard-Segal. Page 265 talks about carpal tunnel. Pages 265 - 270 offered me so much inspiration. So much....

I did follow Sarno’s recovery program in the divided mind and it was really hard work. One of the things that helped was Andrea’s guidance. “The patient who has recovered from TMS grows into a happier, more comfortable, more peaceful person who sees new paths toward greater personal fulfillment”. I believe it. I am proof. However, it does take time.

I’ve read many books since the divided mind two years ago but it was the most influential for me and it set the stage for a lot of life changes - good ones. Good luck and have faith in your ability to improve.

Best,
AC45

 

OP, my story is similar to yours. I've made a lot of progress the past 3 months. You can't try to hard. I theorize that the RSI type symptoms never even would have set in if I wasn't afraid of it happening. Yours sounds similar. Once you believe at a gut level this is TMS you can begin to shut down your worries. No more worrying means there's not much reason for this pain to stick around much longer if you've addressed the emotional side as well.

I'm at the point where my rsi pain is getting low enough to possibly just be called annoying vs a problem. It's starting to seem kinda silly, the whole thing. More and more I'm become convinced that I CAN be a success story. Anxiety levels are so much lower than before.

Just realize that you don't need to analyze the pain so much and it's progress. I have trouble with this too. Just know that improvements may not be linear or day to day, or even make any sense to you. If you can come to believe this is TMS and calm yourself I think you will see improvement, instant or gradual.

 

I've been reading through various stories on the site. So much inspiration!

My symptoms have been ramping up since I returned to work yesterday. I decided today that I needed to get my current work restriction removed because it only feeds into the idea that I have to be delicate with myself.

The symptoms have changed again. While they have been so heightened they can't be ignored, the presentation has changed radically. I've got a severe ticklish feeling in my pinkies, the inside of my forearms, triceps, rear shoulders, almost my entire back, my groin, and my upper legs. There's only fleeting pain in my hands, but most of the time there's none at all.

Despite this weird development, it's much more familiar ground. I had an episode in my early 30s that was similar. I guess this is really a confirmation that I've had PPD a good portion of my life without realizing what it was. Of course without it presenting as pain, my doctors were at even more of a loss back then. It gradually faded over the course of many months, helped along by intense workouts in the gym that gave me temporary relief and put me on the path to feeling good and healthy.

 

Day 17 since finding out about TMS.

I had been doing really well at the beginning of this week. I had two mornings of waking up and feeling like I had turned a corner. My pain was 85% resolved on those days. I stopped my daily readings about TMS thinking I was over the hump.

Wednesday things were a bit worse, then yesterday I had full-on burning sensations in both hands for a good part of the day and up until bed. I wasn't terribly stressed out about it. and I wasn't doubting I had TMS. I still kept telling myself it was brain pain and though it was annoying I wasn't going to injure myself. I even ignored the pain at it's worst and went about my activities despite it. Now I wonder if that was such a good idea. I know progress isn't linear, but is it OK to push oneself too much? Is it possible I could be re-enforcing the association of pain by doing too much?

I did note that this worsening came about at the same time I was slacking off from keeping up with TMS reading.

During my night's sleep I must have been thinking about it a lot because I half woke up and checked my hands in mild discomfort. I told myself if this was TMS, I could be able to change the pain level. So as I lay there perfectly still I willed the pain to increase. And it did all the way up to full burning again. Satisfied, I stopped paying attention to them and quickly fell asleep again. When I woke up this morning I no longer had burning hands, but aching fingers instead.

I recent got the book "Unlearn Your Pain" and have resolved to start the program laid out there. Hopefully everything is back on track soon!

 

Do as you wish with the activities. Pain will likely follow the activities if you are anything like me. Just realize it doesn't mean anything. Your brain has learned this association, and you haven't reset it yet. You are not hurting your hands or arms, and one day you will be done with this.

Progress is measured by how you react to the pain. If you can "not care" even though feel pain, you will improve. It has to be genuine. Work to rid yourself of the fear.

I am making progress myself in how I react to the pain. Last night I noticed I only felt the pain then and NOT while typing and doing other activities all day. Doesn't make any sense. That's awfully convincing for me.

I had a moment twice in the morning laying in bed this week. When laying on my stomach and having my right foot face down the ball of my foot hurt pretty bad. Like a 6 out of 10. First day I just turned over. Next day I said, "this is just ridiculous. I didn't even injure my foot. There's not even a cause to makeup." So I sat in the pain. Told myself it wasn't real, didn't work. Visualized the pain going away, didn't work. I decided to just tolerate the pain as long as I could. 5-10 minutes later I my mind just kinda went somewhere else. The pain subsided. It felt kinda weird for a couple hours but not pain. It's gone and did not come back. As you progress look for a moment or opportunity like that. It really was helpful.

 

I haven't posted in awhile, mostly because I didn't need to. Around the middle of the fourth week after starting on my TMS learning experience, I was completely over the pain in my hands and arms. So throughout the majority of March I was symptom-free!

But I am having a relapse now, so I'm back. In a nutshell, I set up the perfect conditions for the relapse due to a lot of stress, anxiety around work and having dental issues (horrible pain with that too). This led to doing a lot of gaming to divert my attention, so I'd basically set up the same circumstances from last year that led me to having TMS in the first place.

Fortunately this time around I'm not freaking out or giving into fear. I know what this is, and I know how to deal with it. And I have this forum to and the community for support.