When I was twenty-one, I went into the student health center, complaining about stiffness and soreness in my left hand. I was told that I had carpal tunnel syndrome. The doctor gave me a series of exercises to help with the stiffness, and recommended ibuprofen or naproxen for the pain. I did not question this diagnosis, because I trusted the doctor to know better. I did perform repetitive tasks regularly, including typing, sewing, knitting, and crocheting, which can lead to carpal tunnel syndrome. I performed the exercises, took the recommended over the counter medications, and went on about my daily life for almost ten years.
Days before my thirtieth birthday, during an appointment for something unrelated, my regular physician asked the words that changed my life: “Is there anything else you want to ask about?” I mentioned that I thought my carpal tunnel syndrome was getting worse, because the stiffness and soreness was getting more painful, particularly across the back of the fourth and fifth fingers, and I could no longer wear my wedding ring. He took one look at my hand and asked, “Who told you that you have carpal tunnel?” We discussed the type of pain, and I mentioned that my left shoulder was also frequently stiff. He told me he suspected Rheumatoid Arthritis (RA). He ordered a series of tests, including a blood test to check my RA factor, and an echo heart scan. He was especially concerned, since the pain was only in my left side. When the results from the blood test came in, he explained that my RA factor was high, but my heart did not show any signs of thickening, which can happen when RA is left untreated. He referred me to a rheumatologist.
The rheumatologist took one look at my fingers and said it was definitely RA. She showed me the swollen bumps on the first joint, where my ring used to sit, and said they were rheumatoid nodules. She ordered a series of blood tests, and an MRI of both hands and wrists, to determine the extent of the damage. I was lucky. While I had developed nodules, which are irreversible, I did not suffer significant joint damage. Considering RA can fuse joints and leave them unusable, being untreated for ten years could have been devastating. My inflammation factors were not excessively high, and I was able to start a basic therapy of prescription strength naproxen.
From my experience, I have determined several issues I should have mentioned, and recommend anyone in a similar situation bring up to their doctor:
1) The pain was not in my dominant hand. Typically, carpal tunnel syndrome occurs in the hand you use most. I am primarily right-handed, but the pain was in my left hand.
2) The pain is worst in the morning. Arthritis tends to be worst in the morning, when the joints have stiffened overnight. Carpal tunnel tends to be worst after activity, such as typing for a couple of hours.
3) I had not had a blood test recently to check my RA factor. This is a common test in a physical, but many adults only see a doctor when something is wrong.
Had I known to bring up any of these issues, the doctor at the student health center may have diagnosed me correctly, and I would not have gone ten years without treatment for a condition that could have had dire consequences. Many doctors are quick to diagnose carpal tunnel syndrome, and patients need to know what questions to ask to make sure their doctors know exactly what is wrong and how best to help them.