Need support: hypermobility and carpal instability

Julie from here,

ISa trained & skilled Physiotherapist & She got Mid Carpal Instability in both hands/wrists,

She's had to have time off work & to under go Surgies,

& Her Consultant Orthopeadic & Trauma Hand & Upper-Limb Surgeon - Mr. Charles A Pailthorpe - tinyurl.com/8d8z9o

He believe's Julie suffered Mid Carpal Instability to both her wrists/hands through Repetive Movements/Tasks & Her Job.

If you have an E-Mail Address, I can send you copy of Page: 30 of Wrist Instability Ueli Buchler - 1997,

States:

Midcarpal Ligament Tear Or Attenuation

*Pain & 'Clunk' In Hyperlax Young Patient After Light Injury Or Repeated Stress

*After Rotational Significant Injury I Normal Patients

& From other medical journals I have read & people I've spoken online & Consultants, Confirm MCI can be caused by Repeated Stress, Or a light injury that patient had years ago or doesn't even remember as the injury was nothing bad.

Hi Ryan

Thanks for sending me this thread.
I can completely relate to your story as similarly to you I started getting pain in my wrist for no apparent reason other than due to the work I was doing.
I had been a physio for ~10 years with no problem and then without injury ~4 years ago I started to get pain in my R wrist followed ~1 year later with pain in the L wrist. My first consultant didn't diagnose me and I went through 2 years of rest, splinting, injections and physio but nothing helped. With xrays, MRI and an arthroscopy he then discovered arthritis in my R triscaphoid joint and I had a joint replacement but this didn't stop any of the pain. After another ~1 year with no improvement he referred me to a collegue who instantly diagnosed me with MCI. He performed a laser capsular shrinkage on my L wrist ~9 months ago but unfortunately that also has not stopped any of the pain even though the joints are now stable. I never knew I had any instability as I never really experienced any popping or clunking only clicking in my thumbs and pain. My consultant is now unwilling to perform any more surgery to try to alleviate the pain as my previous surgeries did not improve it and he is referring me to another specialist.
The consultant said that although I had MCI and possibly more generalised hypermobility I would never have had a problem with it if my job had not been so physically demanding on my hands and wrists. (Most people who complain of symptoms of MCI without injury are manual workers of all sorts). I imagine the same may be said of you. I can't imagine that you will be able to go back to work as before unless something is done to stabilise your MCI. My consultant felt if I had been treated effectively earlier I could have had a much better outcome. Has anyone ever spoken about giving you an MRI or performing an arthroscopy to really see what's happening in your wrist? If it is MCI a capsular shrinkage should be effective as your problem is so new. You may even become completely stable and pain free. As for continuing typing I'm not sure it would be the best job for you as it obviously puts a lot of stress on your wrist and hand joints.
I had to be medically retired 4 months ago and am waiting to hear if I will get permanent injury benefit (if it is accepted that my condition was aggrivated by my job). At present I am unable to work as I am too limited by the pain and am waiting to see what the new specialist says.
It seems that you have good access to specialists so if I were you I would keep pushing for a true diagnosis and plan of action and that may well help with your workers compensation.
It's good to talk to you and if I can be of any help please do ask as we seem to have similar cases.

Take care
Julie

Hi Ryan

Thanks for sending me this thread.
I can completely relate to your story as similarly to you I started getting pain in my wrist for no apparent reason other than due to the work I was doing.
I had been a physio for ~10 years with no problem and then without injury ~4 years ago I started to get pain in my R wrist followed ~1 year later with pain in the L wrist. My first consultant didn't diagnose me and I went through 2 years of rest, splinting, injections and physio but nothing helped. With xrays, MRI and an arthroscopy he then discovered arthritis in my R triscaphoid joint and I had a joint replacement but this didn't stop any of the pain. After another ~1 year with no improvement he referred me to a collegue who instantly diagnosed me with MCI. He performed a laser capsular shrinkage on my L wrist ~9 months ago but unfortunately that also has not stopped any of the pain even though the joints are now stable. I never knew I had any instability as I never really experienced any popping or clunking only clicking in my thumbs and pain. My consultant is now unwilling to perform any more surgery to try to alleviate the pain as my previous surgeries did not improve it and he is referring me to another specialist.
The consultant said that although I had MCI and possibly more generalised hypermobility I would never have had a problem with it if my job had not been so physically demanding on my hands and wrists. (Most people who complain of symptoms of MCI without injury are manual workers of all sorts). I imagine the same may be said of you. I can't imagine that you will be able to go back to work as before unless something is done to stabilise your MCI. My consultant felt if I had been treated effectively earlier I could have had a much better outcome. Has anyone ever spoken about giving you an MRI or performing an arthroscopy to really see what's happening in your wrist? If it is MCI a capsular shrinkage should be effective as your problem is so new. You may even become completely stable and pain free. As for continuing typing I'm not sure it would be the best job for you as it obviously puts a lot of stress on your wrist and hand joints.
I had to be medically retired 4 months ago and am waiting to hear if I will get permanent injury benefit (if it is accepted that my condition was aggrivated by my job). At present I am unable to work as I am too limited by the pain and am waiting to see what the new specialist says.
It seems that you have good access to specialists so if I were you I would keep pushing for a true diagnosis and plan of action and that may well help with your workers compensation.
It's good to talk to you and if I can be of any help please do ask as we seem to have similar cases.

Take care
Julie

Hiya Julie, Ryan

2008 - The Non-Dissociative Clunking Wrist: A Personal View - M. GARCIA-ELIAS - tinyurl.com/8x9xk3

DIAGNOSIS:

Intrinsic clunking rarely results from a specific traumatic event having caused severe ligament rupture.

Most patients have congenital laxity with repetitive stress or mild injury, altering the necessary neuromuscular control, thus triggering the initiation of symptoms.

Yet, unless there is discomfort, asymptomatic clunking wrists should not be considered pathological (Anatomy and Biomechanics Committee of the IFSSH, 1999).

Indeed, despite exhibiting a different pattern of motion, most of these wrists have excellent proprioception and achieve stability through a complex but efficient neuromuscular control.

In both the anterior midcarpal and combined radiocarpal–midcarpal clunking forms, there is an obvious sag of the wrist in the palmar direction, which is actually the consequence of a palmar translation plus supination of the distal row relative to the forearm, a misalignment that corrects itself in ulnar deviation (Fig 2).

In the posterior midcarpal clunking, the wrist appears normally aligned except in ulnar deviation and slight flexion, when a dorsal subluxation of the capitate appears, often with a clunk, which may be painful, or not, depending upon different factors such as the status of the cartilage, the presence of localised synovitis, etc.

Mid Carpal Instability Journals, Websites, Or Wrist Sprains Journals/Websites @ wristinstability.multiply.com/journal

hi julie thanks for joining the discussion,

your case does indeed sound very similar to mine.

i have not yet had an MRI or arthroscopy. i have to go to another doctor and hopefully he or she will refer me to the hand and upper limb orthopaedic doctor that i want to see (i think he is the best in the city).

i never plan to return to my job typing, my wrists would surely be destroyed!

hearing your story gives me hope of a proper diagnosis. the last doctor i saw claimed that carpal instability can only happen from a severe traumatic injury to the wrists (such as a motorcycle accident).

take care ~

bombadil wrote:

hi julie thanks for joining the discussion,

your case does indeed sound very similar to mine.

i have not yet had an MRI or arthroscopy. i have to go to another doctor and hopefully he or she will refer me to the hand and upper limb orthopaedic doctor that i want to see (i think he is the best in the city).

i never plan to return to my job typing, my wrists would surely be destroyed!

hearing your story gives me hope of a proper diagnosis. the last doctor i saw claimed that carpal instability can only happen from a severe traumatic injury to the wrists (such as a motorcycle accident).

take care ~

Hiya Julie & Ryan

Have you read Mick's Post AT: tinyurl.com/MICKSPOST

I am little bit worried, As I've not heard from in awhile & I've sent him a few Private Messages through Ablehere.Com

Julie have you heard or seen Mick???...

I hope his ok, The last time we spoke he was a bit down