Numbness in fingers and hand

[Gary_C]

I have spent waay too many hours in machines using joysticks to operate the controls. One of those machines is my forwarder and the joysticks are the large black knobs that I have to reach over the top and grip with a claw grip plus activate two buttons on the front for the grapple open and close. For some time now I have been having trouble with numbness and tingling in my thumb and first two fingers on my right hand. Most days when I start using those controls, I have to stop and do some motion exercises with my hand and fingers to regain the feeling in my thumb and first two fingers. It usually gets better somewhat, but those three digits are always somewhat numb.

What could be the cause and solution?

Oh, and I could trade for a newer machine with newer and more ergonometric controls but I don't have a spare $150K.

And if you want to see those Sauer-Danfoss implements of torture, they are the middle one in the picture of three in this pdf.  Sauer-Danfoss PVRET

[doctorb]

The pattern of numbness you descibe is exactly the distribution of the median nerve.  The most common cause for the symptoms is compression of the median nerve as it passes through the carpal tunnel at the wrist.  Otherwise known as carpal tunnel syndrome (CTS).

Many people get nightime numbness as, with lying down, we get some slight increase in fluid/swelling in our upper extremities.  Some patients wear night splints to hold their wrists in a mildly cocked-up position.  Many patients with CTS have occupations with repetative wrist movements, as you describe.

Median nerve compression can occur anywhere from the neck/shoulder to the wrist, so other reasons for these symptoms may have to be ruled out.  If you are a betting man, however, CTS would be your best bet because it's so common.

I am not saying you need surgery, but a CTS release is not a big procedure, and the liklihood of recovery is pretty high.  Go see a hand surgeon if you have one in your area.

[grweldon]

I assume that doctorb is actually a doc, so it's not surprising that he most-likely hit the nail on the head!  I've had issues with CTS in the past.  Never had to have surgery, but I have worn the wrist braces at night and this caused me to learn how to sleep without curling the covers and putting them up to my neck, as most people do.  The surgeon will probably want to start with some sort of PT and wrist braces before he OKs surgery, but whatever the case, good luck to you!  It can be very painful having to deal with it.  Might go buy some braces anyway and see if they help.  Probably won't keep you from working, you may have to do things a bit differently.  Oh, and just a tip... Cut out the toe of an old white cotton sock to wear under the brace.  It is a bit more comfy....

[Gary_C]

Thanks doctorb. I've suspected that CTS was the cause for some time. I suspected part of the cause was because I have to keep my wrist bent upwards so I can actuate the two buttons with the tips of my first two fingers. But if the wrist braces keep the wrists slightly bent up, I am not sure if that would be a cure or more of the same.

Is it something that will go away if I quit using those type of joysticks or will it most likely take the surgery to correct the problem?

[doctorb]

There is no way to predict whether it will resolve on its own or not.  I would be less than optomistic if you keep goinmg with the same repetative motions and wrist positions.  People who stop those motions often get relief, but the syndrome can occur with plain everyday life, and not require a specialized repetative motionb at work.

[beenthere]

What could be the cause and solution?

An extra 30 years or so, so the solution is to somehow lose 30 of them....  ;D

The computer games that involve repetition seem to be able to get similar conditions (pain)... so I quit some of them or I find a way to vary the postion of the arms, hands, and fingers for long periods of time.

[tyb525]

Taking a break for a minute or two every 30 minutes or so to do some hand exercises and some hand stretches might be a good idea. Anything to break the repetition and get the blood flowing.

[Gary_C]

I could be blaming the wrong thing. Those three fingers on the right hand are the same three used for a computer mouse. Except I am hardly on the computer anymore.  :

[Ron Scott]

It sounds like carpal tunnel with the nerves being pinched off in the wrist from your repetitive hand activity. A doctor can determine the seriousness by tests for it. I've had to have surgery on both wrists a few years a part when it was determined that the arms were going dead due to the pinched nerves in the wrist cannel (carpal tunnel). Both hands and arms have been fine since the surgeries and short recovery periods.

My problems were caused by excessive chain saw use, wood piling, and use of a tree marking gun.

[Shotgun]

It sounds like carpal tunnel with the nerves being pinched off in the wrist from your repetitive hand activity. A doctor can determine the seriousness by tests for it. I've had to have surgery on both wrists a few years a part when it was determined that the arms were going dead due to the pinched nerves in the wrist cannel (carpal tunnel). Both hands and arms have been fine since the surgeries and short recovery periods.

My problems were caused by excessive chain saw use, wood piling, and use of a tree marking gun.

Come on, Ron. Did you mention to your doctor repeated movement of your forearm from horizontal to vertical, as in beer can from table to mouth as one of the causes?  Or did you just forget to mention it?   :D

Norm

[Okrafarmer]

Gary, one thing about the forwarder is, if you own it, you could see about having the controls modified. No need to buy a whole new forwarder, just see if you can do soemthing about the positioning of the controls. Are they electrical over hydraulic? If they are, it should be fairly easy to redo them, even give you multiple locations where you can activate them, so that you can do it different ways from time to time. Possibly even with your feet. If you had two or three different ways to activate the same circuit, you could reduce the amount of wear on any one body part. Maybe you could give your left hand an extra button to do the same function that the right hand does. If I was there, I could look at it with you and look for some solutions. Then get a tech-minded person (if you are not one) to help you rig up your new controls.

Think about the old 1970's and 1980's ten-speed bikes. They had the curved ram's horn handlebars. You could hold the lower handlebars, or you could sit up higher, and hold the inner parts of the handlebars. Make things adjustable, so you don't have to do exactly the same motion, or sit in exactly the same position all day long. If you had to spend $1,000 or $2,000 on this, sounds like it might be worth it if you do this all day long, day in and day out.

I developed CTS from milking cows. I think my wrists must be particularly susceptible to it anyway, because all I had to do was squirt each teat a few times to check for mastitis clumps, squirt and wipe down, before installing the automatic milker units. But I worked on some production dairy farms, and my wrists really took to hurting.

Then I went (eventually, year 2K) to work at Hancock Lumber in Pittsfield, Maine, and pulled planed lumber off the green line into sale stacks. The pace was so fast and furious, that my carpel tunnel came back with a vengeance. Something about using that thumb and fingers to grasp the end of a smooth board and pull it quickly and forcefully off the conveyer onto the stack, repetitively and under the pressures of time constraint. I had to stop there and go back to farming, that time as a field hand, and eventually on to other things.

One thing I am intending as I start my new lumber business, is not to fuss at my offbearer if he can't keep up with me.  :-\

[Gary_C]

Okra, yes I have looked into changing those joysticks. They are mounted on the arms of the seat and are electric over hydraulic. And the positions are easily adjustable. Plus there is another style of joysticks called mini joysticks that were available on that machine.

However it is a major changover as the controllers must also be changed and with six functions involved it would be cost prohibitive to switch. And I doubt the parts would be available anymore. Not the complete assemblies anyway.

[Okrafarmer]

Do you think it would be cost-prohibitive if you got to the point where you couldn't work at all, or had to sit out for several weeks for surgery? (I'm not sure how long it would take for you to recover from the surgery, nor what it would cost, nor whether you have insurance that would cover it. Workman's comp might if nothing else, but don't know your situation).

[SwampDonkey]

Another thing that can happen it loosing your grip on something your carrying. Just slips right through your hands as your not able to close your hand firmly on the item. I often have a pain up into the forearm from the wrist. I've had CTS when doing wreaths one time and used to get it some when thinning, running the throttle trigger. Doesn't seem to be bad now except getting a good grip sometimes. I also blame some of it on firewood and from years ago crimping and handling potato sacks. It all adds up over time. ;)

[Roxie]

My left hand has been numb for a few years now.  It doesn't hurt or prevent me from doing anything.  Is doing nothing an option? 

[Okrafarmer]

My left hand has been numb for a few years now.  It doesn't hurt or prevent me from doing anything.  Is doing nothing an option?

If you mean, is doing nothing about the numbness an option, my non-professional opinion is, yes, it probably is an option. Just be sure you aren't making it worse.

If you mean, is doing nothing with your hand in order to try to let it heal, an option, then that may help, but not guaranteed.

If you mean, is sitting around and doing nothing an option, well, I think you know the answer to that!  :D :D :D

[Roxie]

Your mind works in puzzling ways.   :D :D

I meant the first one, because the numbness doesn't bother me or prevent me from doing anything. 

[SwampDonkey]

Not to offend anyone on this thread. But, my mom always had this saying about numbness. The short and sweet of it was this phrase: "numb from the heals up". Now as I said, no offense to anyone. But, mother speaks her mind. :D

[doctorb]

Roxie-

The problem with long term nerve compression is that, if the pressure is great enough and the duration of that pressure long enough, release (decompression) of the nerves may have minimal improvement.  The motor branch to the thumb muscles, which help with thumb positioning and grip, are part of the median nerve as it passes through the carpal canal.  So if this nerve is damaged, your function can eventually suffer.  I would have it looked at, as a baseline.  The surgery, if you are a candidate and if you consider it, is very minimal with newer techniques.

[beenthere]

SD
Your Mom was referring to you at the time?

Roxie
So no sense of touch or pain in that hand?

[Roxie]

The area that has feeling, is the skin on the top of my hand and most of my palm.  The thumb isn't numb below the first joint, either.  All four fingers and the part of the palm that is just below the fingers has no feeling. 

I will mention it to my doctor at my next regular checkup, which should probably be after the first of the year. 

[SwampDonkey]

SD
Your Mom was referring to you at the time?

Nope, just usually someone that gets her infuriated. I never do that.

[hardtailjohn]

Just a little food for thought..... I went through the carpal tunnel surgery. It worked good for about 2 months....then started right back up again. I just put up with it, as it's expensive and I didn't have the time to sit and recouperate if I went through surgery again.  Not long after, I started having a little trouble in my other hand/arm... all the Dr's kept telling me that I needed to go back to surgery and they'd fix it....  Finally, I wound up going to a good chiropracter and in about a month's time I had no more trouble. He explained that it starts in your back/shoulders, and the wrist is just where it shows. Opening the tunnel just relieves the symptom, not the cause.  Just my personal experience...
John

[Okrafarmer]

Hmm, worth investigating. I do know that sitting in most any forestry machine, bouncing along all day is bad for the spine alignment.  :(

[doctorb]

hardtailjohn-

Whatever works for you is great, so I am not discounting it.  But the explanation of your chiropractor is not founded in science or the experience of millions of people who have this syndrome.  For the vast, vast majority of people, the nerve compression is at the wrist, and not in the neck/shoulder.  A pre-operative EMG - NCS  (electromyogram / nerve conduction study) can differentiate between nerve compression at the neck / shoulder and the wrist, and is a common test used to to identify the location and possible cause of nerve irritation.  While the explanation of your chiropractor may be true for some, it is most definitely not true for the majority of patients with CTS.

A more likely scenario is that the nerve, once compressed, swelled into the increased space available to it after the carpal tunnel release.  That change in the nerve generated some irritation, leaving you with some of the same symptoms that were present prior to the surgery.  The fact that, a month or so later, this resolved with a few neck manipulations and shoulder exercises does not prove that the wrong site had surgery, or that the neck / shoulder treatment was directly related to resolution of the numbness.  And, before you jump to any conclusions, I am a doc that believes that chiropractors are helpful and have their place in the great scheme of medical care.  I just think that explanation is way too simplistic and generalized, and flies in the face of the long list of patients with median nerve compression at the wrist, i.e. carpal tunnel syndrome.