Tendonitis/Carpal Tunnel?

[reepicheep]

Am enrolled in woodworking school.

Major flare up of swollen stuff in fleshy part of right hand between thumb and wrist, also tendons running along wrist, about an inch's worth. Started Wednesday of last week, ignored being in pain on Thursday, spoke with the instructor Friday after no overnight improvement, bought a wrist brace Saturday.

Physician's Assistant with a couple decades of experience who is also enrolled as a student says maybe carpal tunnel, might need surgery.

Need to use my hands in unusual new ways every day for the next 10 weeks. Spent the day today with a hot pack and a wrist brace, "coaching" the class's TA through working on our latest project.

Maybe shouldn't even be typing? Possible use of phone is aggravating? Literally every damn thing I need to do hurts, from opening doors to brushing my teeth.

Things I'm doing:

NSAIDs (don't love this)
CBD pain relief cream and some non-CBD pain patches
Was icing, at PA's suggestion switched to wet heat (succeeded in blistering my skin without noticing, go me )
Wrist brace, wearing it to bed as well
Trying to take it easy, impacting my education
Got really stellar massage Saturday, helped a lot, going again this weekend
Googled some strengthening exercises, honestly not sure if helping or hurting
Spoke with mom and sis, who have both had this issue and gave me some of the Things I'm Doing
Learning to be ambidextrous (not going well)

Difficult/Impossible to do anytime soon: Go to a doctor, get surgery

My primary care doc is in Oregon, 3+ hours away, which might put me at trying to get an appointment with the VA in WA, something that isn't going to be fast or easy. I expect they would tell me to stop doing things that are causing pain and to continue doing the exercises and hot pack and NSAID thing. They might refer me to physical therapy, which I frankly am going to have a difficult time getting to because I'm supposed to be in class M-F 9-5.

Really don't love the idea of getting surgery.

Suggestions? Experiences? Good exercises? Ideally I'm better by Monday, or at least in a place where I can continue in the class, do most of the work myself, and not create physical long term damage. Would hate to drop out.

[Slevin]

Hey, sorry you ended up with tendon issues while taking a serious class that super wrist physical. That sucks so bad.

Now, it sounds like you have a serious injury. You are not going to be better in a few days, recovering from serious tendon issues is something that can take weeks to months to heal with proper care if you are doing everything correctly and luck is on your side.

First thing first: don’t do shit that hurts and/or flares up the tendonitis/ carpal tunnel.

Second thing: there is stuff you will probably need to be able to do that hurts. Figure out what motions (external rotation, internal rotation, some way your wrists are bending, etc) are causing the issues, and see if there is a way to work around it without pain. If you can work around your issues without any pain / stressing the injury, then you are probably okay to continue doing it. If you can’t, probably put that activity on hold. That includes the course. I’m sorry if that ends up being the case, that sucks. But let me promise you, weeks more of 5+ hours per day of continuing damage to your wrists is going to end up being much worse than missing the rest of the class. Assume 1 week of damage at this point is causing increasingly more damage and extending recovery time by way more than a week.

Third thing: recovery. You’re gonna want to get a set of simple wrist exercises / thumb exercises. Keep the intensity very low week one and week two. They shouldn’t feel like exercises, they should feel like a warmup of the tissue. I’m of the camp of 30+ reps for a set of light recovery. Do this 3x/ day. Check in every 3 or so days to see if you need to tune this up, if it’s not working, etc. never work through pain. Continue this and continue slightly scaling up exercises until you are feeling no more pain.

End disclaimer: I am not a doctor. This is not medical advice. Just a guy with a decade of experience recovering from physical injuries and helping others using a similar protocol, and has suffered from something very similar in the past (circa 2018 IIRC).

[chenda]

Perhaps you could get an online consultation with a doctor or psyotherapist ?

[IlliniDave]

I had something similar last spring from overdoing it on a guitar. Ultimately it took a 6-week layoff from the instrument then about ~3 months of restricted activity with the instrument to get back to 100%.

[Henry]

I look at tendonitis and tinitus as unavoidable health consequences of our historical reality. What dying in childbirth and bleeding out of your asshole were to those who lived in the 14th century, they are to us.

[jacob]

Some specific woodworking tricks that you might already know in order to make it less likely to happen again once the tendonitis is cured.

• Being ambidextrous is useful, especially when sawing. I'm ambi with all tools except what is probably the main culprit here: the plane. Think about it ... if you can switch, it's literally half the work load.
• Push with the palm part of the top of the ulna (pinkie side). It is the strongest part of the "pushing" hand. And have that hand line up with the forearm as much as possible.
• Pastewaxing the bottom makes the plane glide a lot of easier ... especially on sappy wood. As does a sharp plane of course.
• Find the right bench height. I built my bench specifically for me. The commercial world is always 1-2" too low. If you need to be taller, maybe some sheets of plywood to stand on next to the bench.
• Replace the handle on the plane with one that fits you. Make your own handle and just move it around---or make a couple. IIRC Lie-Nielsen planes (what I use) all use the same standard handle. Lee Valley (which looks like what you're using?) has probably standardized the handle as well.

[Slevin]

For the recovery exercises, it’s gonna be hard for anyone on the internet to diagnose what exercises will help. If it’s a thumb thing (which I think you said it is), jump
On YouTube and find exercise treatments for Thumb tendonitis (De Quervain's). If wrist issues, you can just search for wrist prep / wrist injury treatment.

When filtering down these results to what exercises actually help, they should lightly activate the same muscle groups as the injured muscle groups / tendons, but they should not introduce any sharp pain. You may get awareness of the injury, as long as that is very slight it may be fine. Do the exercises on the other wrist too, I know it may be an injury to one limb but balancing out the wrists is also great.

Heat is for healing (bringing more blood to the region), cold is for bringing down swelling. Stretches in the wrist region may help with the pain and bring the inflammation down if it is in the wrist. It is possible taping the region with physio tape can help reduce pain / let you actually work, but this needs to be done by a body worker / physical therapist.

[reepicheep]

@Slevin, yeah, navigating the various issues involved with continuing in the course vs. dropping out and re-taking at a future date sucks. On the plus side, I think it's more like 2-3 days of serious injury, not a full week, although it's possible I was ignoring issues for longer than a day. I was gratified to find today that the very tender to the touch tendons on my wrist are no longer tender and painful, although the fleshy part of the palm under the thumb is still swollen. What's difficult is figuring out where exactly the line is between "don't do that for awhile", "strain", "flare up that is going to cause problems later" and "pain".

I found some exercises that seem to be hitting the right spots. I'm doing them on both arms.

https://www.healthline.com/health/de-qu ... in-stretch
https://myhealth.alberta.ca/Health/afte ... 12%20times.

No sharp pain really with any of these.

@chenda, managed to get a telehealth appt with my primary doc tomorrow morning, before class. Kind of amazing. Also found a Physical Therapist in town that takes my health insurance, scheduled an appt with them for Tuesday of next week, also kind of amazing, and told them I'd get them a referral from my primary care doc by end of day tomorrow. I think that'll work -- I pay a premium for extra special health care on top of my regular health insurance so that my doctor can spend up to 90 minutes with me in an appt and handle multiple issues, and generally they give me what I want when I talk to them. Going through the VA gets me "free" health care...but you get what you pay for. If I can't get a referral I'll just pay for PT.

Fellow student is hooking me up with her acupuncturist husband this weekend. I've had decent success with pain management with acupuncture before, so, hell, why not.

@Henry, well, when you put it like that...

@IlliniDave No bueno, but good you made a full recovery.

@Jacob, tried some ambidextrous sawing today. Challenging. Slow. Didn't get very far. Going to try doing other less scary things with left hand too. Trying to work out bench height. They have a six inch high platform in the shop for shorties, but it seems maybe too tall. Going to bring up plane handles with the head of the school, thanks for that, -- I've requested a meeting with him and my instructor so we can see if we can figure this out, like if I'm present but not completing projects is that a good use of anyone's time, how much of each project do I need to do myself to show proficiency (like if I did two sides and the instructor did two sides, would that be considered acceptable?). I suspect they are going to recommend that if I can't do it all I drop out and come back next fall, unfortunately, and I'm not sure how that's going to impact my VA funding or the course I want to take here this July, or honestly where in my life I'll be next fall.

Here's to hoping swelling and pain continue to decrease with aggressive healing efforts. Thanks all for the input.

[reepicheep]

Pretty solid day. Swelling in the palm went down some and the tendons in my wrist are less sensitive to touch.

Things I can do tolerably well with my left hand: non-precision sawing, use the shooter board to clean up end-grain, brush my teeth

I can feel the places my tendons and muscles get worn out from this activity in my left arm -- I'm not used to using it so much, and it's probably just as at risk as my right wrist of having a problem. But I'm much more familiar with how this feels now and I'm taking more breaks, doing stretches and exercises for this hand/arm, and so I think things will be ok.

Got through most of the day with low levels of pain, knocked off about 10 minutes before clean-up time and the instructor did some rasping work on my handle on my behalf.

Really impressed with the school. Had a convo with the Executive Director and my two instructors today and came up with some hopeful strategies to make my participation continue to be viable, even if my work output/pace diminishes. The ED made me a new, smaller handle for the jack plane this afternoon, @Jacob, and we were able to swap out the front pommel with a smaller one from another tool (we're using Veritas btw). I mentioned some of your suggestions and he talked to me about the grip strength/pinky side of the hand thing, which helped make that more clear. We also talked about ergonomics in general.

They are definitely emphasizing my physical and mental safety first and he's talked to the admin staffer about what it would like in terms of VA funding and housing if I did drop out early, so they have that ready if I decide to go that route, but are also willing to work with me as long as I can/want to play ball. They aren't insisting that I finish projects on schedule and are prepared to help me turn this course more into "today I'm practicing this skill until it hurts" instead of "today I'm finishing x% of this project". They're also willing to have one of the instructors help me with my projects off and on. They thought that if I could get at least a little bit of practice with each new concept that would be a good place to start, but that it wasn't necessarily essential that I do every single joint or cut or whatever.

Also got a call from the physical therapy place this afternoon and they were able to move my appointment up to tomorrow, plus my primary care doc came through today with a referral, which she faxed to the new PT place. Unbelievably fast turnaround.

Things seem hopeful -- honestly I may become a better wood worker from all of this than I would have otherwise been, with less psychological challenge around keeping up with the class and the opportunity to practice skills with my left hand.

[reepicheep]

Saw the PT (technically occupational therapist) today. Very positive meeting -- I'm already doing a lot correctly from my own research and your/a fellow student's suggestions. She showed me some additional exercises, made a suggestion for adding an additional, more supportive brace for sleeping, and we talked about ergonomics and how far to push things. She noted that thumb/wrist injuries like these are extremely common for the type of work we're doing.

Her professional opinion based on the state of my hand/wrist today and my self-described current treatment regimen is that I'm not in danger of long term damage, and can continue the course as long as we all continue to basically do what we're doing -- taking breaks, self-monitoring ergonomics and tension/pain, treating with heat, pain meds, and massage, doing exercises and stretches every day, and getting instructor help on projects if necessary. She was very impressed by the immediate support I received from the staff and noted that folks who develop long term problems from these kinds of injuries are typically folks who push past the pain point and continue to do this work without making ergonomic adjustments, continue without assistance from coworkers or supervisors, or continue without seeing a professional for help.

[Slevin]

Saw the PT (technically occupational therapist) today. Very positive meeting -- I'm already doing a lot correctly from my own research and your/a fellow student's suggestions. She showed me some additional exercises, made a suggestion for adding an additional, more supportive brace for sleeping, and we talked about ergonomics and how far to push things. She noted that thumb/wrist injuries like these are extremely common for the type of work we're doing.

Her professional opinion based on the state of my hand/wrist today and my self-described current treatment regimen is that I'm not in danger of long term damage, and can continue the course as long as we all continue to basically do what we're doing -- taking breaks, self-monitoring ergonomics and tension/pain, treating with heat, pain meds, and massage, doing exercises and stretches every day, and getting instructor help on projects if necessary. She was very impressed by the immediate support I received from the staff and noted that folks who develop long term problems from these kinds of injuries are typically folks who push past the pain point and continue to do this work without making ergonomic adjustments, continue without assistance from coworkers or supervisors, or continue without seeing a professional for help.

Awesome. Glad you saw a professional and are treating it well and doing all the recommendations (and were doing them well before too)! I hope it improves and you get to finish out the class with no big hiccups!

[reepicheep]

@Slevin, me too. VERY glad I was able to stop and take a couple days off when I did and that the school has been so supportive. Between the service dog and the wrist flare up I'm like a poster child for ADA accessibility, which has been a psychological challenge in and of itself, but honestly everyone has been really great about it.

[Salathor]

I had tendonitis for years. The thing that cured it for me, almost instantly (like, within a week or two after literally years of pain), was chin ups. I had to exercise through it. No amount of rest/drugs helped. Now, whenever I have a flair up, I realize I've been slacking on my chinups. A few days of dedicated work gets me normal in no time.

[reepicheep]

@Salathor, that's pretty counterintuitive I would think. Are these wrists facing your face, away, or both?

[Salathor]

@Salathor, that's pretty counterintuitive I would think. Are these wrists facing your face, away, or both?

Wrists facing me during chin-ups. It helped my brother as well. I don't think it would help carpal tunnel, but I've found that, for me, most of these types of problems have been due to weakness exacerbating inflammation. Strengthening the area is the only thing that has helped.

I did bracing, NSAIDs, heat/cooling, topical NSAIDs, quirky novelty wrist exercises, stretching, and none of those things helped.

[DutchGirl]

@reepicheep, glad you're doing better. And I do believe you're learning new things about yourself. Reading new parts of the reepicheep manual, so to speak.

[EricG]

Sorry if this was already mentioned, but have you tried icing your wrist/palm? I have been putting a covered ice pack under my wrist for years while using the ccomputer and I think it helped me avert full-fledged carpal tunnel. If I don't use an ice pack my hands become very painful. I also have psoriatic arthritis which adds to the inflammation in my hands at times.