Thank you again Re: Back spasm, dr visit and questions

[Guest guest]

How do you do an adverse reaction test? My wrist pain is a

generally achy but also up through the thumb and into the pinky

mainly. It is the most painful on the underside of the wrist (where

you can clearly see the veins and take your pulse)

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I assume by " adverse reaction test " you mean the interactions of the

various meds. Trust me, you don't want to do a " test " on this.

A " test " is taking two or more meds/supplements/etc and seeing if

anything wierd happens to you. The way you find out is you check

various reference books or sources to see if other folks who

have " tested " them before you had problems. Again, if you want to

post what you are taking (or send an off-list email), feel free and

I can check the books for you.

The rule of thumb I have read by those heavy into some of the

research and writing about adverse interactions is to not take ANY

new medication until it has been out on the open market for at least

three years. The reason is that long-term problems won't show up

until then. The testing required to get FDA approval simply isn't

long enough, particularly with the push to bring new medications to

market faster.

The flip side is the arguement that new, experimental, beneficial

medications are being unnecessarily delayed in being brought to

market. Personally, I would follow the advice of those on the

inside preaching caution.

As for your wrist pain, the pain pattern is interesting because it

involves BOTH the thumb AND the little finger. Carpal Tunnel

Syndrome involves compression/irritation/inflammation of the median

nerve which ennervates the thumb, first and second fingers and half

of the ring finger along with the hand on a line bisecting the ring

finger and all the way over to and through the thumb. The other

half of the ring finger and hand through and including the little

finger are ennervated by the ulnar nerve.

True Carpal Tunnel generally involves a problem at the Carpal Tunnel

in the wrist. Ulnar Nerve problems in the hand are frequently

caused by ulnar nerve compression/impingement in the elbow. Given

the combination pain pattern, combined with your hand getting cold,

suggest that your problem might lie further north - as in your

shoulder (read potential Thoracic Outlet Syndrome).

One quick test you can do yourself for Carpal Tunnel is called the

Phalen's test (after the person who devised it). Put your arms in

front of you, forearms parallel to the floor, place the backs of

your hands against each other with your hands fully flexed so your

fingers are pointing towards the floor. Push your hands against

each other and hold the pressure. If you have Carpal Tunnel, you

will not be able to hold that position for more than about 10-15

seconds before it gets really painful and the thumb side of your

hands start getting numb. If you can hold that position without

pain, you don't have carpal tunnel.

There are also four really simple, quick tests that can be done for

the main causes of TOS and to pinpoint which muscles might be

involved. Your doctor or ortho should be able to do those for you

and I would recommend that you have them done. All four can be done

in less than ten minutes total time. I would tell you how to do them

right here but they are not ones you can easily do on yourself. On

the other hand, if you want your boy friend to try them for you, let

me know and I will post the instructions again.

Again, with the combination of cold and pain/numbness, it is

suggestive of some type of compression/impingement syndrome. The

pain and numbness are suggestive of nerve involvement; the cold is

suggestive of circulation restrictions - reduced blood flow. If it

is TOS, there are a number of massage/bodywork techniques that are

very helpful and effective.