Undiagnosed Hand and Foot Pain

[Calvin1218]

Here's a rundown from what I think is the beginning.

Several years ago I was diagnosed with degenerative disc disease in my neck. I received physical therapy and while the home program helped, the neck pain would still continue off and on.

In January of 2011 I noticed that my left hand ring finger would "click" in the morning when I woke up. It would work itself out after a few minutes. It never hurt. I went to a hand specialist in March 2011 and he told me it was nothing. Just getting old (I'm 37).

Not long after I saw him, my fingers in both hands started to hurt. I went back to my primary, and he ordered a number of tests. A bone scan showed no arthritic scratches. CBC, ESR, and ANA were all normal, but my RF was slightly elevated at 16. A rheumatologist cleared me. My B-12 and D were low (and I have since been taking supplements).

My neck pain seemed to be getting a bit worse, so my primary ordered a cervical MRI, which showed a mild disc bulge at C5 – C6 and a mild disc bulge with a small right lateral recess disc herniation at C6 – C7. There was no stenosis found. I then went to a neurologist, who performed an EMG and nerve conduction studies. She did find some irritation coming from my neck, but no carpal tunnel. In the Fall of 2011, she sent me to a new place for physical therapy, where they helped me fix my posture and gave me new stretches for my neck (turns out the old ones were bad!) My neck rapidly improved, but despite tissue work and stretches, my hands did not improve as fast.

I've gone back for a few more stints of physical therapy since, and while the clicking in my finger seems to have improved through tissue work and stretches, there was very little overall improvement. And then I started noticing pain in my feet, too.

Which brings me to the present time. My hands and fingers hurt off and on, often around the middle knuckles, but sometimes it feels like it's coming from the phalanges or metacarpal sections. (Keep in mind that it feels like pain, not numbness or tingling.) The pain has also extended into my wrists, and sometimes crawls up the chords of my forearms, which can be tender (the pain in my hands and fingers are not). I also have a ganglion cyst on the top of my left wrist towards the index finger/thumb side; the pain is mild for now. My feet hurt in similar places—the toes, around the balls, sometimes the ankles. The pain in my feet and hands comes and goes; sometimes it hurts with activities like using a mouse, driving, writing, playing an instrument, or walking the dog, but just as often as not, I can seemingly hurt for no reason. Now that the weather is starting to turn, my hands get a little cold, and some of the skin on my right hand pinkie, ring, and middle fingers will get dry and crack.

I have fixed my posture and ergonomics, I have an appropriate physical therapy program, I take appropriate supplements (B-12, D, multivitamin, magnesium), eat a balanced diet, and I have been doing yoga every day for the past 3 months (which has been wonderful). And yet I still hurt. We have recently checked for diabetes and thyroid problems, but they're normal, as is my CBC and Hepatic Function Panel.  I'm at a loss as to where to look next. Any ideas would be greatly appreciated.

[Calvin1218]

Thank you for your response. I get frustrated a lot with my own pain, especially because I want my old hands back, but when I read descriptions like yours, it makes me realize that sometimes I need to take a step back.

I've already been doing a few things that you suggested; ibuprofen, baths, daily bananas (and sometimes powerade zero too--that way I get the electrolytes without the calories).

The clicking is not the same as cracking a knuckle (I think it occurs below one of my knuckles). When I move my LH ring finger forward, sometimes I feel a "clicking"--the pt who gave me some stretches for it said it is probably a tendon adhesion. Not sure if that's why that finger hurts.

Lately I've given more thought to the possibility that I am clenching in my sleep. I've felt it in my jaw after waking up in the middle of the night like that a few days ago. I already see a sleep dr. for sleep apnea (I'm on a cpap machine), so I might mention this on my next visit. Maybe mention it to my neuro too. I've read some posts on other forums where people talk about clenching their fists, and it seems to cause some of the types of pain I'm experiencing.

Weathergirl, I'd like to thank you again for your kind response and I hope that you are doing well.

[Weathergirl21]

Hi there...

Yep...getting older stinks! LOL...

It sounds like you have done everything right by getting all the appropriate tests to make sure there isn't anything seriously wrong.

So the next step is to take some anti-inflammatories like Ibuprohen when needed. You need to be careful with any stomach/ulcer issues so use as directed.

Keep lotion at hand (lol...literally) and use this throughout the day to prevent the dry and cracking...

And if you are speaking about cracking like your knuckles...then I would not do this...

It's really about pacing yourself and in between or after activities that cause a bit of soreness...you can take a nice warm bath...do some stretches of your hands and feet and take an Advil as needed.

I see you mention magnesium but potassium can help with muscle spasms/soreness as well. So daily bananas are good:)

Again...they have done every test so it should help ease your mind..

You said you have a healthy diet so I assume that means you are at a good weight for your height. As well as don't smoke or drink very much.

I mean...my great aunt lived until 96 years old and the only time she took medication in her life was when she had both breast cancer (mastectomy) and colon cancer (had colostomy and ostomy pouch for 6 months)...

She was amazing...and aches and pains happen with our body. We can only do what you do and get it checked out and when we are given the all clear...we just continue on.:)

I'm 44 and live with daily pain from 3, two-level, cervical fusions, a brain tumor, knee surgeries, foot surgeries, and lap surgeries, as well as surgery on my hip where they took bone for use in my neck at the first surgery.

So I can empathize with aches and pains:) Just so you don't think I am not understanding...I think you are doing the best you can...