Carpal Tunnel Syndrome or Multiple Sclerosis

by Sajid

Dear Doc

I have typical symptoms of cts e.g family history, pain related to median nerve entrapment area, waking up at night due to pain and then getting relieved by shaking, muscular wastings /weakness and feeling of swollen right hand etc.

My doctor insists that it is due to MS (suspected case). Only one out of three EMG tests suggested CTS. What should I do? Pl comment especially constant pain in right hand and constant muscular wasting below thumb.

Hello Sajid,
So, the pain definitely goes into the middle finger, and often the ring finger, but never the pinkie? In which case, a very strong likelihood of CTS, not MS. As they say: "if you hear hoofbeats, think horses, not zebra."

There are four likely areas of impingement, often what's called a "double-crush". More than one of these areas: Lower cervical nerve root irritation, often UncoVertebral Joint Luschka degenerative changes. And/or
Thoracic Outlet syndrome ... and/or Pronator Teres impingement or a pure carpal tunnel syndrome ... Median nerve irritation in the wrist only.

Has it affected your eyes? Often one of the first signs of MS. A brain scan is the only way to be absolutely sure. By your "doctor" do you mean the local GP, or a neurologist? Only the latter can make a definitive diagnosis.

I hope this contributes.

Dr B

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