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Medical Forum / Diseases and Disorders / Arthritis / November 2007

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Going for OT - anyone got any pointers?

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Plantmistress - 14 Nov 2007 16:37 GMT
I saw my RD yesterday - he says I'm doing well.  I mentioned that I
was still having a lot of trouble with my wrists (he dx'd carpal
tunnel at my last visit), even though I was wearing the braces from
Wally-world (Wal-Mart) like he suggested at night.  He said that he
didn't want to send me for carpal tunnel surgery, because he didn't
think it would help me any - he says it is arthritis-related, not
repetitive injury related.  I asked him if there were any exercises I
could do to help my poor wrists out & he said that maybe going for
some physical therapy on my hands & wrists would be beneficial,
especially since I type a lot at work.  He wrote me an Rx for it, so I
made an appointment for tomorrow morning.

I've never had to do PT or OT before.  What should I expect???  Can
anyone think of any questions I should be sure to ask?

Thanks in advance!!

Shannon
Navy - 14 Nov 2007 20:30 GMT
Some one will interview you to get an idea of your limitations and needs.
Then they will start a program just for you.  Usually, it starts with a
heating pad for a bit and then after the exercises, they will put ice packs
on the area.  They are very good, at least the one I went to was.

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Navy
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>I saw my RD yesterday - he says I'm doing well.  I mentioned that I
> was still having a lot of trouble with my wrists (he dx'd carpal
[quoted text clipped - 14 lines]
>
> Shannon
Squirrely - 14 Nov 2007 20:42 GMT
No suggestions, just wanted  you to know I was thinking of you. Sorry you
are having to deal with this too.

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Love and Hugs to all
Jo the squirrely one
I am nuts about you.

>I saw my RD yesterday - he says I'm doing well.  I mentioned that I
> was still having a lot of trouble with my wrists (he dx'd carpal
[quoted text clipped - 14 lines]
>
> Shannon
california_chief - 15 Nov 2007 09:00 GMT
Shannon wrote:

> I've never had to do PT or OT before.  What should I expect???
> Can anyone think of any questions I should be sure to ask?

Physical Therapy should go over your medical history and come up with an
exercise program to improve strength and ROM while reducing pain.

Occupational Therapy is interested in your limitations performing normal,
daily activities - dressing, putting on shoes, cooking, laundry, house
cleaning, etc. etc. etc.

PT gave me an over-the-door traction kit for my neck spasms and headaches.
Got me on a stationary bike, and performing a few other exercises.   Ca.
1964-66

OT gave me a "grabber", a long-handled shoe horn and a sock-aide to help me
dress.   Same dates.  Once I'm dressed, I have no big problems performing
other chores as long as I pace myself, don't overdo anything, and don't
exceed my weight-lifting restriction too much, too often.

... Geezer, formerly known as Stud Muffin.
Plantmistress - 15 Nov 2007 16:39 GMT
Thanks all - I went today & they checked out my range of motion, grip
strength, showed me some exercises, gave me new wrist braces that I
can type in, dipped my hands in warm paraffin (I love that stuff - it
makes the pain go away), gave me a brochure on which braces to buy to
sleep in (anyone use a "pillow" brace?) & gave me one of those funny
looking pens that you stick your index finger through to use.

Also set me up to come back in twice a week for a few weeks to do ROM
& hand strengthening exercises.

Interesting trying to type in the braces - I was really bending my
wrists, apparently.
nanny - 16 Nov 2007 11:09 GMT
Okay.  Sounds like you're off to a good start!  :-)  Nanny
> Thanks all - I went today & they checked out my range of motion, grip
> strength, showed me some exercises, gave me new wrist braces that I
[quoted text clipped - 8 lines]
> Interesting trying to type in the braces - I was really bending my
> wrists, apparently.
Squirrely - 16 Nov 2007 20:19 GMT
Glad they gave you wrist braces and the warm paraffin treatments. I hope
that helps you greatly. I hope the exercises help you out too.
I wish only the best for you.

Yeah it is interesting trying to type in braces isn't it. I tried that one
time and took the braces off. I couldn't do it. Also the mouse was an issue
with the braces. It kept getting away from me. LOL ;-)

It is amazing what we find out that we are doing wrong with things like
bending wrists and such when we are trying to get fixed.

You take care and hang in there.

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Love and Hugs to all
Jo the squirrely one
I am nuts about you.

> Thanks all - I went today & they checked out my range of motion, grip
> strength, showed me some exercises, gave me new wrist braces that I
[quoted text clipped - 8 lines]
> Interesting trying to type in the braces - I was really bending my
> wrists, apparently.
Plantmistress - 19 Nov 2007 22:07 GMT
> Glad they gave you wrist braces and the warm paraffin treatments. I hope
> that helps you greatly. I hope the exercises help you out too.
[quoted text clipped - 13 lines]
> Jo the squirrely one
> I am nuts about you.

Thanks, Jo!

I went back in today & they showed me some isometric exercises for my
hands - apparently, I have lost a ton of grip strength.  Today was
lots of stretching exercises & then work with the "therapy putty."  It
seems like the PA is more of an issue than the CTS.  The daytime
braces help & I am waiting to get the Pil-o-braces in from Amazon.  I
am supposed to sleep in those - they keep my wrist & hand in a
"neutral" position while I sleep (no tingly fingers when I wake up -
yay!).  My therapist has a student right now, so I got to give them an
education about PA - while the student was showing me how to use the
putty, the therapist was looking PA up online & reading stuff off to
us - she was surprised at how many people have it & how it affects the
bod.  I love helping to spread knowledge!

The braces seem to be helping w/ the CTS (when I wear them, anyway! -
still not used to typing & filing in them - am supposed to work up to
wearing them for 4 hours at work).  I can do about an hour at a time,
unless there is a rush for whatever I am working on right now.  I may
try a couple of hours at once tomorrow.

Anyway, that's the scoop on my therapy.  Talk/type more later.

Shannon
nanny - 16 Nov 2007 11:08 GMT
Hi Shannon.  I just have one piece of advice:  don't allow your PT to "group
you" into the average category with everyone else.  What works with one
person may not have the same effect on another.  I've found in my own
experience, particularly with the young men PTs, that they tend to think
that everyone should be able to do the same thing.  Go at your own pace.  PT
can be a good experience, but don't let them push you to the limit.  Nanny
> Shannon wrote:
>
[quoted text clipped - 19 lines]
>
> ... Geezer, formerly known as Stud Muffin.
Harvey R. Stone - 16 Nov 2007 12:56 GMT
> Hi Shannon.  I just have one piece of advice:  don't allow your PT to
> "group you" into the average category with everyone else.  What works with
[quoted text clipped - 3 lines]
> PT can be a good experience, but don't let them push you to the limit.
> Nanny

The limit is where damage is done and Nanny is sooo right about this but PT
is where we get better,,,our joints get closer to normal.
Harv
jofirey - 15 Nov 2007 21:45 GMT
>I saw my RD yesterday - he says I'm doing well.  I mentioned that I
> was still having a lot of trouble with my wrists (he dx'd carpal
[quoted text clipped - 14 lines]
>
> Shannon

OK.  I'm  not opposed to PT.  A physical therapist was the first to diagnose
my SI joint problems and to get me proper treatment for my arthritis.

And the SCORE program for the lower back is amazing.

But I question the use of PT for carpal tunnel problems.

First I question what difference it makes in treatment if the inflammation
in the carpal tunnel is caused by repetitive stress or by the inflammation
from arthritis.

In my own experience and from what I've seen in others over the years,
various treatments for carpal tunnel syndrome just draw things out.
Possibly allow the permanent nerve damage to worsen.

Regardless of the cause, if you need to treat the carpal tunnel problem, you
are likely going to have the tissue release surgery to relieve the pressure
on the nerve.

It isn't difficult surgery for the patient and provides relief for most
right away.

A common reaction to the surgery is "even the post op pain from the surgery
was far less than I had been living with every day.  And it went away pretty
quickly"

I did have PT on my hands after the surgery.

Big mistake for me anyway.  I finally called it off after several weeks.
Instead of giving be more strength in my hands and providing any kind of
relief, it just managed to irritate all the connective tissue in my hands
and make them extremely painful.  It took months to get over it.

So what I would ask.  If the PT is painful, what gain are we looking for,
and are we getting that.

Jo
nanny - 16 Nov 2007 11:10 GMT
Jo, this is just the type of experience that I was referring to in another
post.  The end results don't *always* justify the means.  Nanny

>>I saw my RD yesterday - he says I'm doing well.  I mentioned that I
>> was still having a lot of trouble with my wrists (he dx'd carpal
[quoted text clipped - 53 lines]
>
> Jo
Plantmistress - 16 Nov 2007 18:03 GMT
> But I question the use of PT for carpal tunnel problems.

The therapist seems to be concentrating more on the arthritis issues
in my hands than the CTS.  She pretty much just gave me braces to wear
& instructions on how to keep my wrists neutral both at work & while I
am sleeping.  Almost all the exercises are to strengthen & loosen up
my fingers.  I am thinking that maybe the pain is more from the PA
than the CTS, since dipping my hands & wrists in paraffin made the
pain go almost completely away. Interestingly, she told me not to use
ice for treatment unless there was swelling - she said the heat
appeared to work best for me.

> First I question what difference it makes in treatment if the inflammation
> in the carpal tunnel is caused by repetitive stress or by the inflammation
> from arthritis.

Honestly, I have no idea.  There may not be any difference, except
that the PA complicates things.  I know I was not having CTS symptoms
prior to dx w/ PA.

> In my own experience and from what I've seen in others over the years,
> various treatments for carpal tunnel syndrome just draw things out.
> Possibly allow the permanent nerve damage to worsen.

I will keep this in mind & will let RD know if it worsens - he is one
of the good ones (very responsive).

> So what I would ask.  If the PT is painful, what gain are we looking for,
> and are we getting that.
>
> Jo

So far, PT isn't painful.  If it is, I will be sure to ask.  Thanks
for the advice. :0)

Shannon
spodosaurus - 16 Nov 2007 15:39 GMT
> I saw my RD yesterday - he says I'm doing well.  I mentioned that I
> was still having a lot of trouble with my wrists (he dx'd carpal
[quoted text clipped - 14 lines]
>
> Shannon

You type a lot at work, but he ruled out RSI as the source of the pain?
That sounds a bit off...

Ari

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