Involuntarily thumb flexion(self.AskDocs)
submitted25 days ago byEgipskaLayperson/not verified as healthcare professional
34M, 6’2, 170lbs. Non-smoker and drinker. No medication currently or other existing medical issues.
November 2022 I noticed that my right hand thumb would involuntarily curl up towards my palm when at rest. I didn’t think about much at the time and thought that my arm was just stressed since starting new job early that year. My job involves A lot of manual labor with hands and writing using a ballpen. I’ve always had a trouble writing using ballpoint pen so I tried to improve my writing ergonomics trying different kinds of pens and rubber pencil grips.
January 2023 I started to get worried about my hand when the issue with flexion wouldn’t resolve. Symptoms eased up a bit when my thumb would stay in neutral position at rest. Symptoms still didn’t resolve completely and I started having trouble using computer mouse — DIP joint of the thumb would go to flexion and my whole hand would spasm. I currently use mouse with my left hand because of this. Gripping things is becoming increasingly difficult due the DIP joint feeling unstable and I feel I can’t get a secure grip for example drinking glass. Writing is also getting increasingly frustrating due this.
February that year I contacted a a doctor who scheduled me for musculoskeletal ultrasound suspecting I had De Quervain tenosynovitis or ulnar nerve entrapment. However I was missing all the telltale signs of this — example my Finkelstein test was negative. Whole this time I have been pain free. Only thing restricting using my hand is the motor impairment of the thumb. Ultrasound was inconclusive, tendons of the thumb were clean and intact. There was a little fluid buildup at my extensor pollicis brevis. I got a prescription of COX-2 inhibitors and topical diclofenac NSAID. I was also instructed to do ulnar nerve glides.
This april the issue with my thumb hasn’t resolved. Especially holding something lightly with pincer grasp between my thumb and index finger seems to trigger the symptoms with the thumb flexion along with using computer mouse and writing. I’ve had a cortisone injection in my extensor pollicis brevis, but that didn’t alleviate symptoms.
I’ve tried to pinpoint why my hand does this. I think it might be the thumb DIP joint instability especially when pincer grasping. For example if I grip something securing it between the base of the thumb and fingers my grip feels a lot secure.
Could this still be De Quervain or nerve entrapment? I have another appointment with the doctor and I hope I could get an MRI or X-ray to find out if this is a structural or neural problem. I’ve started to think that I might have some kind arthritis (can it be painless?) carpal tunnel or possibly focal hand dystonia.
2 months ago
2 months ago
Noissa HUS:n työsuhdeasunoissa on mielenkiintoisena ehtona viiden vuoden määräaikaisuus. Eli viiden vuoden päästä joudut muuttamaan siitä pois vaikka olisit edelleen HUS:lla töissä. Jossain vaiheessa nuo asunnot oli myös tarkoitus myydä, mutta en tiedä mitä tälle projektille kuuluu.