23 replies to this topic

[Travelling Blackbird]

Do any of you manual chair users get pains in your wrists, and if so, are they dull aches or sharp pains, all the time or only when you're moving around a lot with the chair? I'm having a problem with mine, and I'm at a bit of a loss.

I've been getting more and stronger pains in my wrists. It's generally a dull ache, and it makes moving the wheelchair around more tiring. Also, when I'm transferring myself, I can get some really sharp pains, shooting up from wrist to elbow. It's worst on Mondays, when I have to go about ten blocks in the wheelchair (Ti Lite TX, ultralight manual), and Wednesdays, when I run my errands and do the groceries and stuff, so I am assuming it's related to moving the wheelchair.

I've had my GP look at my wrists, but he says that moving the wheelchair shouldn't cause pain, and that there must be something else I'm doing. The only solution he offered is wrist braces to take the pressure off and let my wrists rest. I can't use them while I'm in the chair though, because they are a bit too clunky, and they get in the way of the wheels.

I'm still waiting for an appointment with my neurologist, but it's a long wait because my insurance company is a bit naff.

[Trinity]

I haven't got any problem with my wrists but I have a problem with tendonitis in my elbow which started after a couple of weeks of 'burning the candle at both ends!'.

Despite trying to rest it (not the easiest thing in the world, it's my left arm and I am very left handed!) and industrial doses of ibuprofen it is still a problem 2 months later.

When it first started I could hardly transfer at all as I wasn't able to put any weight though it without a lot of pain and the elbow kept giving way. It has improved since then but I am still waiting for an 'urgent' physio appointment, luckily I have a couple of friends that are physiotherapists who have given me some tips to give me a head start.

Edited by trinity, 14 September 2008 - 10:07 PM.

[qbounce]

A lefty, ay trin? Well . . . that explains everything!
I thought your words looked a little slanted-hehe

btw, right shoulder here.

TB, have you tried the type of wrist braces bowlers use. I'm not sure if they're the same as you've already tried, but I remember it not being that cumbersome. And if you could hold a bowling ball with it on, then maybe it isn't as difficult to wheel with either.

Edited by qbounce, 14 September 2008 - 10:29 PM.

[nomis]

Obvious there's stress on the wrists. Like Trin says, it might be tendons, or it could be stress on the joint bones or ligaments.

You're a bit young for osteoarthritis but that or a preliminary to it should be considered. Fish oil is supposedly good for joints.

First up, I'd be looking at your wheelin' style. Are you smooth and smart in your wheelin' or aggressively in a hurry? And what about your diet?

[Hapahowlee]

Hi TB,

I'm AB and never had to use a wheelchair, but I did break my foot some years back and was on crutches for 6 weeks and had issues with my wrists and shoulders. The first thing I thought of when I read your symptoms was either tendonitis or some form of arthritis. I discovered I have tendonitis in certain parts of my body when I was 15 and arthritis sometime in my early 20s. It actually doesn't bother me too much since I moved to Arizona where the air is very dry.

Seems like you've gotten some good advice already about the brace and fish oil. I've heard the same. Whatever it is I hope it's just temporary.

Take care,

Hapa

[E-DOG]

Put the Playboy down and step away from the vaseline.

sorry TB. i tried, but i just couldn't stop myself.

Gotta be your push technic. Sounds like you're impinging a nerve (ulnar?)
As humans we obviously were not designed to push a wheelchair. Eventually something's gotta give.

E

[Slowlegs]

Travelling Blackbird, on Sep 14 2008, 09:43 PM, said:

Do any of you manual chair users get pains in your wrists, and if so, are they dull aches or sharp pains, all the time or only when you're moving around a lot with the chair? I'm having a problem with mine, and I'm at a bit of a loss.

I've been getting more and stronger pains in my wrists. It's generally a dull ache, and it makes moving the wheelchair around more tiring. Also, when I'm transferring myself, I can get some really sharp pains, shooting up from wrist to elbow. It's worst on Mondays, when I have to go about ten blocks in the wheelchair (Ti Lite TX, ultralight manual), and Wednesdays, when I run my errands and do the groceries and stuff, so I am assuming it's related to moving the wheelchair.

I've had my GP look at my wrists, but he says that moving the wheelchair shouldn't cause pain, and that there must be something else I'm doing. The only solution he offered is wrist braces to take the pressure off and let my wrists rest. I can't use them while I'm in the chair though, because they are a bit too clunky, and they get in the way of the wheels.

I'm still waiting for an appointment with my neurologist, but it's a long wait because my insurance company is a bit naff.

It sounds like RSI (repetitive strain injury), also called OOS (occupational overuse syndrome). I work on a computer all day in my job and have the same symptoms as you. I can switch mouse hands but you can hardly use one hand for your chair. Perhaps there are options for you with regard to an electric loan chair perhaps. Your GP or a physiotherapist should be able to give you an idea on what it is. I did hear an article on the radio that disabled people suffer more of these sorts of injuries because we rely on our arms as arms and legs. Good luck, I know it can be painful, I first discovered I had mine when I was working on my car with a screwdriver. The twisting and gripping was agony. I also use tiger balm when it gets really sore.

[Travelling Blackbird]

trinity, on Sep 15 2008, 12:06 AM, said:

I haven't got any problem with my wrists but I have a problem with tendonitis in my elbow which started after a couple of weeks of 'burning the candle at both ends!'.

Despite trying to rest it (not the easiest thing in the world, it's my left arm and I am very left handed!) and industrial doses of ibuprofen it is still a problem 2 months later. ... luckily I have a couple of friends that are physiotherapists who have given me some tips to give me a head start.

Trinity, if you have the chance to share any of those tips, I'd love to hear them. A few people have suggested tendonitis, and even though the doctor hasn't said so yet, I'd like to try something pro-active instead of just waiting.

It is almost impossible to rest, isn't it? I mean, we use our hands EVERY DAY!

qbounce, on Sep 15 2008, 12:28 AM, said:

TB, have you tried the type of wrist braces bowlers use. I'm not sure if they're the same as you've already tried, but I remember it not being that cumbersome. And if you could hold a bowling ball with it on, then maybe it isn't as difficult to wheel with either.

Qbounce, thanks for the suggestion. I shall look into it.

nomis, on Sep 15 2008, 01:50 AM, said:

You're a bit young for osteoarthritis but that or a preliminary to it should be considered. Fish oil is supposedly good for joints.

First up, I'd be looking at your wheelin' style. Are you smooth and smart in your wheelin' or aggressively in a hurry? And what about your diet?

Nomis, thanks for the suggestions, and I think you've put me on to something. My diet has been worse since school started back. Normally, I would have a decent breakfast and lunch, and then a light dinner. I've been just having a sandwich or donut for breakfast and another sandwich for lunch the past few weeks, and then having my main meal late, and I'm usually so hungry by then that I just bung something in the microwave. I never think of diet as a cause of problems. I should have looked at that sooner.

As for my wheeling style... yeah...
I'm usually good at pacing myself, really. I try to go smoothly, pacing either left-right-left-right if I need to be a bit faster, or both together at a good steady pace for just getting around, but last week I was getting up a little later and speed-demoning it from the train stop to the school for a couple of days.

I'm embarrassed to admit I didn't think of this stuff myself.

Hapahowlee, on Sep 15 2008, 05:34 AM, said:

I was on crutches for 6 weeks and had issues with my wrists and shoulders.

That was a big issue for me in rehab because I was being really stubborn and forcing myself, trying to prove I'd be better by the end of the first month.

Hapahowlee, on Sep 15 2008, 05:34 AM, said:

I discovered I have tendonitis in certain parts of my body when I was 15 and arthritis sometime in my early 20s. It actually doesn't bother me too much since I moved to Arizona where the air is very dry.
Take care,

Hapa

Glad to hear that it bothers you less now. Arthritis is a painful one, from all reports.

And thanks for the well wishes. Fingers crossed!

E-DOG, on Sep 15 2008, 06:26 AM, said:

Put the Playboy down and step away from the vaseline.

sorry TB. i tried, but i just couldn't stop myself.

Gotta be your push technic. Sounds like you're impinging a nerve (ulnar?)
As humans we obviously were not designed to push a wheelchair. Eventually something's gotta give.

E

Bwahahahahahaha! You da man, E-dog. Never stop.

With what you and Nomis have said, I think I do need to look at my push technique again. I can be an impatient roller.

I have an appointment with my neurologist in a couple of weeks, and I'll mention that idea. It feels muscular, but neurological pain often does.

Slowlegs, on Sep 15 2008, 08:31 AM, said:

It sounds like RSI (repetitive strain injury), also called OOS (occupational overuse syndrome). I work on a computer all day in my job and have the same symptoms as you. I can switch mouse hands but you can hardly use one hand for your chair. Perhaps there are options for you with regard to an electric loan chair perhaps. Your GP or a physiotherapist should be able to give you an idea on what it is. I did hear an article on the radio that disabled people suffer more of these sorts of injuries because we rely on our arms as arms and legs. Good luck, I know it can be painful, I first discovered I had mine when I was working on my car with a screwdriver. The twisting and gripping was agony. I also use tiger balm when it gets really sore.

Is it that Carpal Tunnel Syndrome that you have? A friend got that from computer work and painting wargame miniatures, and has surgery coming up.

Tiger balm? I'll have to look that one up.

[Slowlegs]

Tiger balm is available in a lot of alternative and chinese health stores. I am not sure if carpal tunnel syndrome is the same thing but I will take a look. I was also thinking, rather than a hard plastic splint or brace, there are also wrist supports made of neoprene which can help with pain and some support too.

[nomis]

...and maybe some slow, gradual build-up strengthening of the wrists. Whatever the problem, careful continual exercise is more than likely beneficial.

I've been shovelling horse and chicken shit all day around my garden. Don't do this. It's tough on your senses, saps your energy and as hard on your wrists as a lonely adolescent feeling neglected on prom night.

Edited by nomis, 16 September 2008 - 07:36 AM.

[McRobb]

Actually, I was looking for some info on this very topic!

Just got the diagnosis of carpel tunnel in both wrists and will need surgery on both. I have been having trouble for a number of months and blamed it all on arthritis but it has gotten so bad the last few weeks that I have been on pain pills in order to make it through the day and night.

I have been in a electric chair for over 4 years and the repetitive movement of joystick and use of hands for everything you do has caused this. Will do the surgeries but not looking forward to being "down" for a couple of weeks or more after each one.

My husband and I wondered how common it was for people to get carpel tunnel after being in a chair for so long - any idea on what percentage of SCI people get this?

Best of luck to all who have trouble.

[Hapahowlee]

nomis, on Sep 16 2008, 12:35 AM, said:

I've been shovelling horse and chicken shit all day around my garden. Don't do this. It's tough on your senses, saps your energy and as hard on your wrists as a lonely adolescent feeling neglected on prom night.

Nomis, I guess I'm a little slow today, I had to read that last line again before I finally understood what you were referring to, got it now

[Trinity]

Travelling Blackbird, on Sep 15 2008, 08:08 PM, said:

trinity, on Sep 15 2008, 12:06 AM, said:

I haven't got any problem with my wrists but I have a problem with tendonitis just above my elbow which started after a couple of weeks of 'burning the candle at both ends!'.

Despite trying to rest it (not the easiest thing in the world, it's my left arm and I am very left handed!) and industrial doses of ibuprofen it is still a problem 2 months later. ... luckily I have a couple of friends that are physiotherapists who have given me some tips to give me a head start.

Trinity, if you have the chance to share any of those tips, I'd love to hear them. A few people have suggested tendonitis, and even though the doctor hasn't said so yet, I'd like to try something pro-active instead of just waiting.

It is almost impossible to rest, isn't it? I mean, we use our hands EVERY DAY!

The tendonitis I have is actually tricep tendonitis, apart from being told to avoid over extension and repetitive movement I have been advised to gently stretch it several times a day, massage the area (but only in one direction, not sure why!) and ice it. The funny thing is the very movement I have been told to avoid is using my arm to push myself up with, the exact movement you use when transferring or relieveing pressure. Think thats one i can't easily avoid.

You need to get a diagnosis though as a solution for one problem could actually cause more problems if it was something else

[Travelling Blackbird]

Slowlegs, on Sep 16 2008, 09:30 AM, said:

Tiger balm is available in a lot of alternative and chinese health stores. I am not sure if carpal tunnel syndrome is the same thing but I will take a look. I was also thinking, rather than a hard plastic splint or brace, there are also wrist supports made of neoprene which can help with pain and some support too.

Thanks for the tips. There's a large Japantown here in Dusseldorf with several Far Eastern health stores. I'll look there. The neoprene wrist supports that I tried before cut into the muscle between my thumb and index finger because moving the wheel moved the wrist support, so I have shied away from them.

nomis, on Sep 16 2008, 09:35 AM, said:

...and maybe some slow, gradual build-up strengthening of the wrists. Whatever the problem, careful continual exercise is more than likely beneficial.

I've been shovelling horse and chicken shit all day around my garden. Don't do this. It's tough on your senses, saps your energy and as hard on your wrists as a lonely adolescent feeling neglected on prom night.

Bwahahaha!

Good suggestion with the wrist exercises. I am looking for some good ones online.

McRobb, on Sep 17 2008, 03:02 AM, said:

My husband and I wondered how common it was for people to get carpel tunnel after being in a chair for so long - any idea on what percentage of SCI people get this?

Best of luck to all who have trouble.

I don't know how common it is, but it'd be interesting to find out. As others have said, our wrists weren't designed for this movement.

trinity, on Sep 17 2008, 10:37 PM, said:

You need to get a diagnosis though as a solution for one problem could actually cause more problems if it was something else

Good point. I should know better.

Still waiting for an appointment...

[Char]

Has anyone had the closed (endoscopic) carpal tunnel surgery? Allegedly you have full use of your hands within a couple days but how does the translate to wheelchair users who needs hands to transfer, push, etc.....? My doctor says he would put a brace on for a few days as the main concern is to avoid opening the sutures. course he is not the one in a chair, so does he really know the pain and hassle it would be?? So, if anyone out there has had the surgery, please let me know the outcome and the real recovery to expect. Thanks!

[E-DOG]

Slowlegs, on Sep 16 2008, 12:30 AM, said:

Tiger balm is available in a lot of alternative and chinese health stores.

TB,
The tigerbalm is for your WRISTS!
Don't use it to replace the vasaline.
You wont like the results.
And what did I say about that magazine?
E

[jane]

It has improved since then but I am still waiting for an 'urgent' physio appointment, luckily I have a couple of friends that are physiotherapists who have given me some tips to give me a head start.
[/quote]


I have got pains in my right wrist and upper sholder - from using both my cutches and chair - my gp says it is tendonitis and has also given me a 'urgent' referal to physios - 2 months ago!! still waiting.

still in pain - but trying hard to rest it.

[ems]

I had an operation this year for an ulnar nerve prob on my left arm. I lost the feeling in my 4 and 5th digits and parts of the front and back pf my hand. I lost the muscle on the side of my hand nearest my 5th digit, and also the muscles between my thumb and index finger. I was booked in for nerve conduction studies as soon as I was refered. Result was as I had left it so long, surgery was needed to repair the damage to the nerve and to site the nerve elsewhere so as not to damage it in the same way again.

I had Ulnar Nerve Transposition surgery and repair to the sheath done in May, I had it done under a nerve block in the neck so I could watch ;) I will not see the results of the surgery for atleast a yr or even more, and my surgeon said I should get 40% return. Nerve regeneration is around 1mm a day. Had I gone to the docs sooner, I could have got away with a simpler operation and more return.

I was sent home in the evening after going into surgery at 8:30. I was given a bag which had in it, 50 Codeine 30mg tabs, 50 Dicofenics, and 50 tramadol! I stard up at the nurse, and asked her if the amount of painkillers given was equal of the amount of pain I was apparently due to have! She said that I may joke while I couldnt feel it, but when the feeling came back it would be pretty painful. I smiled sweetly, put the drugs in my bag, and went home. Well, after seeing consultant AGAIN, and then the bloody OT who didnt want me to go till she showed me how to USE A BLOODY TRANFSER BOARD!!!! and a physio which took 5 hours in all

After the surgery I was still paralysed on that side for 48 hours which was a pain in the ***. I had put an indwelling in for the op anyway and left it in for 2 weeks. I had a banana board and an electric bath chair and was in an electric chair for 5 days, after that I still used it outdoors, but used my manual chair indoors. I used the board for about 2 weeks, just till the stitches were out, and then started to use my arm more. I used the bath lift/chair for about a month.

I was sent to the splint maker the week I had the stitches out to put it into a "useable" resting splint, and it supposed to stretch my fingers, but it hasnt worked, and I do wear it when ppl arent watching!!

I still to this day have had ZERO pain from the op. I didnt open any of the packets of pills, though I never have got the feeling back around my elbow all around the site of the operation, I couldn't feel the stitches come out, and I had 26 of them. I still cant move or feel my 4 and 5th digits, and have a floppy side of the hand.. you can see the bones now . But I have no pain, so I'm pleased. I was told to not play basketball this season, and really, I wouldnt have anyway. I still ride my bike alot, I do 10 miles a day in the morning, and more if I have the time.

I am now due to have another operation to snip the tendons in my hand so I can straighten my fingers better as they are pretty curled up and to release the carpel tunnel in the left hand as that has been affected too, if I have an L shape cut they can do it all in the same op ;) I know after having the elbow done, carpel will be nothing. We'll see what happens.

All in all the op went fine, I was fine, I've got used to naughty fingers that dont do anything. The cause of the problem!? Well, surgeon says it is a mix of pushing the chair, to hard elbow injuries from falling out of my chair at speed ( ;0 ), leaning on my elbow, which yes I do do I guess. I lean on my left side to balance myself while I'm doing something with my right arm, you just do it automatically.

So really I think he doesnt really know why it happened. I've banged my right arm just as much, I lean on my right arm too, and I would say I actually push harder on my right than my left!!!

Personally I think its the chair, as someone else commented, we were not designed to be using our shoulders as hips, we were not designed to push a chair all day, and sometimes, parts get worn out!

Conclusion: Well, dont leave any tinglings, aches and pains, elevctric bolts up arms till you cant feel it! I was told not to use my arm ( not suppsed to bend my elbow or push down on my arm) for 8 weeks after the op, I gave it 5 days for bending it, and two weeks for pushing down on it. My mental health would have been affected had I done so little in the way of excercise etc had I subjected myself to 2 months rest. I found it hard to sleep in the first few days as I had done NOTHING, nothing energetic. My mind was tried but my body wasted to get my bike out of the garage and cycle to brighton and back. That really was the only annoying thing out of the whole experience.

Getting dressed was fine with only one hand. I only wore dresses and cardigans really! Anything I could put on by myself. You soon learn to buy boxes of wine instead of bottles, for one handed dispensing ;)

Edited by ems, 23 November 2008 - 05:11 PM.

[edlee]

Tendonitis,,, bursitis,,, arthritis,,,if it's got an "itis" on the end of it,, we get it from the abuse we put our hands, arms, and shoulders through, on a day to day basis.

Carpel tunnel syndrome is just another of these wonderful gifts SCI keeps bringing us.

Cortizone shots have helped my shoulders,,,, temporarily,,,,,,the wrist splints seem to help my carpel tunnel ,,,,,temporarily,,,,,,,, Tiger balm, Analgesic balm, Bengay, and any number of these oils, salves,and sprays that stimulate a feeling of heat help with my arthritis,,,, temporarily...

I'm afraid the only real cure for these problems we face is the same one that cures getting old,,,,,,,, and I'll pass on that one for as long as I can.

ed

[wheelkid]

maybe, carpal tunnel syndrom....???

Some calcium pills might help, you might be getting small stress fractures in your ams.

[LuckyinKentucky]

Tendonitis,,, bursitis,,, arthritis,,,if it's got an "itis" on the end of it,, we get it from the abuse we put our hands, arms, and shoulders through, on a day to day basis.

Right on Ed... My carpals were acting up a few months ago so i tried going on light duty and just when it would seem to be getting better I'd move just right an feel that stab signaling that yep it's gonn hurt for another while. No matter how easy i tried to be I'd always end up hitting it.

The doc said it was carpals and really the only thing to do (besides surgery...ugggh) is to give it rest. Which by the way is not what your doing during your push to work blackbird.

I solved the problem by getting a wrist splint ( the one with the metal bar that runs uo the inside of the wrist) from Wal mart. By day 2 the metal had burst through at the inside of the hand but i duct taped it and made it last for 3 or 4 days after which my wrist was feeling great, and has since.


Long story short//// it needs a little rest/// or you can operate..and have to rest it anyways.

[Travelling Blackbird]

Update on the old issues that I first asked about:
I tried out bowling wrist braces, and they were really helpful. They don't get in the way when I'm wheeling, and they don't take as much damage themselves, because they fit under the gloves.

I also started using tiger balm, and don't worry, E-Dog, I kept on the right part of my body, and away from the vaseline. I found it quite soothing, and it's less expensive than a sodium diclofenac cream, which was the neurologist's suggestion.

Wrist exercises helped, although it's tough to strike a balance between exercising and resting. It does no good to overdo things by exercising on a day when I have a lot to do.


New issue (and why not?) (and come to think of it, more of a vent than anything else):
My right wrist was broken, and the cast only recently came off. The atrophy is incredible - my wrist looks like skin and bones. It's still very weak, and I've been given exercises to do to strengthen it. It gets tired very fast, and consequently, I can't get around as far or as fast in the wheelchair as I used to. The docs just said "Have someone push you." but I really don't have anyone in my life who could fit that role. An excuse to take it easy... *grumbles*

Has anyone ever broken their wrist or hand? How long after the cast came off before it got back to normal? How much trouble did the wrist give thereafter?

[greybeard]

Would something like this help? http://www.physiomed...s...&rangeid=34

[Travelling Blackbird]

greybeard, on Feb 28 2009, 07:16 PM, said:

Would something like this help? http://www.physiomed...s...&rangeid=34

Thanks. That might be just the ticket. I have a good enough range of movement, and comtrolled exercises like that would be a good thing.
I'll look into it and report back.