For the past few months, I have had pain on the posterior aspect of the PIP joint of my ring finger. I usually just tape it and it’s fine. However, after climbing at the gym last week, I noticed pain at the junction of my finger and palm. It hurts across all fingers with pressure. I have also experienced some tingling in my pec to antecubital area, the posterior humerus, anterior forearm, anterior wrist and palm. The tingling happens on and off. What gives? Do I have two injuries, a pulley and carpel tunnel? I have decided to take a few weeks off, but would appreciate any advice. I know the median nerve can be impinged at many places, so I will tell you that I have some protruding discs at C5/C6.
EILAH23/Rock and Ice Forum
Finger pain can be related to nerve-root pressure in the neck, but usually with pain all the way down your arm, and if it gets to your fingers you’ll find yourself in a world of hellfire that even the Creationists couldn’t imagine. Therefore I suspect your finger pain is related to something local.
The pain on the front of your fingers at the base is probably A2-pulley related. My guess is that you have either upped the ante with training or you are relatively new to climbing and the pulleys are not coping. As one of Australia’s ex-prime ministers once said in relation to an imminent terrorist attack: “Be alert, not alarmed.” Brilliant(ly stupid).
In this instance, however, it is actually a good axiom. Your pulleys are pissed off. Ease back until they calm down. If they start to hurt when you’re climbing, as opposed to with direct pressure, then you need to back off even further. Or go skiing for a month. I prefer to work on my shagging, but two kids are making that more difficult, so instead I’ve been buying power tools.
The pain on the posterior aspect of your PIP joint is more difficult to diagnose without seeing you—could be the joint, could be soft tissue.
Tingling, you say? Sounds like enough tingling to suggest you either own a meth lab or that C5/6 disc bulge you mentioned is wreaking sensory havoc. Carpal tunnel syndrome will only affect sensation below your wrist.
So, here’s what I’d do—back off on the intensity for a few weeks, then hang it all and go climbing. The loss and sadness of not climbing would outweigh the pain you are getting from climbing. It’s a no brainer!
Right now I’m in so much pain my doctor lets me inject pure opium (just kidding). Seriously, though, I’m experiencing some pain around my quadratus lumborum muscle in the low back. I’m taking Gabapentin and it helps, so a lot of the pain must be nerve related. The pain goes away while I’m lying down or sitting. Standing and walking cause the pain to ramp up. Do you have any advice? Drink 18 Red Bulls a day, take five grams of vitamin C? Anything? MRI’s show mild herniation, but zero doctors out of four have recommended surgery. Muscle relaxants help with my symptoms but not the problem.
Chris Dylan/El Paso, Texas
Pure fantastical opium … those were the days. I remember when people used a concoction containing opium to calm their crying children. Lucky for me, I was a fussy baby. The problem here is that your QL spasm is a response to your disc herniation, and no amount of pharmaceutical placation will resolve that.
Eighteen Red Bulls these days will probably just give you some funky heartbeats. Back in the mid 1990s when you could only buy them in Asia and they contained some truly potent amphetamines, 18 might have been fatal!
Five grams of vitamin C is a long shot even for hippies. Although research suggests high doses of C can reduce the duration of a chest infection, I’ve seen nothing to suggest it operates as an analgesic.
Spinal surgery has come a long way, but you’d do well to avoid it until that Mack truck is so close you need to look left and right to see its headlights. The different surgical options depend on the severity of your disc issue, where it presents, and if it puts pressure on the exiting nerve root. Not least of all, it depends on how much pain you are in. Sometimes a bulge that appears moderate or even small can produce an inordinate level of discomfort, which, even without neural symptoms like numbness and weakness in your legs, can be rather debilitating in terms of life’s finer pleasures.
Although I think cortisone is bandied around like fairy floss at the carnival it does have some use in pain control if the bulge looks like it may resolve. Mostly they do, given enough time. Patience might allow you to avoid the risks of anesthetic, surgical malfunctions and issues associated with fused vertebra. That you have to at least try conservative management is a given. Osteopath, PT, chiro, acupuncturist, blah blah, whatever humps your camel. Do it, and if it doesn’t work try something else.
If all fails and life has lost its fun, see a surgeon, but don’t book anything this side of six months unless you’re in paroxysmal pain or need a catheter to pee. Ride it out as long as you can and give your body every opportunity to do what it does best—heal thyself!