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Living with Psoriatic Arthritis (PsA)

Doctor for cubital tunnel

#1

I’ll be making phone calls tomorrow about this. I’ve had cubital tunnel and carpal tunnel for a while. I was looking at my wrists last night for visible swelling there bc my wrist was hurting, and realized that I’ve got significant wasting of my right hand. Primarily it’s on the pinky side, but apparently there’s some on the thumb side as well. My right hand is now significantly smaller than my left. I ran into my friend who’s an OT and she was impressed and said there’s definitely weakness.

So here’s my question. Who do I see? The neurologist? The hand doctor? Someone else completely? Who does the assessment and surgery if needed?

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#2

In the UK - it would definitely be a specialist hand surgeon who consults with a neurologist.

#3

Hey Stoney,
I have a family member who has required this particular surgery, so I called her to ask. She informs me it was an orthopaedic surgeon who was consulted and performed the surgery BUT as your situation involves multiple fields I’d recommend a joint consultation with all parties, if this can be arranged.
I have in the past consulted one specialist without consulting another field specialist (totally unrelated field) and although I did not consider there to be any alignment, the other dr was less than impressed that he had not been asked for his input. Some medicos can be a little self important when it comes their own patients, even when it may have very little/nothing to do with their specialization.

Merl from the Moderator Support Team

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#4

Thanks Sybil and Merl. I’m guessing that the hand doc will want nerve testing done beforehand anyway. Now I need to see if I can work a minor miracle and get in to be seen by the hand doc (who has done a few surgeries on me already) can see me or if I’ll be seeing his physicians assistant.

#5

FWIW when I had it done last year i saw a Hand ortho-specialist who first referred me to physiatry for nerve testing before doing the surgery. They need to confirm that it was nerver entrapment first as it there are OTHER reasons for the symptoms including immpigment in the acromion which is very common with PsA. A torn rotator cuff will cause it too. That requires an MRI of the shoulder. Its a completely different surgery (and MUCH more pleasant than the nerve release)

#6

Great. Thanks! Made my appt with the hand doc for next week and then figured there might be nerve testing.

#7

Hope it works out That entrapment or acromion damage causes a lot of back pain right around and just below the shoulder blades too and even into the neck…

#8

That makes me think that it is NOT located there, and is at the elbow. That’s the same side that I had the AC joint surgery on in November, but this is brand new, and I’m not having any pain there that sounds even remotely like that. I do have elbow issues, and definitely already have carpal tunnel and cubital tunnel problems. I guess the nerve testing will show that all.