Addressing Worsening Bilateral Intersection Syndrome: A Personal Account
Hello everyone. I’m a 31-year-old male, standing at 5 feet 5 inches and weighing 77 kilograms. My medical history includes over a year of intravenous stimulant use, specifically with substances like Mephedrone and Methamphetamine; however, I have been clean for the past month and a half. Currently, I’m self-administering testosterone at a dosage of 100mg weekly and plan to discontinue it this September. I have no history of alcohol consumption or smoking. The symptoms began eight months ago in my right wrist and have just started affecting my left wrist within the last month. Initially, I was diagnosed with De Quervain’s Tenosynovitis. To manage my condition, I utilize a splint during the night and take ibuprofen every four to six hours. Additionally, I apply ice to the affected area and use a cold gel for further relief. I have also attended occupational therapy sessions and closely adhered to their recommendations. Despite these efforts, my hand function appears to be deteriorating daily; my movements are often accompanied by a locking and popping sensation. Pronation is particularly excruciating compared to supination. Finkelstein’s test yields a positive result, but the associated pain is only around a 2 or 3. In contrast, the discomfort from the locking and popping at the intersection escalates to an 8 on the pain scale. As a lifelong PC gamer, I haven’t experienced any prior issues like repetitive strain injury (RSI) or carpal tunnel syndrome. The onset of these symptoms correlates with a period when my substance use affected my gym routine, leading me to take a break for two to three months. Strangely, the discomfort first manifested in my right arm and has since progressed to my left arm. There is a family history of lupus, and while I underwent blood testing, the doctors have advised a retest, leaving me without a definitive diagnosis so far. I am wondering if there may be a connection to the lupus in my family, or if the hiatus from the gym could have led to my tendons becoming scarred and stiff. Should I consider advocating for an ultrasound? I had an X-ray when I was diagnosed with De Quervain’s, but the results warranted no further action. Currently, I don’t experience joint or tendon pain in any other areas. In the past, I occasionally dealt with issues such as elbow pain from weightlifting, tennis, or golf overtraining—but nothing has surfaced elsewhere since this began.
Answers (1)
6/22/2025, 10:01:11 PM
OpenHealth AI
It sounds like you’re dealing with increasing discomfort from your wrists despite your diligent self-care efforts. It's important to address both your symptoms and any potential underlying issues, especially given your family history of lupus.
Key Points:
- You have worsening symptoms related to De Quervain’s Tenosynovitis.
- You have a family history of lupus, which may warrant further investigation.
- Your treatment regimen includes splinting, medication, and physical therapy, but symptoms persist.
Explanation
De Quervain’s Tenosynovitis is an inflammation of the tendons on the thumb side of your wrist, but your symptoms, including locking and popping sensations, suggest there may be more complexity. Given your family history of lupus, there is some rationale to explore this further as autoimmune conditions can sometimes present with musculoskeletal pain.
The fact that you're experiencing rising pain levels, especially during specific movements, can indicate either a worsening of the current condition or a possible new issue developing in response to your wrist function being compromised for an extended period.
Next Steps
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Continue Current Management: Keep using the splint at night and apply ice to reduce inflammation. Take ibuprofen as needed but ensure you're adhering to recommended dosages.
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Advocate for Further Imaging: Request an ultrasound or an MRI of your wrists to gain a clearer picture of the soft tissue structure, which can help inform both diagnosis and treatment. Ultrasound can show tendon health, fluid accumulation, and other abnormalities that an X-ray would not.
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Consider a Referral for Further Evaluation: Discuss the possibility of having a rheumatologist evaluate you, especially given your family history. They can assess for signs of autoimmune disease and may suggest specific blood tests.
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Monitor Functionality and Pain Levels: Keep a detailed food and activity journal to note correlations between activities, pain levels, and symptoms progression. This information will be useful for any healthcare professional you consult in the future.
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Explore Modified Activities: Temporarily reduce or modify your gaming or activities that exacerbate the pain, as rest is crucial for tendon healing. Look into wrist-friendly exercises that can maintain strength without increasing strain.
Final Note: Your situation is complex, and it’s clear you’re committed to managing your health. Collaborating closely with healthcare providers is crucial at this stage, especially to address symptom persistence and the potential connection to your family health history. Please keep me updated as you progress.
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