Bilateral nerve pain in hands - possibly nerve root?

[Mintie]

Hi everyone, this is my first post. I sustained a C5 injury in September 2021 and have been dealing with constant nerve pain in my hands since then. It's bilateral, worst in my little and ring fingers and running up that side of each hand to about my elbow, decreasing in intensity up my harm. I was on gabapentin for roughly the first 11 months and went up to a very large dose before stopping it because it wasn't helping. I haven't taken any pain medication since then and have just been trying to ignore it, as it's more a low level discomfort than anything acute. The only things that do help temporarily are very intense pressure - massaging and pulling on the fingers - and hot water, to a much lesser extent.

This whole time I've just accepted it as the generalised nerve pain that comes with SCI and often can't be treated very effectively, so haven't raised it with my doctor as a priority. However, recently I've been doing some more research into it and it seems to fit the description of nerve root pain, C8 specifically, which is something that can be treated much more effectively. Does anyone have experience with nerve root pain and if so, what treatments have you found to be helpful? Also, what was the process of discussing it with your doctor and getting the appropriate tests done?

Thanks for your help!

[SCI-Nurse]

Have you tried Lyrica? Tegretol? Marijuana?

Do you have metal hardware in your neck? If not, TENS might be worth a trial.

Some people have had some relief with acupuncture.

Root pain is difficult to differentiate from pain due to the cord lesion itself, especially in the cervical area.

(KLD)

[Mintie]

Thanks for the suggestions KLD. I haven’t tried any pain relief apart from baclofen, because usually the pain isn’t quite great enough to prompt me to do anything about it, but I would like to give some more things a try. I’ve heard positive anecdotal evidence about acupuncture and marijuana, so they could be good alternatives to yet another medication.

I also used an FES machine as an inpatient to strengthen my finger flexors, which I found provided good temporary relief. Is this similar to what TENS would do? I stopped the FES when my flexors started tightening, but maybe I could have a look at something like that again.

[SCI-Nurse]

Similiar but FES is to stimulate the muscle. TENS and similiar is to decrease pain by the “gate theory”. Basically won’t feel the pain as the electrical stimulation will change it. Diclofenac gel on hands also might be helpful if inflammation related. CWO

[Mintie]

Thank you, I’ve done some more research into TENS and it looks like it could be helpful. Definitely something to discuss with my team.

[DarcySB]

I'd suggest checking into high-intensity laser therapy with a class IV laser.
I've just started laser therapy for tingling and numbness in my hands and it's looking promising.

[Mintie]

Interesting, I hope it makes a difference for you. Had you tried other things before?

[DarcySB]

Interesting, I hope it makes a difference for you. Had you tried other things before?

Yes, I have tried a number of things. Ibuprofen for 10+ yrs, wrist splints at night, cortisone injection, myofascial release, and now laser.
Trying the laser therapy is actually due to a comment on this forum by a user who had success treating carpal tunnel with it.