Painful tingling in my hands...

[Skittl1321]

I was wondering if anyone would like to give opinions on this situation.

I have a very minor spinal cord injury at C5 and have some neuropathy in my wrists/hands/fingers, but 95% of the time have no symptoms. When I do have symptoms it is usually tingling or slight pain, especially if cold air is blowing across my hands (like an air conditioner) or slight weakness compared to an average person's baseline.

I did my OW checkouts this weekend- very simple diving. Saturday I was underwater about 40 total minutes, max depth 25 feet, most common depth 15 feet. Sunday I was underwater about 70 minutes, max depth 20 feet, most common depth 15 feet. The temperature was 65-70 degrees, in a 7mm so I was warm, though the water was cold (it was much colder below the thermocline, but we were not under that much on Sunday, slightly more on Saturday). The computers didn't even register NDL times- the whole dive was basically a safety stop, so I am not concerned at all about DCI issues.

I had no issues with my hands Saturday (though a roaring headache), but Sunday about 4 hours after diving my hands were very tingly and extremely pained. Massage helped reduce the pain, but as soon as that stopped it came back. It felt very similar to how I felt as I was recovering from the temporary paralysis, not pins and needles, or stabbing, just all over burning pain. (Of course then, I was medicated, so this amount of pain unmedicated was the same amount I felt then medicated.) This has never happened to me in the summer, generally if I have pain like this it happens when it is cold.

It was minor pain, but enough that I couldn't use my hands much yesterday afternoon. I had some weakness, where I wouldn't have wanted to weight lift, but was able to do things like pick up a fork to eat with no problem. The main thing is just they hurt too much to want to move around.

Today, they are back to a normal level of minor tingling, nothing like yesterday. So I do not think I have any serious issue going on.

But is it at all likely that diving had anything to do with this? Or just a coincidence that some sort of 'attack' happened after I was diving?

Should I just record this and if I see a pattern, maybe not dive? I was cleared by my doctor to dive, but she isn't a specialist in diving or neurology.

 

[boulderjohn]

I have the same problem. I have had extensive work done, including MRIs identifying the stenosis that affects the nerves going out to the hands and arms. A nerve test also showed mild carpal tunnel issues, as well as some impingement in the shoulder. All in all, my nerves have a rough go from spine to fingers.

Right now I am just fine because I have not been diving for several weeks. When I get back into the swing of things, the problems will return. I think the problem is not so much the diving. It is carrying around the equipment while on land or boat. I had the same problem earlier this year when I went for a long walk and ended up carrying my granddaughter back much of the way on my shoulders--much like a heavy set of scuba tanks. I have had problems after carrying golf clubs.

I have had physical therapy, and that helped. It mostly helped in that I was shown exercises I could do on my own to help. One thing that really seems to help is just letting the arm dangle for a while. To me, it is an annoying problem that is worth it for the fun of diving.

 

[tracydr]

Diving puts some stress on your neck, not only from the lifting of gear,but also because you put your neck in extension ( head back) position while diving. This could be one reason for the pain. Excessive lifting could be another. Both these reasons cause my hands to act up, as I have problems with my neck as well.
Both these issues should be checked out,as they could indicate a worsening of your neck. Did you have a fusion when you injured C5? Sometimes you can have issues above and below the fusion with disc herniations and spinal stenosis.
The other concern that I have is that this seems to be related to cool temperatures, especially since you also say you have problems with winter time. I'm concerned that you could have Reynaud's phenomena,which is an extreme reaction to cold extremities. If that's the case, diving in cool water may be dangerous for your fingers and toes.
A couple of final things-has your blood sugar been checked? Have you ever had your B12 levels checked?
I would see your doctor and discuss this. He may want you to see a neurologist or possibly a rheumatologist.

 

[Skittl1321]

Did you have a fusion when you injured C5?

Yes, I have C4-C6 fused. The C5 bone was removed and grafted. It has been 14 years since my surgery and I was given a 20-25 year 'sentence' on when I'd need another fusion due to degeneration, though my last MRI (2 years ago) showed the bones in good health. (I had an EMG/ Nerve Conduction study done 10 years ago and it shows damage to the spinal cord at C5, neurologist thought maybe a trapped nerve, got referred back to the neurosurgeon's whose response was "well, duh." However, that test was so painful, I'll never willingly have one done again.)

I have heard of Reynauds, but haven't really shown many of the symptoms. My feet don't have severe issues in the winter (I mean, they are cold when it's well below freezing, but not with pain or tingling), and my hands don't discolor. I live in a winter state, so it can get really cold around here. B12 might be something to look at as I am 'always cold'. Blood sugar was checked last year (for a pre-diabetes screening) and that all was fine. I didn't have blood tests this year.


So it sounds like I'm not crazy and it might be diving related, but maybe not. I'll just make sure next time we go to write down if I have any issues and how long they last, that way I have something to talk to the dr. about... And maybe stop trying to be so helpful and let people carry tanks for me. I do some light weight lifting, so while they are heavy, they are manageable for a short trip to the truck- but maybe it is just too much stuff for one day, with the other issues (I see what you mean about the diving position putting neck into extension.).

I'll probably add gloves to my gear. I had them in the bag, but chose not to wear them because the instructors said the water was warm enough, and I didn't want to deal with doing skills in gloves. While I never felt cold (well except below the thermocline, where everyone was cold) adding gloves might help since cold has been known to be a problem.

 

[DocVikingo]

Reynaud's phenomena, which is an extreme reaction to cold extremities.

Hi Skittl1321,

RP typically has an abrupt onset after cold exposure--it would be atypical for it to appear "about 4 hours after diving...." on the second day of cold exposure. Also, while an episode may last for hours, it most often only lasts for about 10-15 minutes.

When you have an episode, do your fingers (especially the fingertips) change color, such as turning bluish or white? If so, do the tingling & pain tend to abate as finger color returns to normal?

Do you develop such tingling & pain after cold exposure in other situations? Or under stress?

Regards,

DocVikingo

 

[Skittl1321]

When you have an episode, do your fingers (especially the fingertips) change color, such as turning bluish or white? If so, do the tingling & pain tend to abate as finger color returns to normal?

No, I don't show any other symptoms of Reynaulds. No color change in my skin tone associated with the tingling and pain. But my hands are always cold, especially in the winter (when I am never without gloves indoor or out).

Do you develop such tingling & pain after cold exposure in other situations? Or under stress?

I have never noticed any nerve issues related to stress.

I have a very low base level of tingling about 95% of the time (which, based on the potential severity of my injury, I'm thankful this is all I deal with. I could be not walking, or dead...). The level of pain is higher in the winter than the summer, so I've attributed it to cold. I have more weakness in my hands when I am cold, but still at a functioning level (so, for example, I can't open jars- but there are plenty of people with no issues who can't open jars. But when occupational therapists have measured my strength in my hands, I measure weaker for my hands than what would be expected based on my general fitness level. I do not regularly see an OT anymore). In the summer the main source of pain is from blowing across my wrists- I don't know if this is an actual cold reaction or the movement of the air, but since air conditioning is really the only thing that blows directly at my hands, it is cold air.

I don't have any issues if I'm say, hand washing clothes in cold water or holding a cup of ice cream- that sort of cold doesn't cause pain. We were in a swimming pool recently that probably was warmer than what we were diving in this weekend, but with no exposure protection, and although we all felt cold in the water, I didn't have any non-normal symptoms then.

 

[DocVikingo]

Hey Skittl1321,

Then it probably makes sense to work the musculoskeletal rather than the vascular hypotheses first.

Cheers,

DocV

 

[TSandM]

I'd be suspicious of the weight lifting or neck positioning issues simply aggravating any degree of nerve or cord compression that you already have, but the physicians who are familiar with your imaging studies would be better able to advise you than we can on line.

 

[Skittl1321]

Hey Skittl1321,

Then it probably makes sense to work the musculoskeletal rather than the vascular hypotheses first.

Cheers,

DocV

Thanks

---------- Post added July 29th, 2013 at 12:41 PM ----------

I'd be suspicious of the weight lifting or neck positioning issues simply aggravating any degree of nerve or cord compression that you already have, but the physicians who are familiar with your imaging studies would be better able to advise you than we can on line.

This seems like it is the most logical reason. It doesn't make sense for me to run to the doctor right now (not enough symptoms, takes too long to get an appointment, and costs too much money)- but I think logging the symptoms, and keeping track of them as I dive is going to be the best bet. If it is a reoccurring issue, then I'll have to see if it means diving isn't in the cards for me, or if I need to modify what I am doing somehow.

Thanks all.

 

[boulderjohn]

I'd be suspicious of the weight lifting or neck positioning issues simply aggravating any degree of nerve or cord compression that you already have, but the physicians who are familiar with your imaging studies would be better able to advise you than we can on line.

My physical therapist recommended specific changes to my weight lifting routines, especially using a rolled towel to support my neck while doing any work lying on a bench.