Doctor recommendation

Okay, so I'm in my 4th year of serious cycling and I think I have finally reached the point of breaking down to go see a doctor about my hands. My hands hurt when I ride. EVERY RIDE...for the ENTIRE ride. There have never been any exceptions. I have learned to just "suck it up" and tolerate it (I guess I have a high threshold for pain)...otherwise I would never ride, if I let it stop me. The pain and numbness are so bad, that at times, I am on the brink of tears. But again, I just suck it up, shake out my hands and continue on. I have tried everything...and I do mean everything. I have had 4 professional bike fits, including a Retul fit, and one other very extensive fit that involved the use of Dartfish video motion. I've been through 4 bikes in as many years (currently riding a custom Ti Seven Axiom SL) and still have had no success in resolving my hand issues. Even the fitter of my Seven is completely stumped on this and feels that we have hit a "dead end". I have spent so much money on bikes and bike fits, yet every single ride I do results in sheer agony. I just cannot take it anymore and if I want to continue riding (and I really do!), I need to get to the root of what is causing these chronic hand issues. Problem is...I have no clue what kind of doctor I even need to look for. Is there even such a thing as a hand specialist? Any recommendations for such a doctor in the Chicago suburbs would be so greatly appreciated!

Linda

There are orthopods that specialize in hands. I had to see one for a finger issue some years ago. He's a board certified ortho, but his specialty was hands. Not sure that ortho is the right field for this (though it certainly would be a start), but I can tell you that there are ones that are hand specialists. Not sure about a neuro that might specialize in hands though, and given your description, I'd possibly want to start with a neuro. That also is a personal bias since I've been dealing with some parasthesias with my leg and the ortho was worthless, but the neuro seems to really be trying to find out what is amiss.

Do you think it's nerve related? If so, then I'd try to find a hand surgeon as a place to start. There's a place near you called The Chicago Center for Surgery of the Hand. Otherwise, I'd see a neurologist. Good luck; I'm sorry you're still dealing with this.

Hope you find a solution.

Do you ride on dropped handlebars? Presumably you've tried different gloves with various padding styles.

Consider more upright bike geometry style.

My hand pain comes directly from my neck. If I let my head sink, my shoulders rotate forward or let my chin come up, my hands immediately have problems. It is not the fit of my bike; it is my spinal posture.

Maybe start with your family doctor. You may end up being referred to a neurologist if it is likely due to nerve compression. My husband had similar hand pain that went on for years. He is a stubborn cuss and didn't see a doctor until he had trouble even grasping things. He had such bad nerve impingement in his wrists and elbows that he ended up with permanent damage to his hands and permanent nerve pain, even after surgery. His was an extreme case but it shows what ignoring things can do.

Do your hands every hurt at other times at all, ever? Numbness in shoulders or arms, even a little? Nerve impingement in the neck can cause referred problems in the hands depending on where the problem is located. I learned this the hard way last fall when a neck injury aggravated/caused some cervical spine issues which caused significant hand problems. Posture also matters greatly - I must have a very upright position on the bike. I can no longer attend spinning class as it isn't possible for me to be upright enough :(

Personally, I would start with your regular doctor to determine which direction you should go. It could be a problem in your hands, wrists, elbows, or elsewhere. The important thing is to get this checked out. Hang in there and I hope the cause is easily found and resolved.

Sending you warm thoughts and good wishes.

I would second the notion of NOT going to a hand surgeon first off. It's my experience (not just personal experience, but what I've seen from working with people with disabilities) that doctors with narrow specialties are wonderful about doing the work they're trained to do, but not so great about identifying issues that may have arisen outside their area of focus (or deciding whether they're truly the appropriate specialist to be treating you at all). This is especially true of surgeons (not just my opinion, but what I've heard from other doctors and PTs too).

Nerves that feed the hands can be entrapped anywhere between the neck and the hand. Neck, shoulder (thoracic outlet), elbow, wrist.

What you need is someone who can identify exactly what it is posturally that's causing your issues. For myself, my sister urged me to see a general ortho who's trained and experienced in manual muscle testing. Some PTs can do this as well.

Some doctors like to do EMGs. I've heard various things about the value (and painfulness!) of these. They're popular in my area - I'd like to hear from people in other parts of the country/world whether EMGs are still used there too?

Hang in there and hope you get it sorted soon.

I had an EMG when they were trying to figure out my issues in 2007. I had a very nice brand new neurologist who was amazed that I didn't mind the pain. I told him my suffering quotient was high from cycling! Seriously, it was not that bad.
I don't know anyone else who has had one.

I'll chime in and agree with those who say start with your regular doc. Your next step may be a neurologist or an ortho doc.

I've had a couple of EMGs, I didn't find the pain horrible - probably because the pain in my arms and hands was already hideous.

Good luck, I hope you find a solution soon.

Thank you all, for the great suggestions! Yes, I have had an EMG before (on my legs/lower spine)...it wasn't bad at all (like others said, must be my high pain threshold). The idea that this could be stemming from a neck problem has also occurred to me, so I will definitely explore that avenue. To answer some questions that were asked by a few...yes, I am riding on drop-style handlebars, my positioning on my bike is quite upright. I'd like to continue riding on drop-style bars, if at all possible. I just purchased a VERY expensive custom Ti road bike, and changing the bars would completely alter the look of the bike which is something I really don't want to do. I do spin classes as well, and my hands are not an issue during those classes (and I set-up my handlebars to be even with my saddle in spin class, so the bars are fairly low). I do, however, feel like sometimes my hands will bother me during weight lifting...feels like my grip is affected...like I can't squeeze my hands sufficiently around the bars/dumbells/attachments. And I have tried every combination of gloves out there...lots of padding, a little padding, no padding, gloveless...you name it!

I'm just hoping that there is some doctor out there that can help me. I will start with my regular family doc, and see what he thinks.

Linda

Good luck! It sounds awful. Have you considered a recumbent bike if you can't resolve the issue? That might as there should be no pressure upon your hands.

I'd recommend a sports medicine doctor. Mine is associated with an orthopaedics group. If you were in the Orlando area I would highly recommend her. :)There are times when an understanding of your sport
is key to the problem.
offered.

I'd recommend a sports medicine doctor. Mine is associated with an orthopaedics group. If you were in the Orlando area I would highly recommend her. :)There are times when an understanding of your sport
is key to the problem.

Second the recommendation about starting with your regular doctor & get a referral. Also, second the recommendation about NOT starting with a hand surgeon. If all you have is a hammer, everything looks like a nail.

I recently had an EMG for pain/numbness in my hands - yes - after buying an insanely expensive bike. The EMG wasn't too bad. It wasn't definitive about where the pain is coming from - either the neck or nerves that run through the elbows. So, I'm going to have a cortisone shot in my neck & if the pain/numbness goes away, it's coming from the neck. Otherwise, it's the elbows. Ain't science great?

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Originally Posted by Dogmama

Second the recommendation about starting with your regular doctor & get a referral. Also, second the recommendation about NOT starting with a hand surgeon. If all you have is a hammer, everything looks like a nail.

I recently had an EMG for pain/numbness in my hands - yes - after buying an insanely expensive bike. The EMG wasn't too bad. It wasn't definitive about where the pain is coming from - either the neck or nerves that run through the elbows. So, I'm going to have a cortisone shot in my neck & if the pain/numbness goes away, it's coming from the neck. Otherwise, it's the elbows. Ain't science great?

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Dogmama...I'm curious as to what type of doctor you are currently seeing for your hand issues? Sounds like we are in similar situations. I simply cannot get another bike at this point. I am embarrassed to even say how much money I (well, my DH) spent on the 4 bikes I have gone through in as many years. This custom Ti Seven I am riding now is it, for the foreseeable future. My DH will divorce me if I even consider another bike! (joking, of course...but seriously, another bike is completely out of the question).

Linda

I PM'd you but thought I'd also respond here...

I have been seeing an orthopedic surgeon who specializes in spine disorders. He is handling all of the referrals. Makes sense to have one guy overseeing the whole process.

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Originally Posted by Muirenn

Did you ever get any answers to this Linda?

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I have an appointment on October 1st, to see a physical medicine doctor that came highly recommended to me...so we shall see what he has to say. My hope is that after he evaluates me, he will perform an EMG to test the nerve function in my hands. I'm not looking for 100% relief here...as I know that is not likely to happen. But I would be absolutely thrilled if the numbness and pain could be slashed in half...heck, I'll even settle for a third!

Linda

Bummer that you have to wait so long but hope you get answers. Hand numbness can be elbows or neck. EMG should help pin it down. Be sure to check back & let us know!