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Suggest Treatment For Pain And Burning Sensation In The Hand

Posted on Thu, 14 Apr 2016

Question: I xxxxxxxxxxxxx working in bank have been suffering from writer's cramp in right hand since 2002.Somewhow I can write but the problem is burning sensation felt in my palm and the finger left hand while counting of currency notes.I fear whether cramp may occur in my left hand or not?Now i take medicine like Pacitone 0.2mg twice a day & liofen 10 one tablet in a day.Last year I took injection Botox with EMG at institute of neurological science at XXXXXXX by Doctor XXXXXXX XXXXXXX but it shows nil result. Three times I took Botox at Bangur institute of neurology but no such result I got three occation.I am living XXXXXXX west Bengal.Plz advise me the any exercises with medicine. with regards

Answered by Dr. Neeraj Kumar (7 hours later)

Brief Answer:
Take treatment and steps as advised

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Writer's cramp is usually unilateral on initial stage of problem but may involve the other hand also later on.
The treatment is with drugs like pacitane, baclofen, clonazepam and doses may be increased if required.
Botox injection are used to weaken abnormally overactive muscle to prevent posturing and difficulty in writing. It is not a one time medication and will be required repeatedly life long. Initially two to three sessions may be required to figure out actual muscles and required doses.
Physiotherapy may not be very helpful.
Avoid excessive force while gripping pen, write with support of upper limb.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Neeraj Kumar (23 hours later)

I just want to know whether injection Botox will be helpful for my left hand when I feel burning sensation after counting the currency note.Will you plz issue me a certificate for not counting the currency note.I got nill result by Botox injection.Is there any remedy which can minimize my burning sense in my left arm palm & finger.
With regards

Answered by Dr. Neeraj Kumar (1 hour later)

Brief Answer:
Take treatment as advised

Detailed Answer:
Hello,
Botox will not be very useful for pain only.
For medical certificate you need to get it from your treating neurologist or a government institute in your state.
You can try pregabalin with methylcobalamin for few days along with pacitane 2 mg tds.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr N Kumar

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Neeraj Kumar (11 hours later)

Sir (Dr XXXXXXX Kumar).I ( xxxxxxxxxxx )sending herewith history about Botox injection taken thrice from Bangur Institute of Neurology ( west Bengal Govt) & lastly from Institute of nuero science XXXXXXX under advice of Dr XXXXXXX XXXXXXX (appolo hospital Hyderabad) through Dr XXXXXXX XXXXXXX injected Botox by EMG guided with attachment.

Answered by Dr. Neeraj Kumar (1 hour later)

Brief Answer:
Continue medication if botox is not beneficial

Detailed Answer:
Hello,
I have gone through all your uploaded prescription and evaluated it. You have been given botox in most of the muscles of upper limb in various combination. If you have no substantial benefits then you can continue with oral medications which can be increased if needed.
Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Raju A.T