Babysitting

Middle aged woman came in today complaining of hand pain for sixteen years. The pain was on and off and began after the birth of her first child.

Every time she uses her hands, she gets numbness in her 2nd, 3rd, and 4th fingers of her hand. She denies any strength problems. In her daily life, she lifts alot. She baby sits 6 months to 15 month old babies.

Upon physical examination, she had clear tinnel signs. (The Dr. uses the hammer and taps the patients flexor side of the wrist.) The patient's wrist would clearly withdraw every time she was tapped. (Doc demonstrated this when she tapped me and nothing happened)

Patient did not have any signs of thenar atrophy in her hands.  Which is good because that means the medial nerve was not significantly damaged. She did not have positive phalen sign.

The patient was told to rest the wrists and keep the wrists at 15 degree mild dorsi flexion while she is sleeping as well as avoiding overuse of the wrists.

Unfortunately, if her job is to babysit fairly heavy children who must be lifted because they cannot walk, patient may eventually suffer more.....