Good luck. Hopefully she finds the relief she deserves!!!

I am an occupational therapist and empathize with your wife's situation both as a rehab provider and a client myself. I have had an EMG performed for a pinched nerve (C5-C6) in 1989. The loud sound of static on the machine as the physician inserted needles from my finger tips to my posterior cervical spine was not a lot of fun. When the needles were inserted into muscle bellies, the doc would wiggle them that resulted in the sound of more static from the machine. I had bruising up and down for two weeks. This is nothing I want to do again.

I have had injections in a foot for plantar fascitis, my hips for bursitis, and my low back for continued pain. All of the injections were tolerable. They take a topical numbing agent to numb where the injection will occur so all that you feel is a stick and then the mild pressure of the bolus of steroid being injected into the area. Steroid injections will elevate blood sugar levels of people with diabetes so if this is an issue it requires monitoring.

Has your wife had any peripheral nerve tension tests by any of the therapists? This is assessing how the ulnar, radial and or median nerve can lengthen as it is progressively stretched beginning at the shoulder, moving distally then positioning the head and neck last. You can probably view these on YouTube. Look for Epley's nerve tension tests.

This condition is common for musicians and dental hygienists and you can more than likely find a therapist who is into ergonomics to assist you. Thoracic outlet syndrome should also be considered since the movements involved with playing the violin can constrict nerves and vessels that run between the clavicle and first rib. There are other provocative physical tests that can further assess this.

Thanks for the update and good luck. Recovery and function and the reduction of pain take time so maintain hope.

I hope everything works out for your wife. Also, try to help her avoid any unnecessary stress, both physical and mental.

I have a friend who also got the shot while suffering from carpal tunnel syndrome in his wrist and elbow. He was a postdoc applying for grants and faculty positions at the time and spent a lot of time on his computer.

Around the time he got the shot, still being very busy interviewing, applying for grants and being very very stressed, he got the shingles.

It could be just a coincidence but the shot does lower the immune system, that is the whole idea of the shot, and he thinks his shingles came about due to the shot and being very stressed at the time.

All anecdotal, but I had a couple epidural cortisone shots in my lumbar spine for sciatica many years ago that had negligible effect.  My father in law has had a couple shots in his cervical spine that he describes as "magical."

From what I understand, the shots are fairly low risk.  If they succeed in breaking the inflammation cycle by shrinking the nerve swelling to the point that it stops irritating itself, then they can produce a cure.  But if there is a root cause to the irritation that goes beyond that, then the beneficial effects will wear off and you will be back where you started.  The advice I've always heard was: try it once or twice, but if that doesn't cure it, then consider moving on to something else.  Long term steroid use is bad news.

Best of luck to you.

I had an EMG and an additional test where the neurologist shot electrical currents -- honestly, they were electrical shocks -- from my hands to my neck to confirm carpal tunnel. It took 2 hours and was just horrifying and painful. Like getting electroshock therapy while awake. After a lot of physical therapy, I ended up getting a cortisone shot in my hand that worked wonders. My sister-in-law was having a lot of pain in her neck and difficulty moving her arm. Doc found that she has stenosis -- a narrowing of the spinal cord and she has to have surgery to replace a bone in her neck with a cadaver bone. She said acupuncture helped with the pain in the interim. Has your wife done any acupuncture? I hope she finds some relief. Chronic pain is just so debilitating. 

I'm not a huge fan of cortisol shots.  They are a band aid and usually help for a few weeks, but it won't fix the issue and you'll need to go back for more.  It's like going to a chiropractor.  It makes you feel better, but it's just a short term relief that does not fix the underlying issue.

Another option is to try an injection of synthetic synovial fluid.  There are several manufacturers nows.  It's not FDA approved for anything other than knees yet, but logic tells us if it works on one joint it would work on others.  If you aren't familiar with synovial fluid, it's basically a lubricant for the joints that helps them move easier.

The other possibility is arthroscopic surgery to shave down and reshape the bone.  They go in with a small camera and tool.  It's minimally invasive.  I'm not sure if they do it on such small areas like a finger, but they use in other joints like knees, ankles, etc.  If they do decide to do any surgery see about PRP (platelet rich plasma) injections to help with the recovery.  It likely won't help unless it's right after an injury or a surgery, but can really help healing.  It's also not covered by the FDA or insurance, but sometimes orthos will do it for free with a surgery.

I went through similar issues in how to treat arthritis and bone spurs in my ankle from an old fracture 25 years ago that now gives me pain.  Good luck!

I'm a nurse anesthetist. I don't do pain in general but do work with pain guys occasionally. I do work with spine and hand all the time. I got a cortisone shot for a frozen shoulder and it was magical. It didn't hurt at all. I'm told that's unusual.I have some nerve impingement but haven't gotten a shot for it.

Cortisone injections for spinal problems area usually not long term fixes. You get a series of shots then you get surgery, in my anecdotal experience. If she has to go that route, look for someone who does artificial discs.

Thanks for sharing. I now find myself engrossed in this story and hoping that your wife is able to recover!

I think I commented in your original thread.  I've had 2 cortisone shots, both for plantar fasciitis

Neither shot was very painful and both were very effective and allowed me to heal completely.  Obviously your wife has a specific injury that is very different from the one I had. 

I wish her the best!

EMG/NCV tests are also practitioner-dependent. I know a few neurologists and physiatrists who can perform them with minimal discomfort (though there is always some), and I know a few who seemed to have been trained by Josef Mengele. Still, it is an important test to help differentiate cervical radiculopathy from median or ulnar nerve compression when the physical examination is equivocal.

The epidural steroid injection isn't "a band aide" to temporarily cover symptoms, but is a method to reduce inflammation to help the body heal. The thing is, you can take any random person 50 years or older and run them thru an MRI, and you will find pathology- bulging discs, impinged nerves, bone spurs, central or neuroforaminal stenosis, etc., but most people are asymptomatic; the whole point of treatment is to get you back into the "silent majority." Epidurals can be either transforaminal or interlaminar, and in the hands of a good physician will be minimally uncomfortable, and certainly way less stressful than an EMG. Sometimes they are done under very light sedation, but that is usually not necessary. If one or two helps the pain, usually you then proceed to (or return to) physical therapy. "Put out the fire, then rebuild the house." Surgery should be considered a last resort, if conservative treatment fails.

Good luck!

I remember when you posted this. I was curious how this turned out?I was having nerve problems with my hands at the same time. Since then I had a emg ( brutal) the doctors diagnosed me with cubital tunnel syndrome. I will be getting my surgery July 19. Hopefully it helps. Good luck to your wife and you.

Thanks for posting about what your wife is going through. I just recently found out I probably have a similar issue going on. Mid-May I suddenly began experiencing shoulder pain in my left arm, numbness, tingling with burning sensation all the way down the arm and muscle spasms in the wrist. At first I thought it was my shoulder as the pain in that area felt very similar to previous labrum tears I've had, it was the tingling that was different. 

Suffice it to say, this week I finally got in to see an orthopaedic surgeon and he quickly diagnosed me as having a neck/spinal issue, not a shoulder injury. So I'm off to get an MRI next week and after that possibly a spinal specialist. The Xrays showed possible arthritis and bone spurs in the neck vertebrae. I'm in my early 50's so these type of things are expected to happen. Look forward to further updates on your wife as her journey is similar to what I have begun. 

I've had cortisone shots twice for my shoulders, and I've experienced both a shot that hurt worse than about anything I've experienced and one that felt no worse than getting a flu shot. Both from the same Dr, but I think they improved how they gave them in that span of time. I'm not a fan of needles at all but I usually am good about it since I know it'll help.

I’ve also heard all the stories about how painful cortisone shots are, but when I got one in my tailbone, it wasn’t that bad at all. Hopefully, hers is also easy and gives her a little relief. Sometimes it can be that little boost that helps a person to better position themselves and that sort of thing, allowing them to better heal.