Carpal Tunnel Syndrome And Post-Polio Syndrome

by Allen C. Hill, Greater Boston Post-Polio Association Member

A while ago, one finger in my left ("good") hand suddenly lost noticeable amount of function. My neurologist followed it, puzzled as to what it might be, but apparently not seriously alarmed. When I recently went to the Spaulding Rehabilitation Hospital post-polio clinic for an evaluation, they recommended nerve conduction and electro-myelogram study of my arms and hands to see what was going on.

The test showed that the finger-function problem was "just" post-polio. It also turned up something serious - severe median neuropathy (carpal tunnel syndrome) in that hand. I am functionally one-handed, and losing the use of my left hand would be catastrophic. What was interesting, and scary, was that I did not have the normal symptoms of severe carpal tunnel: I had not lost significant feeling in my thumb and first two fingers, there was no new weakness apparent in the hand and I did not have any significant pain. I did have a very slight numbness in my fingertips, as though I had gotten some glue on my them, and hadn't quite washed away all the residue.

My primary doctor quickly referred me to a hand surgeon, who did the usual physical exam, testing my grip, testing fingertip sensitivity and so on. When he was done, he asked me in a slightly puzzled voice, "Why do you think you need carpal tunnel surgery?" The physical exam had been within the normal range. Once he looked at the nerve conduction results, he knew why I had been referred. I had the surgery a few weeks later, and it seems to have been a total success.

Meanwhile, back at Spaulding, when I mentioned that we had found carpal tunnel problems, they said that it was not unusual in their experience for someone with post-polio to have them and not show the classic symptoms. Apparently, I was one of many. The moral of this story is (again) that post-polio produces strange effects that even a good doctor who is not a PPS specialist can easily miss. We need expert evaluation and counsel from time to time, even if nothing seems askew and we're doing "just great, thank you." And while the nerve-conduction/e.m.g. was not a lot of fun, it was not the torture I had been anticipating. I have had minor dental procedures that were far worse.