I'm kinda getting sick of talking about my #shittywrists but I figured one final(ish) update made sense. I went back in to see my Ortho last week(?) week before maybe, I forget. Mainly to touch base and bring him up to speed on the progress made during my first big block of PT.
He seemed to think that based on the progress I've made and the behavior of the pain / recovery that it is unlikely that it is anything really nasty like RA. Which is good news. But he did say that based on everything hes seen between X-ray, MRI, and his physical examination of my wrists etc. that in his opinion there is some sort of 'seronegative arthritis' present.
Seronegative is a very general term that is used to describe a whole bunch of different kinds of arthritis (caused by all different kinds of things) that don't have the rheumatoid factor and will not show up on blood tests. These types of arthritis are commonly much less severe and can in some cases completely resolve themselves. They can also be very cyclical and can come and go based on some trigger or other environmental factor.
Many seronegative forms can also target tendons not just joints which is why he is leaning in that direction because one thing we have learned through the course of PT is that the last remaining pain/mobility issue that I have and more than likely the root of my problems is an angry Extensor Carpi Ulnaris or ECU. In a lot of ways you could probably call my issue chronic tendinitis. We just don't 100% know what is causing the inflammation. Could be arthritis or it could be I destroyed myself riding rigid started the repetitive stress train rolling and now I can't stop it.
The (sort of) good news is that either way; seronegative arthritis or epic repetitive stress the strategy going forward is the same. Work any and all anti-inflammation techniques and supplement with PT to keep mobility and strength. So thats whats I'm going to do. Targeting the ECU has really gotten me to that next plateau. I can ride my road/cx bike basically pain free on lighter terrain. Diffuse pain during the day is far less and if I keep compression on the tendon itself that helps a lot.
As funny as this sounds there is an off chance there is some shoulder and back involvement as well that could be hampering my recovery which could have been introduced from ergonomics at work. I've made some tweaks recently and I have an appointment to have some Graston done on some back and shoulder muscles to try and hit the reset button and loosen everything down through.
So there you have it. For simplicity sake I think going forward I will refer to my wrist issues as chronic tendinitis possibly caused by seronegative arthritis. I'll keep battling and getting gnar as best I can. #POSITIVITY