Recurring Pain and Tumors: When to Seek Orthopedic Help

excuse me?

Hello, I have developed a tumor on my wrist, and I had surgery for it 18 years ago.
It has recurred now, and this time the situation is different from the first.
A few months ago, I started experiencing a gradual onset of soreness.
Although it is not as large as the first tumor, the soreness has been quite bothersome.
I initially thought that using a pain relief patch would help, but there has been no improvement (others have raised similar issues before).
I have also experienced numbness at times, but a few days ago, I suddenly had an issue with my left thumb shaking uncontrollably (I was trying to text on my phone and was startled).
The shaking lasted all night and finally stopped.
Could all of this be related to the tumor? Should I see a surgeon, an orthopedic specialist, or a neurosurgeon?
Additionally, I have another issue.
Many years ago, I experienced unexplained pain in both sides of my lower back extending to my hips.
I consulted a rheumatologist, but no cause was found.
The pain lasted about 3 to 4 months, and despite taking many anti-inflammatory pain medications, it did not alleviate.
Eventually, the pain disappeared without explanation.
Recently, while sitting with my legs elevated to the same height as the chair for about 10 minutes, that pain returned.
It’s not severe, but I also noticed a slight limp when walking.
This time, the pain is only near the hip joint, and if I don't elevate my legs, I feel pain after sitting for 15 minutes, which causes me to limp when I walk.
What could be causing this? Is it related to my asthma condition? I need to take corticosteroids during asthma attacks.
Could you please provide me with some answers? Thank you!

Doris, 30~39 year old female. Ask Date: 2009/07/27

Dr. Shi Guozheng reply Orthopedics

The nature of the tumor in the wrist needs to be clarified first.
The most common type is a ganglion cyst; if this is the case, a repeat surgery can resolve the issue.
If it is not, further examination and appropriate measures will be necessary.
You should consult an orthopedic surgeon.
Hip joint pain may be caused by inflammation of the bones or tendons.
If you have been using steroids, it could potentially lead to avascular necrosis of the femoral head, so it is advisable to see an orthopedic surgeon.
An X-ray examination may help identify the cause.

Reply Date: 2009/07/27

More Info

It sounds like you're experiencing a complex situation with recurring pain and the presence of a tumor in your hand. Given your history of surgery 18 years ago and the recent developments of pain, numbness, and tremors, it's crucial to seek appropriate medical attention.
Firstly, the symptoms you describe—persistent pain, numbness, and tremors—could indeed be related to the tumor. Tumors can exert pressure on surrounding nerves and tissues, leading to pain and neurological symptoms. The tremor in your thumb, especially if it appeared suddenly, could indicate nerve involvement or irritation, which may be exacerbated by the tumor's presence.
In terms of which specialist to consult, it would be advisable to start with an orthopedic surgeon. They specialize in conditions related to bones, joints, and soft tissues, including tumors. An orthopedic evaluation can help determine if the tumor is affecting your musculoskeletal system and if surgical intervention is necessary. If the orthopedic surgeon suspects that the tumor is impacting nerve function, they may refer you to a neurosurgeon for further evaluation.

Regarding your past experiences with unexplained pain in your lower back and hips, it’s not uncommon for such pain to be multifactorial. Conditions like muscle strain, joint issues, or even referred pain from other areas can contribute to discomfort. The fact that this pain returned after sitting in a certain position suggests that it could be related to posture or muscle tension.
As for the connection between your asthma and the pain, while asthma itself typically does not cause musculoskeletal pain, the use of corticosteroids for asthma management can have side effects, including muscle weakness or joint pain. However, this is more of a secondary effect rather than a direct cause of your symptoms.

In summary, I recommend the following steps:
1. Consult an Orthopedic Surgeon: Given your history of a tumor and current symptoms, an orthopedic evaluation is essential. They can assess the tumor's characteristics and its impact on surrounding structures.

2. Consider Imaging Studies: Depending on the orthopedic evaluation, imaging studies such as an MRI or CT scan may be necessary to understand the tumor's size, location, and any potential nerve involvement.

3. Follow-Up with a Neurosurgeon if Needed: If there are indications of nerve compression or other neurological concerns, a referral to a neurosurgeon may be warranted.

4. Monitor Your Symptoms: Keep track of any changes in your symptoms, including the frequency and intensity of pain, numbness, or tremors, and report these to your healthcare provider.

5. Physical Therapy: If your orthopedic surgeon recommends it, physical therapy may help manage pain and improve function, especially if there are musculoskeletal components to your symptoms.

6. Asthma Management: Continue to manage your asthma effectively, and discuss any concerns about your medication with your primary care physician or pulmonologist.

It's important to address these symptoms promptly, as early intervention can lead to better outcomes. Please ensure you seek medical attention soon to get a comprehensive evaluation and appropriate treatment.

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