The pain is dull and radiates up the palmar aspect of the forearm when it is at its worst. It is sometimes associated with numbness and tingling. The pain comes and goes everyday and sometimes wakes the patient up at night. It is particularly bad by the end of a day at work. The patient has tried several over the counter medications but none of them really relieves the discomfort.
Heat seems to work most of the time.
The patient works as an assembly technician adding legs, casters, and cross braces to industrial dish washers and sterilizers. To complete each unit the patient must tighten over 100 bolts using a hand socket wrench. The patient may complete as many as 20 units in a typical work day. The patient s problems at night can be quite severe. On a bad night the patient wakes up with pain and is unable to get back to sleep without sitting in a chair and reading for a time.