Can DCS symptoms come and go?

[bluebanded goby]

For reasons that are not entirely clear -- although possibly related to a neck injury a couple of years back -- I tend to get mild twinges (i.e. stiff feelings) and tinglings in my left hand and arm from time to time. These come and go, usually lasting for minutes rather than hours at a time, although now and then I'll get a tingling sensation in fingers that lasts for a day or so.

I also get numbness in my hands at night, which seems to be related to sleeping position (interestingly, when I sleep on my side it's not the hand that I'm laying on that goes numb, but rather the one on top). This numbness generally clears up if I shift position or move the hand vigorously.

All of this poses an interesting situation for me because, once or twice, these twinges have begun fairly shortly after a dive. Since they are relatively subtle, so far I've always waited to see if they worsen before seriously considering DCS as a possibility; generally they have gone away completely within a few minutes. Also, most of my diving recently has been very shallow (30 fsw or so), so DCS has seemed pretty farfetched.

I'd like to get back into some deeper diving, however, but on the other hand I don't want to be worrying about this needlessly. Are there any ways to distinguish stiffness, tingling and numbness related to DCS from that with other causes?

In particular, I'm interested to know: If a particular pain or sensation comes and goes, does that pretty much effectively rule out DCS? I think someone mentioned to me once that DCS symptoms generally do one of several things after they appear: they either worsen, or stay the same, or resolve and don't come back. But they don't come and go from one hour or day to the next. Is that true?

Thanks for any ideas on figuring out how to deal with this.

 

[Dr Deco]

Dear Goby:

In my experience, DCS symptoms may come and go to some extent (when mild) in a period of a few minutes but not hours. Certainly, they do not remit and reappear within a period of days. The only exception to this last statement is if one changes pressure. For example, there is a case where an individual had DCS pain in the knee, was treated, and the problem remitted. On an airplane flight three days later, the pain reappeared.

If you are experiences these tingling sensations with exposure to pressure, the case is not related to a separated gas phase. Should a true DCS problem appear, it is possible that it could be mistaken for the normal paresthesia (= numbness and tingling) that you typically feel. This is possible, but most often the tingles are mistaken for DCS and not the other way around.

The only way to really check is a “test of pressure.” A person is placed in a hyperbaric chamber (or if in an altitude exposure, they are returned to ground level) and recompressed. This is not a simple test to do unless you are in a research setting where a chamber is available along with all of the test subjects. Should you problem not remit within your customary few minutes, however, I would suggest that one consider a trip to a hyperbaric chamber. Most likely, this will never occur, since few divers ever acquire decompression sickness.

In addition, I would certainly avoid any strenuous activity with your arms, for example, lifting scuba cylinders after a dive.

Dr Deco

 

[rcohn]

When diving you bend your neck back to look forward, a fairly stressful position. Also pulling on a hood and other activities can stress a neck problem.

You should try to see if the sensations can be made to come and go based on the position you hold or rest your head. If so it may be a piched nerve in the neck and you should be checked out for that by your physician.

Ralph

 

[bluebanded goby]

Hi Ralph,

Thanks for the perceptive comment. Yes, the main time when I experienced hand/arm tingling etc following a dive was after I made an ascent to pretty choppy surface conditions and ended up having a fair amount of stress on my neck. The symptoms don't emerge right away when I crook my neck, but take a little while to show up. My physician has done a neck X-ray, and didn't seem to find much he thought was worth following up on. While he thinks it may be related to whiplash I sustained about three years back, he's also inclined to think there may be a stress component to it, and so he's encouraged me to find ways to relax as much as possible. A few months ago the sensations were more marked, so I slept for a while with a cervical pillow, which seemed to help. I've also been experimenting with various neck exercises so see if they can help long-term. Thanks again!