Revision Surgery Success?
I am 2 years post CTS on both wrists. Immediately after surgery, in both hands, my palms had pins and needles and the tips of my thumb, index, and middle finger were numb. Those symptoms continue with no relief. I have since developed severe trigger finger in my right middle finger. The subsequent nerve conduction tests one year after surgery showed slight improvement in the right hand and none in the left. The dull aching pain in my wrists continues to become more severe. My question: has anyone on this forum with similar symptoms, post surgery, experienced relief from a second, revision surgery? One doctor has suggested that I had an incomplete release (on both hands?). Thank you in advance.
Thank you for your reply. I checked the nerve conduction tests and what was stated was "bilateral moderately severe carpal tunnel syndrome" on the original test. The Doctor said she had no idea why I still had pain after the second nerve conduction tests.
I neglected to mention in my first post that the surgeries on both wrists were arthroscopic instead of "open" surgery. Having gained the gift of hindsight, along with some internet searches on comparisons of the two types of surgery, I would caution others to avoid the "closed" surgery and opt for an open, easily viewed operating field.
I am going to another consult next week and will bring up the possibility of ultrasound or steroid injections to try and ascertain if more surgery would bring relief. I'm getting a bit desperate at this point. I play the piano, garden, and ride a scooter all of which, while possible to do, result in a week of increased pain afterwards. Picking up small objects, or holding on to anything for that matter, is very frustrating. Reading of Chaconne68's experiences was most helpful.
Thank you for maintaining this forum..it is a lifeline in so many ways.
If you are interested I will update you as I move along this journey. I am dealing with an occupational injury as I was a 911 operator for 15 years working 10 and 12 hours days with both keyboard and computer mouse. I am dealing with the state Labor and Industry Administration who closed my case and offered a monetary award for a 5% permanent disability in both wrists when I would much prefer to try and alleviate the pain and numbness instead of taking money. We will see how it goes.
As there is no universally agreed understanding of what 'moderately severe' means in terms of NCS for CTS those results could have indicated a variety of different situations unfortunately. Sadly many US studies confirm poorer outcomes overall when there is litigation/compensation involved but there doesn't seem to be any consistent trend to either better or worse outcomes with endoscopic surgery - just slightly quicker recovery after the endoscopic version. As in all the international cases in this forum I would very much like to hear how it turns out. JB
I underwent revision surgery on my right wrist yesterday morning. The surgeon did more nerve conduction tests and xrays beforehand. My left is still unchanged from before even the first CTS, but my right was worse, therefore he felt a new surgery might bring relief. It seems too early for me to say if the symptoms have improved but I will keep you updated. My surgeon advised that the nerve was "beet red" and that the original surgery left 60% of the nerve still compressed...which he then released. He told me that he was surprised that the first surgery released so little. If this relieves the pain and numbness he will do the left in a month or so. He was optimistic and I am hopeful. Thank you.
If it really was an incomplete decompression the first time, and if the latest nerve conduction studies were too severely abnornal then you would expect to feel at least some definite benefit within a few days.JB
Yes, I am hoping and do believe that the tingling in my palm is gone, but I have a cast on and it is hard to feel anything but the incision so far. Why do you say "if" it was an incomplete decompression the first time? Thank you.
The 'if' is because there are other reasons for failure of carpal tunnel surgery, that's all. A cast after carpal tunnel surgery is quite unusual nowadays - how long are they planning to immobilise it for? JB
Surgery on the 26/August and he will remove stitches and cast on 10/September.He did mention that the nerve was quite red and inflamed. Maybe allowing more rest with the cast? I was surprised as well. I am wiggling fingers often and using the hand more. Today it feels as though the palm pain has improved although the tips of my thumb, index, and middle fingers are still numb. Thank you.
Thanks for the extra info. Let me know how it turns out a few weeks down the line please. JB
It's certainly possible that that was an incomplete release, at least on the side where the nerve conduction studies have not changed at all. Do we know how bad the results were before surgery? Second attempt operations are certainly successful sometimes, though the success rate is not as high as for primary carpal tunnel decompression. Serial nerve conduction studies to try and assess whether nerve function is getting better or worse are sometimes useful. Ultrasound imaging, if there is someone locally to you with the necessary expertise, can often show whether the ligament has been adequately divided or not, and there may be a place for a trial of local steroid injection to se if that makes any difference to the symptoms. Have a look in the forum here for the discussion with Chaconne68. JB