Carpel Tunnel release, i had it done and now its worse
I had the release in my left hand on the 6th Dec 2014. After the operation i noticed my little finger and fourth finger were numb, which in time came back, to to be honest they dont feel right. After they took the stitches out, one of the stitches got stuck and it took the nurses a while to get it out. I then got an infection in my wound, and was given antibiotics for 2 weeks.
Now im nearly 3 months post op and im now having shooting pains in my wrist up into my elbow, my wound is red and swollen. Ive also noticed when im trying to do housework or carry shopping my tendons stick out. First thing on a morning im in total agony with my hand, and ive also noticed i cannot form a fist anymore.
I had my right hand operated on 10 years ago, and i never suffered with this amount of pain as i am doing with my left hand.
Im due to go back to see the surgeon on the 14th March, im not happy and i wish i never had it done now, as im worse of with the pain now.
Hello
Yes the tingling went as soon as i had the operation. When i sleep i cant sleep with my hand down by my side like i used to do, i have to sleep with my wrist on a separate pillow at the side of my head, on a morning i wake up with my hand been stiff, and in so much pain, especially my little finger and ring finger.
Yes i came over from the patient.co.uk, i didnt find any answers there.
I did go back to see another surgeon after my infection cleared up, as i felt that my hand wasnt right. He told me to massage the wound, which i have been doing...but im finding that very painful to do. The bottom of my hand near the wound feels very hard and bumpy. The tendons in my wrist seem to stick out when im doing housework. Im loosing my grip so im tending not to carry that much. When i bend my hand forwards i am getting a tugging pain in my wrist, i cant bend it much backwards either.
Thanks for getting back to me..
That pretty much fits in with what I thought from your original description. It's probably worth them sending you for some hand therapy sessions so it will be interesting to see what the original surgeon thinks on the 14th. Try the splint at night for a few days to see whether it makes things worse or better (assuming you have one). JB
It sounds as though you had a fairly stormy course post-operatively with the second hand. The infection will perhaps have led to the formation of more scar tissue on that side and the transient episode of numbness of the ring and little fingers suggests that there was some compromise of the other main nerve to the hand - the ulnar nerve. It may be that there was enough swelling post-operatively to increase the pressure in the canal of Guyon - the smaller tunnel at the wrist which the ulnar nerve passes through - and affect ulnar nerve function as well. The prominence of the tendons, usually knwn as 'bowstringing' is a known consequence of cutting the carpal ligament so it sounds likely that the surgeon did successfully cut it (failure to completely do this is one reason for failed surgery) . If I am right about this then you should at least have found that tingling and pins and needles in the median nerve territory, the thumb, index and middle fingers, improved quickly after surgery?
If I'm right about all that, then your problems now are likely to related to the fact that you have been left with a very superficial, and easily irritated median nerve which is passing through an area at the wrist where there is probably still a good deal of scar tissue and adhesions between the tendons. The severe exacerbation of pain in the morning might be one of two scenarios I think, either it is staying relatively still all night and everything is sticking together, or alternatively you are sleeping with it in a position which is further stressing the nerve at the wrist. You could try splinting it at noight for a few nights - if it is the first situation this will probably make it worse whereas in the second it might help. As regards the scar tissue in the wrist, in the first instance this needs to be managed with time, rest and massage. It's not certain whether the physiotherapists ministrations with ultrasound, lasers etc help with this but they probably don't do any harm and may be worth trying. If it remains a persistent problem then it is occasionally worth carrying out further surgery to tidy up the area or arrange some form of protection for the nerve, such as inserting a fat pad between the nerve and the skin at the heel of the hand. it will be interesting to see if your surgeon agrees with this analysis on the 14th
If I was managing the case I would probably repeat the nerve conduction studies, assuming that there were some pre-operatively, and take a look at the carpal tunnel area with the ultrasound scanner to see if I could find any evidence of excessive scar tissue formation. I would expect the NCS to have improved from the story you give so if they were not somewhat better at this point that would prompt me to think again. The ultrasound is a bit experimental and there may well not be anyone in your area who is interested in this particular imaging problem I'm afraid so don't assume that that will be available as an option.
One last question - did you come over from the forum on patient.co.uk?