Handy therapy after cts
I had surgery 2/1/15 on right wrist. Scar is sore and have been told to keep rubbing cream (or oil etc) ito it and massage it. Now 7 weeks later this is easier to touch, but right thumb is numb on the palm side, (sensation is that it feels cold but isn't, stiff and numb) and even though I can grip and hold things, its not comfortable (cutting up food, holding a knife).and fingers feel very bloated! Have sleepless nights as pain and numbness in all median related digits, and yesterday resorted to seeing consultant as was in tears with pain. Now being sent for hand therapy under NHS which may take up to 10 days. However I am doing hand/scar massage, hand under warm water to flex digits, trying to use it normally. I am type 1 diabetic for last 25 years aged 57. So do I use hand normally or not? Fingers stiff, and middlefinder feelslike the top "knuckle" keeps sticking, and has like a small electric shock feeling which doesnt last but happens when top of finer pressed. Is this the average progress I can expect including the pain. ? What will hand therapy achieve? Any comments and suggestions welcomed.
Thank you for your reponse. Strange you should ask re the symptons before surgery - I just think of weak wrists No pain, so worse now than before tests. Dont know the nerve condution results, but will be asking next time go back, inorder to check the severity. Consultant did not say what he thought was happening.He did say something which I cant recall as I was in quite a state, but said he had told me originally..something about another syndrome, but it was quite rare, so not sure what all that may have meant. I certainy dont remember him saying anything at previous appointments. Surgeon who did op did say "it needed doing". As I had been seeing my GP for some time re pain in neck and shoulders/spasms, the appoitnmnt with Orthapaedicts was supposed to be about that not turn in to a nerve conduction test then release surgery, I am not 100% convinced the shoulder/neck was not causing the pins and needs at night and nothing to do with carpal tunnel.Having had both shoulders operated on in early 2000's and having injections in both elbows for tennis elbow, and x-rays showing some signs of wear and tear on my top of spine, the carpal tunnel was never mentioned by my GP. No investigatons were done on the shoulder/neck/spine once I saw Orthapaedict consultant, just straight to NCT and surgery. Update in 7 weeks after hand therapy and see then what they say. Will ask re the tests too.Thank you.
It would be worth trying to get hold of those orignal nerve tests. I gather that you did have pins and needles in the hands at night before surgery? That is certainly a very common symptom of CTS - has it gone now or is that contiuing? JB
Yes I had pins and needles at night and shaking the hand would get rid of them. I cant really say they have now gone because the back of the thumb has a tingling sensation which feels like pins and needles for around 10 days now and doesnt seem to be going away. Middle finger also has this same "fizzy" sensation, and maybe typically they are all stiff in the morning. My feeling is ow that I have more problems now than before as during the day I just felt like my wrists were weak, but no pain for pins and needles. As you say once I can get the nerve conduction results it will give us the relevant information to see how "bad" things were. Once I can get hold of them I will report back!
Hopefully symptoms will improve somewhat in the meantime. Thankyou for sharing your story. JB
cannot get consultant to give me answer re nct just that severe in right hand and moderate in left. frst session of hand therapy only resulted in beng told complex regional pain syndrome!!!!went on pregabalin,after 24hrs pain went, but not numbness. had side effects - husband said i was like hyper, and life elf on speed. stopped after 2.5days.75mg x twice a day. now trying 10mg half tablet of amaltripyolyne. first night up at 2.30am wih very bad pain and severe cramp. took2 x 15m g of paracetamol/codeine which eased pain, now up again at 6.30am in severe pain /cramps.keep shaking hand to no avail worse when stting or lying down.worse sensation in middle finger and index, and thumb.HELP!!!!
That's definitely not going the way we want it to. Complex regional pain syndrome can be seen after carpal tunnel surgery but it's important not to use it as an automatic diagnosis for anyone who complains of any persistent pain after the operation. The first thing I would do in this situation is repeat the NCS to check that there has been some improvement (this should of course ideall be done by whoever did the first set) and with problems after surgery I would usually now look at the ultrasound imaging too. JB
That may be no more than an unusually stormy post-operative healing process, maybe aggravated by your diabetes, but there are quite a lot of other possible explanations for some of those symptoms. The fact that your surgeon is just sending you for hand therapy suggests that he/she is not too concerned about the major complications of carpal tunnel surgery - did they actually tell you what they thought was happening. It would be useful to know what has happened to your original CTS symptoms - are they better/worse/changed in any way? ... and also did you have any nerve conduction studies done before surgery and what did they show? - that would give us an idea of how severe a CTS we were dealing with. JB