Post surgery numbness
Hello, I am hoping you can give me some guidance regarding my healing process.
I had open carpal tunnel release on 10/8/2015. Prior to my surgery I was having trouble with numbness and tingling in my right hand very often since 2012. I was waking up a lot at night from my hand feeling very numb. The numbness and tingling has gotten progressively worse over the years. I started to wear a splint at night about a year ago, which did help for a while, but it eventually stopped working, I tried physical therapy which did not really help. My mother had carpal tunnel on both of her hands and had surgery for it when she was my age, so I thought what I was experiencing was carpal tunnel. I went and saw a hand specialist and he did a complete work up and said that I had carpal tunnel and would benefit from the surgery, but he wanted to get some nerve conduction tests done to see what was going on with my nerves. I had the nerve tests done and saw the doctor after. He said my nerve tests were pretty normal, but that didn’t mean I didn’t have carpal tunnel, and he said I would still benefit from the surgery. So per his advice I went ahead with the surgery.
I was in quite a bit of pain in the days following, and was out of work for 10 days. I came back to work full time on 10/19. I work on a computer all day, so I didn’t have any issues getting through my day, and was taking it easy on my hand/wrist. In the weeks following my surgery I was feeling good, the symptoms I was feeling before my surgery were not as severe, I was not waking up at night like I was and the numbness and tingling was definitely improving. I am now at about 8 weeks post op, and my hand is still numb, the numbness is different that is was prior to my surgery, it is more like a light fuzzy/burning feeling on the top of my hand and into my fingers, it doesn’t hurt it is just irritating, it’s not constant, I notice it while I am at work mainly, but at other times also, my fingers also feel cold, they are not cold to the touch, they just feel like they are cold. Also, the incision is still slightly red and hurts when it is pressed on, and on either side of the incision, on the palm of my hand, it hurts when massaged or pressed on. I feel like at 8 weeks post op, I shouldn’t have the numbness and the incision area should not hurt.
I only had one post op appointment 11 days after to get my stiches removed, he said it was looking good and I didn’t need to be seen again. I did call them to ask about this numbness, and his nurse said it was normal, and nothing more.
Is it normal to experience this type of numbness and pain around the incision site at 8 weeks post op? I have read that it does take the nerves quite a while to heal, but I just want to make sure that what I am feeling is normal for post op carpal tunnel surgery. How long does it take for this to go away? The feeling is very irritating, and I was really hoping for it to go away after the surgery.
Do you know of anything that would help get rid of the numbness and symptoms I am having? If this is not normal for 8 weeks post op, any idea what it may be, or where to go from here? I will take any help you can give.
Thank you so much, I really appreciate it!
Thank you so much for replying, I really appreciate it! My symptoms did improve after the surgery, not 100% but defiantly better. What I am experiencing now is similar to my symptoms before surgery, but not as bad. What is weird is my incision, and palm of my hand is still sore and slightly swollen, I didn't know if that meant that it is not fully healed, and could be causing the numbness.
I have read a lot about excessive scar tissue build up after carpal tunnel surgery, and that bring on a lot of the same symptoms as before the surgery. Do you think that could that be a contributing factor to my numbness? How could I tell if I did form excessive scar tissue, could that even happen in 8 weeks?
I will wait until after Christmas, and schedule an appointment with a neurologist to see what they have to say. I have also requested a copy of me pre op nerve conduction study, so I will post those when I get them, I am curious to see what you have to say about them.
Thank you again! I will post my nerve conduction results when they are sent to me!
Although it's a technique which is still developing I think a combination of ordinary clinical examination and ultrasound imaging is a pretty good way of assessing what is going on in and around the scar after surgery. It's certainly plausible that the swelling and inflammation resulting from the surgery itself could cause some pressure on the median nerve in the weeks after surgery in some patients and the various chemicals which are released in an injured area as part of the repair process may affect nerve function. However in most patients this is a trouble free operation so if you do get problems like this you are unusual. If you are able to get hold of your NCS you will probably have to email them to me - details in the contact page. JB
I seem to frequently end up saying this on here but no this is not 'normal', at least if by normal we mean what the majority of patients experience after carpal tunnel surgery. Most patients, especially with milder CTS (which yours would have had to have been with normal nerve conduction studies) find that symptoms resolve almost immediately after surgery and that the incision is fully healed and comfortable in 2-4 weeks. A significant minority of patients have longer lasting difficulty with the scar which can become thickened, knobbly, painful tender etc. The commonest surgical error is failure to fully divide the ligament and in my experience the majority of patients with this find that their CTS symptoms do not improve at all, or are worse, after the operation. It sounds as though your symptoms did improve, if not wholly resolve, so incomplete division of the ligament is probably unlikely.
I think that probably leaves us in the position of wondering what else might be contributing to your symptoms. The story of CTS is pretty convincing so I would accept that this may have been CTS but there is no law dictating that you cannot have something else too. It is perhaps a pity that something less aggressive than surgery (ie local steroid injection) was not tried before operating. Now, if the problem persists I would suggest a neurological consultation, repeat (probably extended) nerve conduction studies and perhaps ultrasound imaging but I would not embark on this until perhaps a full 3 months after surgery. I'm reading that surgery date as 8th October is that right? - so if it still significantly symptomatic after Xmas it's probably time to start thinking about investigating. If you have a copy of your pre-op nerve conduction studies I can take a look and see just how 'normal' they were. JB