Post-surgical problem
My mother had surgery on her R wrist about 9 weeks ago (in January). She has two problems post-surgery.
First. Shortly after, she developed hard little white lumps all over her palm (in the area of the surgery). They are painful. She feels they may consist of broken up but undissolved stitches. A GP office nurse agreed and sent her to Minor Injuries. The MI doc had no idea and referred her on to a Trauma clinic doc who told her to rub Nivea in for 10 min. x6 times per day as she thought it was nerve-related pain due to the nerves re-attaching themselves.
However Mum is sure the pain is not nerve-related and in any case the Nivea massage has done nothing and the pain is as bad or worse now as it was 6 weeks ago.
Second. The "meaty part" of her right thumb, by the palm, is also swollen, red (comes and goes) and sore. Sometimes it runs up her arm, even as far as her shoulder.
If she doesn't use the hand, some of the pain goes away, but it's her right hand!!
Three weeks ago, her GP told her to seek help from her surgeon. Her GP requested an "emergency" appointment with the original surgeon, but there has been no notification yet and she is in a lot of pain most of the time.
I do want to stress that compared to the Level 5 pain she had before surgery this is both less and totally different -- she thinks the surgery itself was a success, but the healing has gone wrong somehow.
Can you offer any advice?
Thanks.
Thank you all for this site. I recently had CTS surgery 3/31/2016. Immediately after the surgery before the stitches were removed, I had little or no pain. I was able to extend my fingers and perform light household duties. I felt as if I were on the track of full recovery. However, on 4/13/2016, I went to see my doctor because I felt a tingling sensation in my hand, my index and thumb was painful when I moved my hand. I felt pain inside and outside of the exterior of my arm. My doctor assured me that there was no cause for alarm. Several days later, I started experiencing a stinging pain in the site of the surgical incision, a burning sensation in my wrist, my hand began to swell and there was redness and heat from my hand. I was holding my hand in a claw-like position to relieve some of the pain. My fingers were curled, because extending them caused further pain. My doctor told me that I had swollen tendons and prescribed, Indomthacin to reduce the swelling.
I had a follow-up appointment with another doctor for an injury I suffered from an accident at work. When he saw my hand and I informed him of my symptoms, he strongly felt that the symptoms that I was experiencing was not normal. He prescribed Gabapentin for the pain, a muscle relaxant and he also prescribed Lidocaine patch to wear under a hand brace. I am still experiencing the pain and the swelling comes and goes. It has been only three days that I am following this treatment. I would like some feedback regarding my symptoms and if I should be concerned.
Those symptoms are definitely not normal at this stage. The suggestion of some form of inflammation of the tendons from the second doctor is a sensible one. The other thing one would worry about would be infection, though it is perhaps a bit too long after the operation for that to show up now. Are you running a temperature? What has happened to the original CTS symptoms - did they improve quickly after the operation? JB
PS - I'll take the duplicate posting out of the other forum as this is better dealt with in this one
Thank you for replying to my inquiries. Initially there was concern that I had an infection fortunately I have not experienced an elevated temperature since the surgery. My original CTS symptoms dissipated however, I am experiencing the tingling, numbing feeling in my hand. I have these sharp stinging pains in the area of the incision that shoot through my index and my thumb. My wrist in the area below the incision often feels like it is burning. I am also experiencing the pain that I experienced in my arm prior to the surgery. Flexing my fingers causes pain so I continue to hold my hand/fingers in a claw-like position. Again the swelling fluctuates and goes from my thumb to palm of my hand around the incision. I am not sure what the next step is as far as treatment. I have a doctor's appointment next week. Until then, I continue to take the medications as prescribed and wear the brace. I would greatly appreciate your thoughts and comments.
Thank in advance,
Webflower
If there is no local infection then some inflammation of the flexor tendons, perhaps secondary to adhesions forming at the operation site as part of the healing process might be a plausible explanation, as suggested by the doctor who saw you. It's very hard to get any further than that without being able to see the hand and carry out some investigations I'm afraid. Immediately around the incision itself there will inevitably have been injury to some small nerve branches in the skin and these might be responsible for some of the stinging pains in that area but I'm not sure why you should get that as a particular problem when the majority of people do not. I do think the fingers should probably be kept moving at least a little - if they are completely immobilised they will stiffen and that will cause further problems in itself. Beyond that I think it is impossible to make any firm recommendations here but I would like to hear if a definite diagnosis is reached. JB
That's quite difficult without seeing the hand I think. I don't know what to make of the description of 'white lumps' I'm afraid - the suggestion of something to do with the stitches seems at least plausible but you need to see it, and probably need to know what sort of sutures were used too. The intermittent swelling/redness/pain around the thumb base is probably inflammation around the cut in the transverse carpal ligament which can persist for some time after surgery. The surgeon who did the operation should be the best person to consult in the first instance about both issues. JB