Carpal tunnel surgery and rheumatoid arthritis
I had an open carpal tunnel release done on my left hand ten days ago. Numbness to fingers has stopped and the incision looks good. Pain and swelling have however been severe. I think that the surgery has caused a flare of my rheumatic disease. The thumb, wrist and other joints at the base of my fingers are hot and painful. I have limited ability to flex my wrist forwards or backwards and when I try it causes pain. I can sometimes bring pinkie and thumb together but not always. Pain is bad at night and I don't have a resting splint. I have bruising below the rest and pain hoing fown the nerve. My left elbow has also become painful. My left shoulder was already bothering me before surgery. I am limiting pain meds to once a day but at times it is bad enough to make me cry. I am doing nerve glide exerciseas as prescribed but it is painful. I see my surgeon next Thursday for stitch removal.
Are symptoms like this normal when you have RA? What is the likelihood they will settle down over time on their own? I am not booked to see my rheumatologist till mid-January should I wait till my surgical post-op visit to call him or get on it sooner?
Many thanks for any input.
Thanks very much for your reply. I don't have a nurse specialist to call unfortunately but at least Thursday is only 4 days away.
Bev
Though not common after carpal tunnel surgery the most important differential diagnosis is going to be trying to tell the difference between an exacerbation of your arthritis and infection. If you start to become generally unwell with it - running a fever, night sweats, chills etc then lean on your GP for an earlier assessment. Otherwise you can probably hang out until Thursday. Pity there's no rheumatology nurse specialist - I thought most areas of the country had those now. JB
That sounds as though you could do with some advice from someone who can see the arm I'm afraid, and ideally someone who is familiar with your RA too - do you have an RA nurse specialist you can call on for advice about flare-ups? In general surgery for CTS in patients with RA is not unusually complicated, though sometimes surgeons will carry out slightly more extended procedures such as synovectomy at the time - only your surgeon will know whether anything more than the usual carpal tunnel decompression was carried out so the visit on Thursday will be a good chance to ask questions. JB