Excruciating pain 6 weeks post CTS
Had CTS right hand on April 9th, 2018. Immediately upon coming out of surgery, the pain was out of control. I spent the greater part of a day in the hospital, while they tried to get it controlled. IV/oral medications. Blood pressure went sky high from the pain. Finally, so may meds, I passed out (after 4 hours of trying)...for 3 hours, and was sent home. Forward to a few days, and the pain was still bad/and worse than before the surgery. Was never referred to physical therapy. Went back for a consult within a week..nothing more done. Went back again, and given an oral steroid & gabapentin (worthless for both)....had been sent home from surgery with hydrocodone and lorazapam (still have 6 hydrocodone left after 6 weeks/only given 20). Nothing touched the pain completely. Fast forward to recently, and the pain is excruciating, like right after surgery. Throbbing/burning, index finger swollen...nothing touches the pain. Steroids and gabapentin did nothing. Can't sleep, no use of hand/can't cut my food, open a pill bottle, limited range of motion for fingers...It was awesome today...we had shut the water off to change a filter...upon turning it back on, I was filling a dog bowl with water and the air pressure blew the bowl out of my hand and my hand snapped back up and hit the bottom of a cupboard. I can't believe that the doctor's thought of scar tissue would be causing this amount of pain. On a scale of pain...well beyond 10. Any one have a similar experience/thoughts? I should have never had the surgery.
There was of course, pain and discomfort prior to surgery, but nothing compared to immediately after. I did have a NCS done...do not know the specific results. Had to call 4 days later to get the surgeon to say - yep - you have carpal tunnel and the surgery was scheduled. When I say - immediate pain after surgery, it was before I even got into the recovery room. They stated that is was unusual. I kept begging them to loosen the bandages, and they would not...until about 2 hours later and nearly instant relief of some of the pain....but also, by then, I had been medicated in several ways. Currently, the pain starts in the pad below the thumb...near complete numbness and throbbing/shooting pain. There is no position for relief, whether above my head, hanging it down. Cannot sleep or basically function at this point with the pain. It is like a huge cramp in the hand, and I cannot straighten my fingers. My index finger is swollen and also has numbness. Thank you for your response. I have physical therapy in about an hour, and want to stop back at the doctor's office. I feel there is something more going on than scar tissue, and I cannot live with this pain, and it just seems like it is not being addressed and getting worse. Is it possible that it isn't even a carpal tunnel issue at this point/something more was aggravated during the surgery? At one point prior to the surgery, I even had pain up to my elbow, which is now happening again. Is it too soon to ask for another NCS to compare?....seems like this surgeon wants to try other things first....but again....this pain is not tolerable. Any suggestions on what to talk to the doctor about?
1 hour initial physical therapy. Not much of actual exercises could be done, due to extensive swelling and pain. Went up to the surgeon's office, and he is suggesting a possibility of RSD...and wants to refer us to a hand specialist. Gave me steroid injections into the scar tissue....extremely painful. Got initial pain relief, but now just numb/no pain/throbbing relief. I fell asleep at a restaurant in between appointments and and in the doctor's office. Says to continue gabapentine (may increase-currently on 300mg TID)...also gave prescription for lorazapam and percocet.
RSD does not start instantaneously after surgery so I think that is a non-starter as a diagnosis. It's not too early to repeat the NCS given a story like that and I would want to do both repeat NCS and ultrasound imaging if you were in my area. Where exactly do you have numbness - ie which fingers can you not feel properly? JB
numbness from thumb thru ring finger, with the shooting pain up to the elbow. The pad under my thumb is large and swollen.
Doctor did a "test" with me closing my eyes, so I could not see what he was doing/used those long swabs/the stick end....asked if I could feel one or 2 pokes...he said that my hand is more swollen than one week ago. I couldn't tell if he did one or 2 pokes.
He says it is too early to do another NCS......after this visit with him...he says to continue the gabapentin, gave me more lorazapam and percocet...which, of course, I cannot take during the day to work (we own our own business and I drive all day to do route surveys for over size loads (think wind tower parts)..so lots of driving, writing notes and then later typing all of it into a template for the company)....now, this is the surgeon talking...says he has to refer me......I love the percocet prescription...it states law prohibits refills, and to ask about a 90 day supply....seems obnoxious...a referral is being worked on...but it could take a week before I hear something. I don't want to take a narcotic. It was horrific getting the steroid shots. Maybe I need to wait until I see a specialist or get a 2nd opinion (which is over an hour away). The physical therapist mentioned something about if I had seen an anesthesiolgist.....for a block....I apologize for rambling and all my posts....I remember now...the meds they gave me immediately after surgery....fentanyl, lorazapam, hydrocodone, tramadol.....a huge cocktail of drugs that just couldn't even touch the pain.
That loss of sensation is pretty much all the median nerve territory. If you didn't have that before surgery then you need some NCS doing as soon as possible, preferably by someone who really understands CTS. I'm afraid your current surgeon is completely wrong about it being 'too soon'. You will need to compare with the pre-operative studies so try to get a copy of those for yourself. JB
Thank you for your time. I will definitely speak with the specialist about another study, and keep you updated.
That's certainly a very unusual story for a carpal tunnel decompression as most patients don't require more than a couple of paracetamol for pain relief after the operation. Was it painful before the operation? How bad was the CTS - ie did you have pre-operative NCS done and what were the results? Where exactly is the pain - if you can work out a distribution for it that is sometimes a useful diagnostic clue? JB