More Nerve issues

JohnLansdown82
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Dear Dr Bland.

My last appointment with you was 22/11/2018 if my own notes are to be believed. At that point I'd had bilateral CTS decompression. Largely successful. I was awaiting Cubital tunnel decompression on my right elbow, this was carried out on 5/12/19. I've since had the same procedure on my left elbow on 17/12/2019. I had two PRP!!! injections at the same time, one for tennis elbow in my left arm and another at the very base of my thumb on my left wrist. the latter was for symptoms of arthritis apparently. Ive been experiencing very acute pain in the area (also a lump there).

The good news is, to complicate things even further is that I've since developed symptoms of some type of radial nerve issue in my right side. this came on suddenly during the day on 24/12/19. Its a really stiff and sharp acute pins & needle type feeling on the top of my right hand, near to the thumb, and also along my forearm. The symptoms are only present when standing and in some sitting positions. When I lay down with my usual thin pillow I feel no symptoms at all. Ive started to do a series of Neck exercises and radial nerve glides. these do alleviate the symptoms on a temporary basis.

Also to add to the mix, I've got symptoms of Cubital tunnel syndrome on and off in my right arm too. the symptoms are the same that I had before the release surgery in 2018, and since the surgery too. I will elaborate on this latter.

I have kept a detailed "hand Diary", so I will do my best to summarise below.

So back in Sept 18 I clapped my hands together (prank with a colleague) rather loudly. Onset of burning pain in ulnar side of Right hand, sensitive in cubital tunnel area of elbow.

2nd October 18. CTS release of left hand by C.J at the Chaucer

4th October 18 Really bad burning in Ulnar side of right hand (Sleeping with a pillow down my left side so that I could keep my bandaged hand elevated *will come back to this point later)

5th Oct 2018 Started Neck exercises and ulnar nerve glides. Noticed a slight twinge in neck. These alleviated symptoms of right Cubital. Kept stretches going for a few days

8th October 18 fell up stairs, landed on bandaged left hand. Xray showed no broken bones.

15th October. First signs of Cubital symptoms in left arm. I put it down to sleeping awkward.

on and off with exercises and glides. a few good days followed by a few bad days with cubital symptoms in right side.

5th December 18. Right elbow cubital tunnel release by C.J at the Chaucer.

9th December 18 Noticed the burning pain was still in right hand ulnar side. felt weak. understood it can take a while to resolve post surgery.

Most things seemed ok, any pain I experienced I put down to the post surgery healing process. I returned to work in mid January.

8th February 2019. Developed a bursa on right elbow. had this aspirated on 12th Feb by CJ at the Chaucer.

16th April 2019 Started to notice acute pain in base on and/top of wrist of left hand. Noticed a pain in left elbow and neck. Started neck exercises for 7 days along with 1000mg of naproxen per day

22nd April 2019 woke up with bad pins and needles in Right arm ulnar side. improvement in left side symptoms.

25th April 2019 really bad symptoms for cubital tunnel syndrome. naproxen and nerve glides for 7 days.

to prevent me rambling, my diary is filled with entries for cubital tunnel syndrome on left side between May and beginning of December 2019. Treated sporadically with naproxen, nerve glides and neck stretches.

lump in base of left hand/top of wrist has caused continuous acute pain.

14th October 2019, big improvement in left side cubital tunnel symptoms. didn't last for that long.

5th December 2019 Fell asleep on coach for 20 mins, woke up with bad pins and needles of RIGHT arm Ulnar side.

6th december. woke up with pins and needles in right arm ulnar side and burning sensation has returned with a vengeance in ulnar side of right hand.

I took 1000mg Naproxen and done neck exercise for five days from 6th Dec. this helped a lot.

17th December 2019. Cubital tunnel surgery of left arm by CJ at K&C day surgery.

24th December as stated at beginning this is when Radial nerve issues in right side have started along with a return of the cubital tunnel symptoms in right side.

A common denominator for bad cubital tunnel symptoms in right side, hand especially is that I've been sleeping with my right arm on a pillow to keep it elevated. I made reference to this in my entry for 4/10/18.

I do have a more detailed diary.

Thank you for your time reading this. any suggestions for new radial nerve issues in my right hand and arm and the reoccurrence of cubital tunnel syndrome in right side?

JohnLansdown82
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I've noticed that I've made an error with the dates. Just to make clear, my first Cubital tunnel decompression on my right elbow was 5th December 2018. The same procedure for my left elbow was carried out last week, 17th December 2019.

jeremydpbland
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I guess the first question by this point is has ayone ever checked if you carry the gene for hereditary liability to pressure palsies? Although it's relatively unlikely with your NCS results it's not impossible that you have a genetic defect which would predispose to nerve entrapments, and we've never checked your feet to see if there is evidence of a problem there. I would suggest seeing a neurologist rather than a surgeon with this latest round of symptoms if they persist. JB

JohnLansdown1982
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Thank you for the quick reply, Doctor. No I’ve never been tested for that. Funny you should say that though, I’ve upset the nerves on my right foot, to prevent the door slamming back on me (arm in sling at the time) I pushed back on the door with the sole of my foot whilst wearing shoes. Not particularly hard either. That’s secondary to the issues with my arms and hands at the moment. I’ve been carrying out neck exercises and radial nerve glides five times a day since the 25th Dec, there has been a small improvement with the radial nerve symptoms.

jeremydpbland
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Get yourself referred to a neurologist and we'll take it from there. JB

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