Post surgery numbness and pain

I'm not sure what your surgeon means by 'normal' - I think most people would take this as meaning the experience of the majority of patients in the same situation and your current symptoms are certainly not that. On the other hand he may simply mean that he thinks your current symptoms are within the range of acceptable experience after surgery. For myself I would worry about these symptoms 2 weeks after surgery and I would normally try to reassess such patients with repeat nerve conduction studies and ultrasound imaging as soon as possible.JB

Dear JB

Thank you for your response, I will contact my surgeon on Monday and request nerve conduction tests and an ultrasound immediately.

Kind regards

Anne

Depending on where you are you may or may not find it easy to track down a doctor with the requisite expertise in ultrasound imaging of peripheral nerves and interest in carpal tunnel syndrome. Let me know how you get on please as there is still considerable uncertainty about how soon after surgery one should start to take persisting symptoms seriously. JB

Hi Annepan

I had my carpal tunnel release on 16th August this year and my post op symptoms are very similar to yours. Dr Bland has carried out ultrasound, and two nerve conduction studies since my op and they have both shown an increase from grade 3 before my op to 5 post op. I am now waiting for another operation to investigate what has happened.

It may be useful for you to read my postings on the Canterbury Patients Forum, although it won't give you any answers.

Martin j k w

Between the two of you that is almost enough for a case series. Hopefully we will get progress reports from both of you on here. JB

Dear JB

Thank you for your advise re: nerve conductivity testing and ultrasound imaging.

I can confirm that I have severe nerve damage and the ultra sound image was inconclusive. The Dr at the imaging clinic sent me to the emergency department of Sir Charles Gardiner Hospital in Perth WA, who made an appointment for me to see a Mr Angus Keogh.

Mr Keogh did a thorough examination and sent me for a MRI. The MRI showed a 9mm cut across 50% of the median nerve.

Tomorrow I undergo surgery, best case scenario is that the MRI was wrong and they just correct the CTR however the surgery has been scheduled to remove a nerve from the top of my foot and graft it onto my median nerve, they will also remove the tendon from my left hand ring finger and place it in my thumb as I have lost the ability to grip.

If you send me an email address I will send you copies of my reports:

I would like to say to other people reading this comment that given a choice of surgery again I would thoroughly investigate the surgeon, this incident is rare and should not put people off surgery to correct CTR. I have had my other hand done with fantastic results.

Kind regards

Anne McDonald

Thankyou for the update, and for anyone else reading, accidental cuts to the median nerve during carpal tunnel surgery are a known complication of this operation but fortunately are indeed very rare. Slightly more common than a cut to the main median nerve is injury to just the branch which goes to the thumb muscles - I have seen six of those out of more than 6000 operations but never an injury like the one described here - if that is what it turns out to be.

The images from ultrasound are usually better than those from MRI for the median nerve at the wrist but for both techniques what you get out of them is more about the experience of the person looking at the pictures than about the method used. If you are happy to share them with me I would find the reports interesting - my email address is in the contacts page here - and of course the findings at re-operation will also be interesting.

One final question. Did you have nerve conduction studies before surgery so that they were able to make a comparison with the post-operative ones? JB

Hi Anne,

My name is Brenda. I read your comments and couldn't believe that your description of your post op is exactly what I am experiencing. It's been a month now and my surgeon doesn't tell me what's wrong other than I have a lot of swelling. I am extremely worried since the swelling, numbness, electrifying, tingling, stabbing cold finger, and constant pain are not going away. I have no strength and atrophy is setting in. I am wondering what your final outcome was to get you hand back to normal, that's if it is and would also like to know what I need to do. I had an ultrasound done, I'm just waiting on the results. Should I see another doctor for a second opinion? Please advise as to what steps I need to take to get my hand back to a functioning hand.

Thank you,
Brenda

After 2 years I suspect that Anne has not been back to the site for some time though she did contact me with some further details privately. The first thing we would really like to know here is how bad your nerve conduction studies wee before surgery as that helps us to tell whether slow recovery is due to the severity of the original problem or if it is a problem with surgery. Post-op NCS can help at this point as can the ultrasound - did they not tell you what they could see while they were doing it? FInally - have the symptoms changed in any way compared to how they were before surgery? JB

I had a NCS done in 2006 and 2012. I was told i had acute carpal tunnel. I was suffering from elbow pain as well as my hand and my first surgeon said he will need to do surgery on my my elbow and do the hand as well. I decided to get a second opinion and was told the was thing the first surgeon said so an appointment for surgery was scheduled. No new NCS was done since i was told it wasn't necessary because the NCS doesn't change. I took the surgeons words and went with the surgery and now I'm worried and concerned. The numbness is slowly spreading throughout my thumb, index, middle finger and the palm around those fingers and the swelling, pricking, burning, electrifying spasm and excruciating pain is an every second, every day part of my life now. I don't know what to do

It sounds as though the second surgeon had a somewhat limited understanding of nerve conduction studies in CTS if he/she really said that. It sounds to me as though you are saying that your symptoms are worse now than before surgery - in which case you need some new nerve conduction studies and ideally an ultrasound scan of the median nerve and carpal tunnel but whether you will be able to get those done in your area I do not know. JB

I've been reason a lot about nerve damage and I have a lot of the symptoms that they describe. What's weird is that I get burning in my legs as well which I don't understand why. I am so worried and concerned that it's literally making me depressed cause I can't use my hand to do anything and the constant pain is making me miserable. After requesting for an ultrasound and NCS for like the fifth time my surgeon finally referred me to get it done which I have an appt this coming Tuesday so I will keep you posted. I don't understand why my surgeon keeps telling me ithat's it's swollen when clearly it's a lot more serious than swelling. I'm just praying it's not nerve damaged. I do not want to be disabled and in everyday pain :-(

If you are getting symptoms in the feet too that raises the possibility of a more widespread disease developing so it should be looked into. At least some NCS are being done now. JB

Dear JB

It has been over 3 and a half years since my surgery and I would like to extend my sincerest thanks for guiding me in those dark days.

To your readers I would love to say I had a full recovery (back to normal), but that isn't the case. What I can say is that I now have survival feelings - hot, cold, sharp and pain and for that I am truely thankful. The nerve may continually recover and who knows as the years pass more feeling may return.

I have learnt to live with my disability and with everything in life you learn to cope and just do things differently.

I may not be able to feel everything but my hand functions normally. My advice to people is to use you injured hand or you will lose function.

Keep up your good work and again thank you.

Take care

Anne

Thankyou so much for letting me know how that has eventually turned out. Yours was one of the most memorable cases from soon after we opened the website. I'm sorry it didn't make a full recovery but not too surprised given the nature of the injury. After three years I would suspect that there is now not going to be very much more change I'm afraid but at least there is enough sensation to stop you getting further injury to the hand. JB

I had surgery Sept 21, 2017. Same symptoms described above: 0 lbs grip left hand, severe nerve pain thumb, forefinger, NO cold tolerance. Cannot even run cool water on left hand and anything colder causes agony. swelling, 2 infections so far where surgeon cut. Dupuytren's contracture bulge on tendon to middle finger developed within 2 weeks of surgery, but surgeon says that is impossibility as it takes years to develop. Anyone who has held my hand prior to surgery can attest it was not there before.. Hand is completely useless. Surgeon denys he could have done anything wrong that could have made me worse, insists there is no reason for my pain, and refuses to do a post-surgery NCT or MRI. He insists I use my hand normally, but physical therapist has proved that I have no useable hand function. I can move my fingers and wrist, but no grip & agony to touch anything with it. Going to have to move out of state next week in order to find competent doctor to follow-up & get this fixed as there are none in this area of the state I live in, and few in the whole state at all.

A surprising number of surgeons refuse to countenance the idea that anything might have gone wrong with their operation. Did you have nerve conduction studies performed before surgery? If not then it make interpretation of post-operative ones much more difficult. JB