Doctor insights on:
Nerve Pain After Carpal Tunnel Surgery
Post carpal tunnel surgery, can a follow-up nerve conduction study (ncs) have adverse effects or make the hand worse. Can ncs lead to complex regional pain syndrome?
Not really ; Ditto: Although I am not sure why a follow-up nerve conduction study would be necessary there is little chance that could cause any type of harm or worsening of symptoms. I am unaware of any literature that supports the notion of complex regional pain syndrome as a result of a nerve conduction study. ...Read more
The brain and spinal cord communicates with what is occurring in the internal organs and limbs by nerve fibers where are like electrical wires with insulation (myelin) and the "copper" (axon). Within brain and spinal cord these nerves connect to other nerves via synapses on both axons and dendrites. A nerve can carry information regarding sensations, and ...Read more
Usually relief: Typically results from carpal tunnel surgery are good. That is, symptoms resolve with relatively little down time. While surgeons differ in their protocol, in my practice the operation is done under local anesthesia with light sedation and the patient can use the hand for most activities right after surgery. Stitches come out at two weeks and the patient leaves with a band aid. That's usually it. ...Read more
Keep fingers moving: Immediately after surgery it's important to keep your fingers moving with your wrist in a neutral position (not bent backward or foreward). Try doing this several times an hour while awake for the first 24 hours. Movements should be slow and full - fully extend the fingers straight and fully flex them into the palm, but without gripping tightly. ...Read more
CTR recovery: In my practice the patient has a soft dressing for 1 week and they start mobilizing in the second week. Recovery from the carpal tunnel surgery can be as quick as two weeks but the nerve recovery may take 6 months if the nerve compression was severe. Scar matures over 6-9 months. Your hand surgeon is the best person to give you detailed information about recovery specific to your condition. ...Read more
Yes: Recent research just published within the last few months does show an increased risk of developing trigger finger after carpal tunnel surgery. The biomechanics of the tendons going through the carpal tunnel are altered slightly after the surgery which can in fact increase the risk of developing trigger finger. ...Read more
Yes: There has been new research demonstrating an increased risk of trigger finger after carpal tunnel surgery. The release of the thick ligament which is causing compression on the nerve does alter the biomechanics of the tendons slightly which can increase the chances of developing trigger finger. This article was just published within the last few months. ...Read more
Will carpel tunnel force me into a new career? I'm a barber and developed carpal tunnel after fifteen years. Is there any chance i can go back to being a barber after carpal tunnel surgery or is it time to find a new profession?
No career change:
Carpal tunnel surgery permanently changes the anatomy of the carpal tunnel so reoccurrent symptoms, even if returning to the same job, is unusual.
So fixing the carpal tunnel should get you back to being a barber -. ...Read more
Yes: Give it time to heal. This can improve with time. ...Read more
It may be that: The amoujnt of nerve compression was evere and that it takes time for the nerve to feel better. It may be that the nerve was irritated by the surgical process and that the nerve is a bit more sleepy. In severe cases often it takes longer ( far longer than it does for the incision to recover) to exhibit improvement and at times full improvement may not be possible. Talk to your surgeon about this. ...Read more
6 weeks: For most patients, they are able to gradually resume most normal activities around 6 weeks after surgery. Most do not require occupational therapy on the hand. However, ot can be helpful if the recovery is slow. The type of work being done influences when someone can return. The more strenuous the work the more time it takes. Your surgeon can help you make a plan as to when you can return. ...Read more
I always tell patients that the time to healing is variable in that no two patients are exactly the same. However typically you can go back to light activites within a few days to a few weeks and heavy activity in 4-6 weeks. Of course this is job and activity dependent. If you are a sedentary office worker its a lot different than a plumber or machinist. General health also affects return to function. If you have diabetes, are a smoker or have fibromyalgia or an inflammatory condition you may have an extended time period.
Healing means different things to people. Some take it to imply return to activity others return of normal sensation.
I take time to clarify these two questions before surgery.
Will my sensation come back or be normal after surgery?
While the goal of carpal tunnel surgery is to relieve the pressure on the nerve not everyone will respond the same to surgery
some patients will have immediate return of sensation while some will take longer. Some will notice an improvement right away but still feel tingling and will describe this as "numb" the return of sensation is dependent on many factors including age, general health, duration of symptoms, circulation and the actual mechanical severity of compression.
In very severe cases while decompressing the nerve stops the carpal tunnel syndrome from getting worse, full recovery of sensation may not be possible. Often this is seen in patients who have muscle wasting noted prior to surgery and in those with longstanding complete numbness and elevated two-point discrimination. Of course there are many in these categories that improve despite having very severe cases.
Having a severe case where you are not sure if you'd have full recovery is not a reason to put off surgery, as progression is likely if nothing is done.
How about my strength?
This is a very difficult question as there are many reasons why a hand with carpal tunnel may not feel as strong. It may be that the decreased sensation in the fingers prevents someone from knowing how tight to hold and object and that object is dropped more easily. With return of sensation or even a slight improvement in sensation, dropping objects becomes less of a problem. Some severe cases of carpal tunnel can be associated with atrophy in the muscles of the hand. In some severe cases, this muscle will never fully recover. However despite loss of muscle, function can still be preserved. In very severe cases a suregon may recommend a tendon or muscle transfer to improve function.
So the short answer is its variabole, the long answer above. The best thing is to ask your surgeon what to expect.
This answer is for general informational purposes only and is not a substitute for professional medical advice. If you think you may have a medical emergency, call your doctor or (in the United States) 911 immediately. Always seek the advice of your doctor before starting or changing treatment. ...Read more
It depends...: In my practice, i allow patients to return to routine activities of daily living the same day of surgery. I encourage typing and light gripping immediately. The bandage is removed after a week, at which time the incision could be washed normally and dressed with a bandaid (avoiding submersion for total of 3 weeks). Load bearing and heavy gripping (manual labor) is resumed usually after 4 weeks. ...Read more
No: Time to get that checked out. Hard to say what is wrong without an exam. It may not be related to the cts. ...Read more
I'm experiencing acute pain 13 days after carpal tunnel surgery in my left hand. I'm wondering if I should go get it checked? Appearance is normal.
Pain hand: Acute pain, yes there can be an infection or another issue, call your doctor. Other things such as arthritis at th base of the thumb, or irritation from prolonged dependency on splints may be suspect as well. By speaking to your surgeon directly they can determine if anything else needs to be done. Often this can simply be a phone call but you must call to start the evaluation process ...Read more
Is pain in the palm of my hand and my pinky normal after carpal tunnel surgery about 3 weeks post op?
The pinky finger, not so much, but the palm, especially the middle of the palm, yes. In fact, different sensations could occur. There could be an aching or tightness, or a feeling of pins and needles or an electrical feeling there.
What does it feel like?
It may be that it improves over time. The nerves will continue to heal now that they are not being compressed. ...Read more
I have pain in arm from neck to finger tips since having stitches removed after carpal tunnel surgery ?
Neck pain: You may have a pinched nerve in the neck that was mimicking the carpal tunnel syndrome. Alternatively, releasing the median nerve at the wrist may have uncovered the pinched nerve in the neck. You may need an MRI of the cervical spine to confirm a pinched nerve in the neck. Physical therapy, transcutaneous electrical nerve stimulation, and neck traction may relieve the pain in the neck and arm. ...Read more
Severity: It depends on the severity of your symptoms and functional abilities. If atrophy has set it or you are not capable of completing daily activities without simple modifications it may be time to seek relief. ...Read more
Good things: Usually an outpatient procedure done under local anesthesia with light sedation so home fairly soon after the procesure. Sutures usually are in for about two weeks but during that time the hand can be used for most things. Pre-operative discomfort should be relieved fairly soon after surgery with full sensation and strength somewhat more variable. A good operation if you need it. ...Read more
I had Carpal Tunnel surgery in 2012 but now symptoms return. What is going on? Should I be concerned?
Recurrent carpal tun: All problems can recur if one resumes the activity which created the problem in the first place. You should be seen by an upper extremity specialist. Many times the diagnosis needs to be accurate. I.e. One may have compression of the nerves from the neck and or brachial plexus , which may also need to be treated. Be sure that conservative treatment is initiated first . Perhaps a second opinion . ...Read more
None: There are tendon and nerve gliding exercises that have been described. I have not found these very effective in treating carpal tunnel syndrome. You can try doing exercises for a period of one month to 6 weeks. If you're carpal tunnel symptoms are not resolved i would consider surgery. ...Read more
Constant symptoms: Once symptoms have been constant for 6 months, it's hard to resolve them with non-operative treatment. Loss of muscle bulk in the thumb or complete loss of sensation in the digits is an indication for operative treatment. Oral/injectable steroids, splints and or therapy are used to treat symptoms. If symptoms continue after these treatments, surgery is indicated. ...Read more
Just slow down: For most patients, they are able to gradually resume most normal activities around 6 weeks after surgery. Most do not require occupational therapy on the hand. However, ot can be helpful if the recovery is slow. Your hand will be sore and possibly swollen for the first few weeks. Fortunately, most patients have a very good outcome. ...Read more
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