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Elbow pain worse after carpal tunnel surgery?
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TOPIC: Elbow pain worse after carpal tunnel surgery?
#3343
Maureend
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Elbow pain worse after carpal tunnel surgery? 1 Year, 11 Months ago Karma: 0
I had been diagnosed with severe bilateral carpal tunnel syndrome 6 years ago. The nerve studies showed the right hand was worse so I had surgery to correct it. Fantastic results - and the left hand actually improved after surgery was done on the right. (My doctor said that happens sometimes.)

However over the past several months, the pain in the left wrist came back to a severe level and I also started noticing sensitivity in my left elbow. Even the slightest tap would send me through the roof. It was like hitting my funny bone but much more painful.

Every morning I'd wake up with numb fingers and a weak feeling in the left arm.

Long story short, I went in for carpal tunnel surgery last Friday on my left hand by the same surgeon who had done such a wonderful job on the right.

But now - less than a week later, my pinky finger is numb and I can't bend my elbow past 90 degrees without the "funny bone" feeling shooting into my pinky and ring finger! This is much worse than it ever was!

I mentioned it to the nurse on Monday when I went in for post-op checkup, and she said it was an ulnar neuropathy and fairly common among carpal tunnel patients. She said they have a procedure for that too... great, more surgery

What could have happened?

Has anyone heard of this before? I am researching these elbow problems and it sounds like CuTS but it could also be Guyon's. Could something have been moved out of place while the doctor was in there fixing the carpal tunnel to suddenly pinch my ulnar nerve in the Guyon tunnel?

Sure seems like a coincidence that it would get so much worse following carpal tunnel surgery.

Thanks,

Maureen
 
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#3346
BrendaB
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Re:Elbow pain worse after carpal tunnel surgery? 1 Year, 11 Months ago Karma: 0
Howdy Maureen, and a Hearty Welcome to the Site!!!

This close to Carpal Tunnel surgery for interference in the Guyon's canal? Post surgical (only a week) swelling....Possible. I wouldn't necessarily throw Guyon's on the table yet. Now as to the other symptoms that you are describing, "Cubital Tunnel" syndrome, sure that is very possible. Don't get me wrong, Guyon's can be involved, but until your swelling goes down, and too they do a new electrical conductivity study, I would not jump to that conclusion.

I had my elbow and Guyon done on the same operating period, so I am not sure if it were just Guyon's how they would have restricted my hand (soft cast, ace wrap etc.) With your Carpal tunnel, is your hand in any sort of "restricted" position? I ask that because it could be if so, your elbow issue is being brought to light because of it. Otherwise you might have had problems for a while, and it unfortunately chose now to manifest itself!?!

Give the surgery on your hand/wrist a bit of time so the swelling goes down, and too wait until they test electrically to see if there is problems still in the hand, or is it in the elbow only? The pain, numb etc., sounds like just the elbow (yeah...okay..just...grrr) so far. I hope some of these symptoms calm down for you Maureen. Again, welcome to the site!!!

Brenda
 
Mar 08 ACDF with Instrumentation C5/6
April 08 Subcutaneous Ulnar Transposition, Guyon's Release and claw fingers release
Aug 09 ACDF with Instrumentations C6/7
Oct 09 (new) Degenerative disk disease with Osteophytes C7/T1 Degenerative disk disease C2/3, disk bulge, Osteophytes
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#3347
Maureend
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Re:Elbow pain worse after carpal tunnel surgery? 1 Year, 11 Months ago Karma: 0
Hi Brenda,

Thanks for the swift reply.

Yes I have had my hand wrapped in an ace-type wrapped bandage since Monday, and the thought occurred to me that perhaps it was exacerbating the problem. I change the bandage each night but tonight I just took it off and let it air for a while to see if the numbness might go away - but no luck.

Immediately following the surgery I was told to keep my hand elevated above my heart for several days, which of course meant I had to have my elbow bent sharply for an extended period.

It's just quite discouraging. I finally bought an elbow wrap which really helps keep me from bending the elbow too much now, but the minute I take it off, if I accidentally bend I get the "zap" all the way down my arm. Just brushing my hair has become a dreaded task.

While I hate the thought of another operation, I'd do it gladly to get rid of this painful situation. And as you said, I'll try to give it some time. Ugh.

Did your surgery correct the problem for you? Also, how do they determine whether the impingement is at the elbow or the wrist?

Thanks again,

Maureen
 
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#3348
BrendaB
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Re:Elbow pain worse after carpal tunnel surgery? 1 Year, 11 Months ago Karma: 0
Howdy Maureen, and your welcome on the quick reply! I have "e-mail" notifications, so it makes it easy for me to know if there is activity on the various boards I am on and posting in.

Okay, yeah (Lyrica moment here), I forgot about the "elevated above heart level"... Yeah, I can easily see how that would aggravate your elbow! Nerves are fickle critters, and really don't take kindly to being restricted or pinched if you will. Now the "good news?!?" Many times where it hurts, the nerve is still viable, weakness (I mean more than like 50% or there abouts - marked), can mean damage has started.

Unfortunately (on the good side), having your hand bound up, and only "giving it a break" for a short time, it won't bounce back that fast. It's kind of like your feet going to sleep. If they "just" go to sleep, unwrap your legs, a little wiggle and they start coming back, leave them in the "sleeping position" for a few hours, it might be 15 minutes before your feet are your again, right? Same basic principle there.

Pain = fix pain. Humm... Most surgeons "hope" your pain will be alleviated, but there are not guarantees. Actually nerve related surgery is to "stop" further damage from the affected nerve! Most times we are lucky in that the pain, and many of the related symptoms (numb, tickles, strength) are fixed or lessoned. More surgery, yeah I hear ya there Maureen. I've had 5 nerve related surgeries in a year and a half, and am looking at between 3 and 4 major spine surgeries this year! Yeah, I am thrilled....NOT. I still try to keep a bit of a sense of humor. I have been a pilot and in law enforcement for 30 years ... I just got a call from HR, and that career is about to end via "disability retirement"... No regrets though, just wish I signed the better warranty as I was growing up! <G>

My elbow hand.... I would say those surgeries were 80-90% success for me there. Originally they were going to have me awake for the surgery, but block my arm. Since there was strong positive Tinel(sp?) sign at my hand, they knocked me out and did the elbow, then they "re" tested my forearm and hand, and when I awoke, found out that the entrapment was "minor" in my elbow, but the issues they found in my hand were umm...interesting? I've been a pilot (jets and helicopters) for 30 years...I am sure you have seen people in movies fly a helicopter. The wrist position on the cyclic (the steering control if you will) is not the most "nerve friendly" if you will. I had 2 issues in my hand. My ulnar nerve was "too close" to the surface of my hand, and the bent position my hand rested in when I flew, compressed it further. So in basics... EMG, physical exams showed elbow and a bit of hand (Guyon's), in surgery, electrical "confirmed" deeper the hand as well.

Sooo.... Pre surgery, electrical, MRI, physical exam etc. determines "where" nerves may be being affected. During surgery, they conduct the electrical testing again to further zero in on it. I hope this helps.

Let your recent surgery heal, then see if it is in the hand still, or (and it sounds more likely given your symptoms) more likely your elbow. Please keep us posted. Of course if I can answer or be of further help, please don't hesitate to ask. I am on day shift until the "retirement" paper work comes down. Take care. *HUG*

Brenda
 
Mar 08 ACDF with Instrumentation C5/6
April 08 Subcutaneous Ulnar Transposition, Guyon's Release and claw fingers release
Aug 09 ACDF with Instrumentations C6/7
Oct 09 (new) Degenerative disk disease with Osteophytes C7/T1 Degenerative disk disease C2/3, disk bulge, Osteophytes
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