i had subq on 3-23, in the last few weeks i have noticed muscle atropy in my hand, between thumb and finger....and some in arm-that i expoected.
my pt is not worried....i wonder if this is normal.....any one else??

Yes, I did lose muscle after surgery, so much that I went in for an EMG/NCV after two months. it showed that I improved on the amplitude and speed, which calmed my fear that something else was wrong besides the double crush I was diagnosed with.

Supposedly, if the onset of symptoms was fast, the muscles will catch up to the nerve loss eventually, hence the loss after surgery.

My muscles were so soft after surgery, then the first dorsal interosseous started tightening but getting smaller at the same time. The adductors are another story.

thank you for that info. i go back to pt tomorrow, i will show her again and ask her if we should call my dr as well.
what surgery did you have? how long after did the muscle loss stop and the symptoms improve?
thanks!
Lib

I had ulnar nerve transposition (subq), guyons canal decompression and the doc threw in carpel decompression for free

You have to remember that the nerve heals around mm/day so it's a slow process. it can take a while. I think I'm bottomed out with muscle loss but can't be sure(3 months), it'll take another 3 months before I would expect to see improvement that I can write home about. Hopefully...

The EMG/NCV would show potential improvement for you only if you did it before surgery. You have to know where you started.

nj55 wrote:
I had ulnar nerve transposition (subq), guyons canal decompression and the doc threw in carpel decompression for free

You have to remember that the nerve heals around mm/day so it's a slow process. it can take a while. I think I'm bottomed out with muscle loss but can't be sure(3 months), it'll take another 3 months before I would expect to see improvement that I can write home about. Hopefully...

The EMG/NCV would show potential improvement for you only if you did it before surgery. You have to know where you started.
well we tested my pinch, i am up a pound from last week....pt is not worried about the muscle lose, ill show dr next wed. i had emg-ncv in feb, it was totally normal....i really am scared to do that again, i had subq as well...and were you not terrified they would needle the nerve in the test....
aside of the muscle loss have your symptoms improved at all?
can you tell where the nerve now is?
thanks!
lib

well we tested my pinch, i am up a pound from last week....pt is not worried about the muscle lose, ill show dr next wed. i had emg-ncv in feb, it was totally normal....i really am scared to do that again, i had subq as well...and were you not terrified they would needle the nerve in the test....
aside of the muscle loss have your symptoms improved at all?
can you tell where the nerve now is?
thanks!
lib

I'm not a doctor, just a patient, but I'm surprised they did both CuTS and Guyons if your EMG/NCV was normal. They had to have isolated it to the wrist and elbow in the EMG/NCV, I'm assuming. Perhaps the EMG was normal but not the NCV part, which would tell you the location of the slowdown in the nerve. EMG tells you how well the nerves are moving the muscles.

My symptoms came on so fast that I forgot to remember how my hand was before the surgery. This is something I would recommend people do, e.g. measure the pinch and grip strength if they have weakness, before the surgery, so you can tell when you've crossed the bottom after the surgery. Since the surgery is so invasive you should expect to lose muscle due to having your arm in a splint for 3 weeks. I had atrophy in my forearm, which came back fully a month after I started PT (no nerve damamge there, just inactivity). My hand is another story, the progression is very slow and I can't tell if I've crossed that threshold yet. but I'm only on month 3.

I never worried about taking a needle on the nerve since I don't think the nerve exists in the place where they prick you. Trust the Neurologist, he knows what he's doing.

Nerves are complicated, PT's haven't really been trained to be experts. Although I always found it that they listen so much better than doctors do . It wouldn't hurt to ask your doc about your concerns. My guess is that your atrophy is minimal and it will come back with pt, especially since you said the EMG was normal before surgery.

I think I can feel my nerve on the inside of my elbow, but my neurologist said they would never do an NCV on that area since the anatomy has changed. They have to know the length of nerve to calculate speed.