post CTS surgery pain

Carpal tunnel release is surgery to treat carpal tunnel syndrome -- pain and weakness in the hand caused by pressure on the median nerve at the wrist. As with any surgery, there are risks involves with CT release. These risks include:

* Failure of the surgery to improve symptoms
* Injury to the median nerve or its branches
* Rarely, injury to another nerve or blood vessel (artery or vein)
* Scar sensitivity

Complete recovery can take anywhere from several weeks to a year, depending on how severely the nerve has been damaged. The longer the symptoms lasted before surgery, and the more severely damaged the nerve appears at surgery, the longer the recovery time.

What does your surgeon say?

My surgeon has little to say other than this has never happened before in all his surgeries. He wants me to keep up my exercises and not wear gloves which help me cope with the painful over sensitivity. There is a syndrome I fear I might have called CRPS (Complex Regional Sympathetic Dystrophy). I see my PT today and will ask her and my doctor about this, Al;so I am planning to get a pain management doctor on board.
-idraw

You poor thing! I'm so sorry to hear about...it make my joints throb just to think of the pain. Please advise what the PT says...I'm interested to know what might help.

My spouse is 2 years past the surgery and the symptoms have appeared again now. Tried PT but did not work much apart from some initial relief. Then a Ortho and a couple of Nuros... Nerve conduction shows up good. So not sure what may have caused this.
Ortho says re-surgery... but we think that's too much.
Nuro says post traumatic pain... take some nerve relaxatant... but that's too sleepy.
Any suggestions?

Manirahul,

I assume when you say the symptoms have returned, that it is the numbness and tingling in the fingers, with pain there also. That he is getting the numbness when grasping and during the night. Also, since it has returned, I am assuming that he did have a period of time where the symptoms were gone.

It is unfortunate that this has happened. He has tried using his splints again at bedtime, I hope, to help with these symptoms (if he is having night problems).



When symptoms return after a surgical release, it can be quite a problem. Usually, when a patient has had resolution, then a return of symptoms, it means that the patient is developing scar tissue around the nerve.

As opposed to the patient who never gets any relief from a release, here, there has probably been an incomplete release of the transverse carpal ligament. In these cases, a second surgery to make sure a complete release is done, usually has a good success rate.

But, when there is the development of scar tissue, the results of a second surgery are not very good. The nerve not only has to be released again, but then usually protected with something in the hopes that scar tissue does not form once again. So, this is quite a bit larger of a surgery than just a simple release.


So, you can try the medication for nerve pain, such as gabapentin (Neurontin) or pregabalin (Lyrica). Also, occasionally, a steroid injection into the carpal tunnel will soften or break up the scar tissue. But, if these measures do not work, and the symptoms are unbearable, then surgery may be necessary.

Good luck.