I had Carpal Tunnel and Ulnar Nerve Decompression surgery on my left arm on 10/11/2012. I was out of work for about a week and a half. I had my stitches removed on 10/24/2012 and my doctor sent me back to work on 10/25/2012 on light duty. No lifting over 1 lb. and no pushing and pulling over 3. This was a company doctor because this is a workman comp issue. I would like to know if that is an appropriate procedure. I explained to my doctor that I am experiencing shocks of pain in wrist and tingling and needle like sensations in my fingers. My elbow is swollen and I cannot lay my arm to rest with out setting off the nerve. Is this normal. I was doing some filing, but after a period of time I started to feel the discomfort, He told me to continue what I was doing that it was normal.
I assume the carpal tunnel release and cubital tunnel release were done for symptoms of nubmness, tingling, and pain due to compression of the nerves in those locations.
After release of the transverse carpal ligament (wrist) and of Osborne's ligament (elbow), it is the usual post-op management to allow the patient to rest the wrist and elbow for just a few days in the surgical dressings. The patient should be moving the fingers from the beginning, to prevent scarring of the tendons in the carpal tunnel.
Once the surgical dressings come off, usually in a few days after surgery, the patient needs to begin gentle range of motion to get the nerve gliding. If range of motion is delayed too much, the nerves can scar back down in the tunnels.
So, usually, patients are allowed to do all the range of motion they want, but to avoid heavy activities for a few weeks. If they have post-op swelling, that needs to be iced and elevated. The patient should never rest on the wrist or elbow, as that just puts pressure on the nerves, making the conditions return.
As soon as the patient feels comfortable, gradual strengthening is instituted as tolerated. But, again, range of motion should be started very early and continued throughout the rehab period.
While the success rate for carefully selected carpal tunnel syndrome patients is very good, the success rate for release of the cubital tunnel is not quite as good. Many patients will have some residual symptoms, though the majority will state that they are better than before the surgery. It can also take quite a while to recover fully from the cubital tunnel release (many months).
You do need to get the swelling under control, as this can continue to put pressure on the nerves. Also, do not rest the arm on the area where the nerves were released, as that also puts pressure on the nerves. The tingling is a sign that the nerve is still being compressed, or has not yet fully recovered from being compressed for so long. As to how long it takes for the nerve to wake up, depends upon how long the nerve was under compression before the release.
Again, range of motion is very important for nerve gliding. If the nerves do not glide through the surgical site, they will become scarred down, which could cause the symptoms to return.