New symptoms after CTS


Dr. Bland, Thank you for providing this resource! This is an amazing community for CTS info.

I had CTS on 7/8/2016 ( yesterday ) to relief nighttime numbness on my pointer and middle finger. Immediately after surgery my ring finger, inside of pinky finger, and side of middle finger adjacent to ring finger were extremely numb and tingly, pins and needles to the touch.

Was told by surgeon that nerve block caused this and would subside within 24hrs.

All tingling and numbness from nerve block has resolved except those fingers I described above.

Could it be possible damage may have occurred to the ulnar and median nerve during CTS? or is swelling compressing those nerves and causing these symptoms?

Should I request a MRI to check for damage?

Any advice would be much appreciated.

Surgeon states its normal to have new numbness after CTS and can take up to a year to fully resolve. I could not imagine the quality of life over the next year, I barely got 3 hrs of sleep last night.

Thank You!


That's a very odd distribution of numbness, exactly correspponding to the territory of two palmar nerve branches, one coming from the median and one from the ulnar nerve, unless you have unusual anatomy and a non-standard arrangement of nerves within the palm. I don't really buy the surgeon's statement that it is 'normal' to have increased loss of sensation after surgery. If he is seeing that regularly then there is something wrong with his technique. As usual I have to ask on here... did you have NCS performed before surgery and what were they like. If it was not very severe CTS then it should already be feeling better 24h after surgery. JB


Was not severe, NCS was performed over 2 years ago and surgery was recommended. However my life did not allow me the time to do the CTS until now.

I was mainly having numbness and tingling at night.

CTS was via single incision endoscopy.

Could you please explain how damage could possibly occur to the palmar branches?

Thank you sir.


So the NCS were out of date, which does not help. Do you think the symptoms had changed very much in intensity in the intervening 2 years? Did they try any other treatment in the meantime such as steroid injection? If the endoscope was inserted too far it is possible to traumatise the palmar branches, and also theoreticaly to damage the arterial palmar arch. It is also possible that the acute increase in pressure caused by inserting the endoscope into the carpal tunnel could compromise the nerve producing a transient neuropraxia, though in practice this seems to be a fairly rare event - all of the studies comparing endoscopic with open surgery more or less agree that the risks with each approach are similarly small but that does not mean zero of course. My current view is that if the CTS symptoms feel worse 2-4 weeks after surgery then the NCS should be repeated, preferably for comparison with a set done during the 6 months prior to surgery. Where there is any suspicion of incompete decompression or nerve injury one should also get some ultrasound imaging done by someone who is knowledgeable about CTS and its treatment - but there are not many such people about unfortunately. JB

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