SEVERE CTS - RECOVERY TIME
I had severe CTS diagnosed in December and underwent surgery in January.
My consultant wrote to me pre-op:
"On examination, sensation in the right hand median nerve territory is 0/10. There is severe muscle wasting of the APB with no abduction or opposition. There is mild reduction in sensation in the ulnar nerve distribution and power in the ulnar innervated intrinsics is 5/5.You are quite swollen across the MCP joints of both hands but worse on the right and there is subluxation and ulnar drift. X-rays today show that you have had a previous joint replacement of the right first CMC joint. You have right sided scapholunate dissociation (SLAC wrist) and advanced STT joint osteoarthritis with complete loss of joint space and sclerosis.
I recommend an urgent right sided carpal tunnel decompression under local anaesthetic. Given the severity of the nerve compression and the underlying peripheral neuropathy, we do not expect a full recovery of sensation and strength in the hand. However, surgery will prevent further worsening of the condition and you will regain some degree of improvement in sensation and strength. Nerves recover very slowly so you will see this improvement over many months (even up to two years after surgery)."
Although there is reference to a long/very long recovery improvement, I have had no improvement whatsoever since the surgery -if anything, the symptoms have worsened!
I am due for a follow up visit (delayed because of other health issues).
What questions can I usefully ask?
Are there any other possible procedures available?
Thanks.
Yes, I had nerve conduction studies beforehand.
I have mild arthritis in that hand and peripheral neuropathy.
Not diabetic.
If you have a copy of the NCS we can make an assessment of how bad it was physiologically to compare withthe surgeons clinical assessment. JB
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That sounds like very severe CTS indeed and sometimes these do not recover at all with surgery. Did you have any nerve conduction studies beforehand? It sounds as though there are also quite severe arthritic problems and perhaps an underlying neuropathy too - are you diabetic by any chance? JB