Tingling in little finger and ring finger and elbow pain
I had carpal tunnel surgery on my right hand eight weeks ago. I was diagnosed in 2008 with carpal tunnel syndrome in both hands after nerve tests. Don' t know what levels they were just told moderate. It was only when the night splints no longer worked that I was referred to a surgeon by my GP. I also had started to drop objects in both hands for no reason. I did not have further tests before the surgery. My question really is that after the surgery I am now in pain more than before but now in the little and ring finger and elbow. Also the elbow of the left hand became painful as I thought it was just working harder after the surgery but has remained painful eight weeks later.
I understand my symptoms indicate problems with the ulnar nerve but am curious as to if the surgery could have triggered this problem. I had rare occasions when my elbows ached before but nothing major.
I discussed with my surgeon the new symptoms. He does complete lots of carpal tunnel operations and seems experienced. He has told me there were no complications in my operation. He did not consider that when the local anaesthetic was injected into my hand at one place, the intense pain I felt along my little finger and ring finger was relevant. This tingling in little and ring finger has more or less been present since operation and worse at night. Also something else relevant was immediately after the operation I had to ask for the bandages to be released as my fingers went a funny colour.
I don't have CTS symptoms now except some tingling in all fingers. My scar on left side is still tight and tender with some pain going up my arm sometimes. I am curious as to if anyone has had similar problems after surgery as my surgeon feels my new problems are not related to the operation. However I keep thinking my new problems must be related to the surgery as it would seem I am very unlucky if not. I need to have my other hand done which is worrying. I did wonder if my ulnar nerve is in a different place to other people and maybe they did inject into it by accident. I know from internet research that is not a good outcome.
Would be great to hear from anyone with similar problems or advice.
Thanks for your reply. I know the local anaesthetic was Lidocaine. The pain did stop once the local took effect and recurred after surgery as the local wore off. The surgeon has advised he will do post-operative nerve conduction in six weeks time as the results would then would be clearer. If the ulnar nerve was damaged by the injection will it heal itself.
6 weeks post-op would be fine for assessing what has happened to the median nerve but for the new ulnar symptoms it's harder to say what the right timing might be. 4-6 weeks after an acute injury is usually good timing for NCS and EMG because it can take a while for needle EMG abnormalities to appear. If I was going to look at the imaging however I would want to do that as soon as possible and I would probably do some nerve conduction studies at the same time as they only take a few minutes.
I don't have any personal experience with intraneural lidocaine injections but there is some anaesthetic literature. This article is a fairly recent review and suggests that mostly you will get away without serious complications, that most of those that do occur recover quite well, and, interestingly, that the needle type might have an influence too. JB
Thanks for the information. The article was interesting and hopefully I will be one of those people who does not have any long term complications. I will ask the surgeon about what needle he used but I did have the impression he didn't consider it a likely cause of my current problems.
I am sure my surgeon does not use ultrasound but will mention it to him when I see him in a few weeks time. I will also mention that the side of my ring finger nearest to my little finger has become numb. Not good I know as it certainly seems to be connected to the ulna nerve. I really don't want another operation as my surgeon mentioned decompression for the ulna nerve in elbow is not very successful.
That 'sensory splitting' of the ring finger is a very clear indication of an ulnar nerve problem but it does not have to be at the elbow. JB
You seem to have done qiite a good job of analysing that yourself. The key lies in that story of 'intense pain in the little finger on injection of local anaesthetic' - which sounds very much like an intraneural injection - albeit of an anaesthetic agent rather than a steroid. If that was the case then that pain should have stopped very quickly as the local took effect? (and then recurred after surgery as the local wore off) You need some post-operative nerve conduction studies of the median and ulnar nerves - it's a pity they were not updated before surgery. 8 weeks might be a bit late for ultrasound but one could still give it a try if someone with the necessary expertise is available. JB