Wednesday, April 10, 2024

Carpal Tunnel And Ulnar Nerve Surgery At The Same Time

What Happens After Carpal Tunnel Surgery

Ulnar nerve elbow & wrist & carpel tunnel surgery

Your wrist will likely be in a heavy bandage or a splint for 1 to 2 weeks. Doctors usually schedule another appointment to remove the bandage or splint. During this time, you may be encouraged to move your fingers to help prevent stiffness.

You’ll probably have pain in your hand and wrist after surgery. It’s usually controlled with pain medicines taken by mouth. The surgeon may also have you keep the affected hand elevated while sleeping at night to help decrease swelling.

Once the splint is removed, you will likely begin a physical therapy program. The physical therapist will teach you motion exercises to improve the movement of your wrist and hand. These exercises will speed healing and strengthen the area. You may still need to sometimes use a splint or brace for a month or so after surgery.

The recovery period can take anywhere from a few days to a few months. In the meantime, you may need to adjust job duties or even take time off from work while you heal. Your doctor will talk to you about activity restrictions you should follow after surgery.

Let your doctor know about any of the following:

  • Redness, swelling, bleeding, or other drainage from the incision
  • Increased pain around the incision

These problems may need to be treated. Talk to your doctor about what you should expect and what problems mean you need to see your doctor right away.

Is Surgery An Option

If non-operative measures have failed, if the sensory symptoms are becoming permanent, or if there is any weakness or muscle wasting, I would recommend surgery. The surgical treatment for cubital tunnel syndrome is a cubital tunnel release or decompression. This is a minor, day-case operation that I often perform with the patient awake under regional anaesthesia. The recovery from cubital tunnel release or decompression is relatively quick.For more information on cubital tunnel syndrome check out Mr Ferran’s website and channel.Do not hesitate to book an appointment for consultation via Mr Ferran’s profile.

Tingling And Numbness In Both Hands Is Emg Important

I have recently had tingling and numbness in both of my hands. It gets extremely painful at night. I woke up one morning and my left hand was totally numb and it took over an hour for feeling to return. Blood tests that I have had in the past have had some form of indication of possible lupus or other disease as the doctors ask to do another test that will rule out these things. When the tests are run, the results are OK. I am being scheduled for an EMG for the hands and the information in your forum has been very helpful in knowing what that is all about. Im just wondering if these blood tests are telling us something and were just missing what it is? There is also extreme cramping in the hands and feet. Thanking you in advance for any reply.

Answer:

I believe that your doctor is working in the right direction to reach a diagnosis. The EMG study, however, should be very valuable to rule out any nerve entrapment at the wrist , as your symptoms do really suggest that.

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Operative Treatment Of Cubital Tunnel Syndrome

Over the years, about seven different operations have been reported and discussed in medical literature regarding surgical treatment of cubital tunnel syndrome. Learmonth, who in my opinion has had a great influence on the misdiagnosis of carpal tunnel syndrome as TOS historically was also the early proponent for submuscular transposition i.e. moving the ulnar nerve beneath the muscle bed, bringing it away from the inner side of the elbow and away from the stretching and compressing that would occur there. This is probably one of the least performed procedures because it is so aggressive and invasive, and takes so long to heal with weeks off of work and in most hands a large surgical scar. There has been no proven added benefit.

Medical History And Physical Examination

Numbness in Hands Treatment Kerala

Your doctor will discuss your medical history and general health. They may also ask about your work, your activities, and what medications you are taking.

After discussing your symptoms and medical history, your doctor will examine your arm and hand to determine which nerve is compressed and where it is compressed. Some of the physical examination tests your doctor may do include:

  • Tap over the nerve at the funny bone. If the nerve is irritated, this can cause a shock into the little finger and ring finger although this can happen when the nerve is normal as well.
  • Check whether the ulnar nerve slides out of normal position when you bend your elbow.
  • Move your neck, shoulder, elbow, and wrist to see if different positions cause symptoms.
  • Check for feeling and strength in your hand and fingers.

To perform Tinel’s test for nerve damage, your doctor will lightly tap along the inside of the elbow joint, directly over the ulnar nerve.

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Emg For Elbow And Failed Carpal Tunnel

Please explain which areas of the limb are tested for these problems, I need to be prepared.

Answer:

Presumably by failed Carpal Tunnel, you mean a failed Carpal Tunnel release . The carpal tunnel is located at the wrist, so if your doctor is planning an EMG for the elbow area, he must be looking into other causes for your pain/numbness. Typically an EMG for any arm/neck problems would involve shocks in the lower half of your arm, and needle examination of the arm and possibly neck muscles. Discomfort felt during an EMG is quite dependant on the individual. Each exam is different for each patient. Skill of the technician or physician administering the test can also have a great deal to do with the degree of discomfort.

Emg Results With Ulnar Neuropathy In Guyons Canal

I was involved in a motor vehicle accident in Dec. of 2000, and have had pain at the right wrist and hand ever since. Surgery was suggested after a EMG was done. I decided to wait to see if it would get any better without surgery. The results of the EMG were mild to moderate, acute and chronic, ulnar neuropathy at the wrist on the right. The lesions are most likely a Guyons type 1 at the proximal wrist on the right. I am still having some pain in that area, and wonder after six months if I should expect to see any more improvement without surgery. Will this be a chronic problem or will it continue to improve over time?

Answer:

What usually happens after a traumatic nerve lesion is that the surgeon would wait for several months before embarking or deciding for surgery. I am not expecting further improvement following this kind of lesion after 6 months. However, see your doctor to discuss this further.

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What Are The Causes Of Carpal Tunnel Syndrome

Carpal tunnel syndrome is often the result of a combination of factors that increase pressure on the median nerve and tendons in the carpal tunnel, rather than a problem with the nerve itself. Contributing factors include trauma or injury to the wrist that cause swelling, such as sprain or fracture an overactive pituitary gland an underactive thyroid gland and rheumatoid arthritis. Other factors that may contribute to the compression include mechanical problems in the wrist joint, repeated use of vibrating hand tools, fluid retention during pregnancy or menopause, or the development of a cyst or tumor in the canal. Often, no single cause can be identified.

Carpal Tunnel Surgery Complications

Carpal Tunnel Release/Ulnar Nerve Decompression Post Surgery Recovery Video

Answer:

I can really understand and share with you the pain. It is not however, clear to me the exact cause. But the surgeon who did the operation should be able to tell you more about it. Perhaps repeat EMG to assess the position of the median nerve post operative would help. I hope you get better soon.

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Cts And Emg Questions

I recently had and EMG done and was referred to an orthopedic surgeon for surgery on both wrists. While having both parts of the EMG done, the doctor tried to explain what he was seeing to me. I guess what I am not clear about is how bad this is. I mean, I know its bad because he insists on surgery and the pain numbness and burning are more than I can handle He mentioned that when he did the shock down by my wrist that it was a 2 and a 6 up by my elbow on my right arm. And 1 and 8 on my left arm. What does this all mean? Can you refer me to any pages to help me understand this more? What are bad results?? Semi bad??? What can you get by on without having surgery?

Answer:

Me too, I am not familiar with these numbers, perhaps further information would help. Generally, a bad CTS depends on the clinical picture and EMG findings. However, the presence of muscle wasting and/or abnormal EMG spontaneous discharges are bad signs. It is important to follow the advice of the surgeon, as without surgery the symptoms would persist. The wasting or atrophy will develop, if it is not yet happened. At advanced stage the surgery would not actually help to recover the nerve, but it would anyway save what is left.

What Is Carpal Tunnel Surgery

In almost all situations, carpal tunnel surgery involves cutting the transverse carpal ligament on the palm side of the hand in order to relieve pressure on the median nerve in the wrist.

Carpal tunnel surgery can be performed as an open surgery or minimally invasive endoscopic surgery .

Depending on factors like the complexity of the surgery and surgeon/patient preference, the operation may be performed under local anesthesia, with a regional block, or under general anesthesia.

One of the factors influencing response rates is the choice of surgeries. In recent years, many surgeons have turned to endoscopic carpal tunnel release as an alternative to traditional open surgery, which has been shown to require shorter recovery times and allow people to return to work sooner.

This is not to suggest that endoscopic surgery is “better” than open surgery. In the end, there are pros and cons to each that need to be weighed with your doctor, as detailed in a 2019 review published in Current Review of Musculoskeletal Medicine.

  • Fewer complications per 1,000 surgeries

  • Faster recovery

  • Faster return to work

  • Scars are smaller and tend to be less sensitive or obvious

Generally speaking, open and endoscopic carpal tunnel surgeries have similar response rates. Although the endoscopic approach allows for faster recovery times with less scarring, open surgery is associated with slightly fewer complications and costs less.

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Can You Have Carpal Tunnel Surgery In Both Hands At The Same Time

Neuroscience Specialists, Oklahoma City, OK / Patient Info / Blog / Can You Have Carpal Tunnel Surgery in Both Hands at the Same Time?

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Most of us use our hands practically every minute without ever thinking about it. But when you have carpal tunnel syndrome, you get tingling, pain, lack of sensation in the fingers. The treatments like corticosteroids and braces may be helpful, but you may need help of carpal tunnel surgeon in more severe cases.

Carpal tunnel syndrome happens due to median nerve pressure. This is how you and all your fingers feel in your thumb except your small finger. When the nerve goes through the wrist it crosses the carpal tunnel that is a narrow path and made by ligament and bone. This tunnel is squeezed and pinched on your median nerve if you get swelling in your wrist.

What Does Ulnar Nerve Decompression Involve

Carpal tunnel release with subneural reconstruction of the transverse ...

Ulnar nerve decompression is a surgical procedure to explore the region around the elbow through which the ulnar nerve passes and remove anything that is compressing the nerve and causing dysfunction. Compression may occur around the triceps muscle in the upper arm, in the bony groove in the elbow and in another passage through the muscle in the forearm. Ulnar nerve decompression explores these three areas and removes any constrictions that are trapping the nerve.

It is performed under local, regional or general anaesthetic. If you have open ulnar nerve decompression surgery, a 3-4 inch incision is made along the elbow, revealing the ulnar nerve. The orthopaedic surgeon then examines the nerve and removes any tissue that is causing compression. The nerve may then be moved in front of the medial epicondyle to prevent it from being pinched or irritated when the elbow is bent, which is called a transposition. The incisions are closed with sutures.

Alternatively you may be offered endoscopic or keyhole surgery which uses much smaller incisions and an endoscope, which has a camera at one end. The surgeon will be able to see inside your joint using the endoscope and will perform surgery using miniature surgical instruments. This minimally invasive form of surgery generally results in quicker recovery.

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Electrodiagnostic Assessment & Management Of Cts

I have been diagnosed with CTS and now am being sent for an EMG. I would like to know what this test is, the pain involved and whether or not a positive or negative result changes the diagnosis. I have done the splints for a long time with relief way back when but no relief now. I have had one cortisone treatment which has done nothing except relieve the nighttime pain but day to day is actually worse.

Answer 1:

An EMG, which studies nerve conductions and muscles , is an uncomfortable procedure but a very useful and sensitive test for carpal tunnel syndrome. If your symptoms are as severe as you describe, then in all likelihood the test will be positive. If it is not, I would seriously question the diagnosis of carpal tunnel.

Answer 2:

have had EMG testing which resulted in surgically releasing both my wrists due to CTS. The pain associated with these tests can be mild to moderate. I would suggest if possible to take a doctor prescribed pain medication one half hour before the testing is done. I am going again for further EMG tests tomorrow as I am still suffering effects of CTS even after surgery. The testing takes approximately 20 minutes to a half hour and is quite bearable. Good luck to you with your results.

Treatments For Both Conditions

Both carpal tunnel syndrome and cubital tunnel syndrome are treated similarly. Resting the elbow or wrist is a critical part of treatment you simply must stop activities that aggravate the pain and dysfunction.

For carpal tunnel syndrome, our doctors at Maryland Orthopedic Specialists may offer a wrist brace or splint. For cubital tunnel, though, you may receive an elbow brace to wear at night.

Anti-inflammatory medications and steroid injections ease the pain and numbness of each syndrome. In severe cases, both syndromes may require surgery to make the affected tunnel larger so the compressed nerve has more room to function.

If you have pain and numbness in your hand, come to Maryland Orthopedic Specialists for a definitive diagnosis. for an appointment or book online.

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Rate Of False Negative And False Positive Results Of Electrodiagnosis In Cts

What is the percentage of negative results on a positive finding? Also, what is the percentage of a positive result of a negative finding? Ive gone through 5 nerve conduction tests previously, and finally was diagnosed with carpel tunnel. The neurologists said it was because of my small boned structure that gave a negative result when it was actually positive. When I received the tunnel releases, it was very tight and surgeon was surprised that it didnt show up earlier. I now have possible ulnar nerve problems, but again my conduction test shows negative. Please give me some information as why this happens.

Answer:

The pick up of carpal tunnel or ulnar neuropathies by nerve conductions is fairly easy so the false negatives there are very low. For pinched nerves however the number of false negatives is higher, sometimes up to 30 or 40%.

I Have Left Elbow Pain Is It Necessary To Have Emg

Carpal tunnel and ulnar nerve surgery

Do I really need this test? I have been treating what the doc thought was tennis elbow. But the cortisone shot I had didnt help that much. So he wants an EMG. I dont want it if it is not necessary! I have always had left neck and upper arm pain The main pain is in the elbow area and runs down the armIt is different form my usual pain. Hurts to use the arm and handgripping and pulling mainly! Any advice out there? Sometimes the hand gets cold and tingles and turns bluish too. I still think it is a joint problem.

Answer:

You are right. It sounds like a joint problem. However, only tingling suggests nerve problem. Therefore, EMG may be of help.

Thanks for the quick response. I am concerned that with the Fibro pain I already have that the test will make my pain worse so if I dont need it I dont want it. The arm is also sensitive to touch. Like skin surface painall this seems to lesson when I dont use it. That tells me it is a joint problem but the doc said since the marcaine took the pain away for 3 hours it could be nerve pain??????????? Any input here? It is set up for next Tuesday in the doctors office. Wouldnt the marcaine take any pain away????????

Answer:

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