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  1. #1
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    Brief Medical History Overview

    Age: 24, Female, Presenting Problem Since: Less than one year., Symptom Behaviour: Worse., Symptoms Worse (24hr Behaviour): I experience the symptoms all the time, but they are occasionally worse at night time., Aggravating Factors:: Excessive movement, stretching, twisting, gripping, driving, writing, typing....the list goes on., Easing Factors:: Elevation of my hand/wrist helps for a short period but loses effectiveness quickly. Ibuprofen eases pain slightly, but again loses effectiveness quite quickly., No Investigations, No Diabetes, No history of High Blood Pressure, No Medications, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues

    Unhappy Mild-Severe Hand/Wrist/Forearm Pain After Carpal Tunnel Decompression

    Physical Agents In Rehabilitation
    Hi all!
    I've come to you guys in the hope that I might finally be able to get some answers as to why I have more pain following my surgery than I did beforehand! Sorry if this is long-winded, but I dont want to leave anything out in case it is important.

    In July 2010, I was knocked over by my (very large) dog, and fell onto my right arm and wrist. I experienced pain and dark purple bruising to the area quite shortly after the fall, and the pain continued for 7-8 days before easing over the course of a couple of days.

    Over the next month or so, I began to experience tingling, numbness, and pain (in that order) when at work, when writing, driving or doing any of the crafts I enjoy as hobbies. Ibuprofen up to 4x daily - at my GP's advice - worked to a point, but I would still experience the tingling and numbness. I stopped my crafts out of fear I would exacerbate the problem, and I also requested some equipment to make my job as an administrator easier - a new, specially shaped mouse and some gel-filled rests, plus a new chair to aid my posture and position when typing. None of these measures appeared to help.

    I attended my GP surgery again in September 2010, and was referred to an Orthopedic surgeon for assessment. I was told in October 2010 by the Orthopedic surgeon himself that I was suffering from Carpal Tunnel Syndrome. He performed a couple of pulling/movement exercises on me, and also asked me to press my thumb and pinky finger together, and tested to see how easy it was to break my grip. On this same appointment, he administered a cortizone injection to my wrist. I experienced a numb sensation for approximately 48 hours, and things eased a little. I was also given a velcro splint to wear at night, as this was when the pain was worst.

    Between then and January, the pain and numbness gradually came back and, by the next appointment in February 2011, was worse than ever, and the advised Ibuprofen was no longer effective. The surgeon referred me to the waiting list for surgery and at this time my pain was quite severe - to the point I had taken quite a considerable amount of time away from work. On March 4th 2011 I had my decompression surgery.

    My recovery was slow and painful. My stitches sunk into my scar and the nurse who eventually removed them almost three weeks post surgery had to cut my hand open at the bottom of my scar to release a suture, which wasnt pleasant. I put the pain I experienced after this down to the extra incision that had been made.

    I attended the Orthopedic clinic at the end of March - almost a month post-surgery, and explained to the surgeon that I was still experiencing mild to severe pain almost all the time. It was on par with the level of pain before my cortizone injection in October, so although an improvement, definitely not the result I had hoped for. I told him that my wrist and scar was tender to the touch, and that the "pad" of skin below my thumb was also painful, and I would get a sharp pain in my thumb when using it to grip small things such as my toothbrush or a pen. I told him that the movement in my wrist was still not enough to enable me to drive, take up my hobbies again etc as the pain worsened with movement. I also described the short, sharp feeling of an electric shock that would happen unexpectedly up to 20 times a day, with pain not unlike that of a cramp, spreading from my middle finger through my hand and wrist, all the way down to my mid forearm. This would lead to my hand feeling tight, and I would lose my grip on whatever I was holding. My crockery has suffered so much!

    I was advised that this was a normal, although not common, complication of the surgery and that it should last no longer than 8 weeks. I was signed off work for that period, which my boss has accepted with no further worries. I was advised to massage the painful/tender areas for no longer than 10 minutes, 2-3 times a day and that I should try putting an icy compress on the wrist when I felt the pain getting bad. Ibuprofen was also recommended to ease the pain.

    I am due back to the clinic tomorrow for a follow up, and - if anything - the pain has got worse. It has, in no way, improved. I have been taking the measures recommended to me by the surgeon and don't know what else to try to make it better.

    I am wondering if I was even suffering with Carpal Tunnel in the first place, or if there was a different problem that would keep giving me this sort of pain.

    I am quite concerned that the surgical team did not perform any other tests or offer me any alternative options before booking me in for the surgery, and if I'd had the knowledge I have now BACK THEN, I would have declined the surgery and lived with the pain.

    I am also getting worried about my job. I am simply not able to return to the duties I was performing before. I have had to write this message out in a word processing program over the course of 2 days to enble me to cover everything without causing myself any pain. I will require a further certificate tomorrow from the surgeon, but fear this is short-term stuff. I need this pain fixing, for my family, for my job and for myself.

    In case this helps: I'm a 24 year old female, about 30lbs overweight but no other medical problems. I have 3 children under the age of 7, married, non-smoker, no drug use for medical or any other reason. I work as a government administrator, using a computer and a handset telephone repeatedly throughout the day (as opposed to the headset.) I used to drive - I am still not driving at the moment due to the pain and reduced movement I am experiencing - and I used to knit, crochet, and write as my main hobbies, all of which I have stopped since before the surgery.

    I really hope someone can give me some more advice, as I'm so stuck and tired of suffering now!

    Many many thanks in advance,

    Kate.

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  2. #2
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    Re: Mild-Severe Hand/Wrist/Forearm Pain After Carpal Tunnel Decompression

    Aircast Airselect Short Boot
    Interesting post and thanks for all the information. From your history and what I believe was a lack of pre-injury symptoms I would never have thought this was a carpal tunnel issue. For my mind it sounds a lot more like a broken carpal bone such as the scaphoid. This is common in falls onto the palm and is notorious for non-union, often only repaired via a small surgery, a screw and a bone graft from the pelvis.

    Right now I would want a scan of the wrist with an Wikipedia reference-linkMRI to exclude any bone fracture and non union. It is quite serious to get it sorted if that is the issue as the bones can degenerate if a repair is not attended to. So get to the GP, get to a hand surgeon and get a new MRI. Then please tell us what is the result. Of couse seeing a physio will help to assess whether this is a possibility if you can access that more speedily as a first point of contact.

    Aussie trained Physiotherapist living and working in London, UK.
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