Carpal Tunnel Syndrome

[Khan]

Any experience or advice?
How effective are cortisone shots?
I think I will be needing surgery for this.
How much personal care will I need for how long after surgery?

Should I start by talking to my regular doctor?

Growing old bites.

 

[heeyy_joe]

Try acupuncture first.

 

[imoldernu]

I think the first thing to do is to be sure that it is carpal tunnel.
Even with an Electromyogram, my own case was misdiagnosed. This led to an open carpal tunnel operation on one hand. The operation is outpatient, takes about an hour and with local anaesthesia. After that, the healing process was about three weeks, bandages and initially, a sling. Final healing took another month, as the skin was still sensitive.
Although the problem was in both hands, the operation is done on one hand at a time. As I recall, the total cost of the operation (medicare) was about (edit) 8K.

I believe that endoscopic surgery is mostly done with younger patients, and may require follow ups...but am not sure about that.

In my case, the diagnosis was incorrect, as the tingling and pain in my fingers was peripheral polyneuropathy, usually a result of diabetes, though I don't have diabetes. The initial pain was in both hands. The surgery did nothing to help the problem.

This was about two years ago. Now, while I still have the neuropathy, I have learned to live with it. the skin on the fingers is totally insensitive, so there is no feeling of heat or cold, and the normal things we do, like turning a page in a magazine, requires learning new tricks of manipulation. The pain part, became just a matter of getting used to, though I do use Neurontin (gabapentin) when it it really bothers.

Most of the people in my community who have had a carpal tunnel operation, report that it was successful, although some found little relief, as was my case.

There are some UTube exercises, that could be helpful... mostly stretching the finger tendons to relieve the pressure on the nerve.

The operation involves cutting a ligament that closes around nerves in the hand/wrist.
Here's an article that suggests alternatives.

Carpal Tunnel Syndrome Surgery, Recovery, Complications, and More

While some people swear by the operation, I would suggest it as a last resort. Also... depending on the doctor, I would want more than one opinion. The operation is relatively expensive, and based on the number of people in the clinic when I went in, (six), it looked like an assembly line. The person at the desk told me there were 15 operations that same day... same operation. Same doctor. Trust but verify.

Good luck...

 

[Moemg]

Carpal Tunnel is a very easy operation. It usually takes about half an hour . You will need someone to take you to the procedure and home because they generally use sedation with the local anesthesia .You will usually not need extra help after the surgery . Some physicians try cortisone shots or a splint before recommending the surgery . As far as growing old this is one of the easiest procedures to go through .I'd take Carpal Tunnel any day over some of the other choices.

 

[dontworry]

My hubby had this done around age 50. Easy peasy, according to him. Almost 100% better. He used to get a lot of numbness, dropping things etc. Now cured. They did one hand at a time. He really didn't need me to help with anything. Good luck!

 

[robnplunder]

Any experience or advice?
How effective are cortisone shots?
I think I will be needing surgery for this.
How much personal care will I need for how long after surgery?

Should I start by talking to my regular doctor?

Growing old bites.

I went through this once and it was extremely painful. I contemplated quitting my megacorp job b/c of it.

First, make sure it is CTS and not something else. Can you share what you are doing on regular basis to suspect that you have CTS?

Work on your current behavior pattern first that is causing your CTS. There experts who can work with you that. Surgery should be the last resort. Without fixing root of the problem, surgery is not the final solution.

 

[MissMolly]

I’ve had the surgery on both wrists. My right wrist was done in 1979. Afterwards there was a lot of pain, arm in a cast for two weeks, needed help for really only the next day due to the anesthesia. My left wrist was done just 2 years ago and what a difference. No pain. No cast. No splint. Nothing. Really didn’t need any assistance. I guess that shows the advances they’ve made in medical procedures during the past few decades. Cortisone shots provided no relief at all. Wrist braces provided no relief at all. Prior to the surgery I was in extreme pain, especially from the most recent one. I was unable to lay down – strange as that may sound. I could only stand and sit only briefly. After 3 days and nights of getting no sleep I went to the emergency room and they gave me dilaudid to knock me out. When I woke from that, the pain was tolerable, but still pretty bad. Shortly after that I had the surgery. Total success.

 

[Khan]

I was tested for it ~12 years ago, electrodes and all (also have ulnar nerve entrapment).
Mother also had it, and had surgery for it.

Thinking (if possible) to schedule surgery so someone can be here to assist me for a few days.

 

[Theseus]

Any experience or advice?

Right (dominant) hand was causing me great concern when last fall I started having involuntary spasms, for lack of a better description. Saw family doc who sent me off to neuroscience clinic, I was actually fearing Parkinson's although there was no family history of it. Actually relived when CT was the diagnosis, and it all made sense immediately, waking up at night with numbness, etc. the symptoms had developed slowly enough that I just didn't realize it was getting that bad.

How effective are cortisone shots?

Was offered as alternative, but I opted for surgery.

How much personal care will I need for how long after surgery?

As others noted, someone to drive you home after a relatively brief outpatient surgery. Wore a "cow" glove in the shower for a few days to keep from getting the incision area wet. Pain meds, but pain wasn't really bad, what one might expect from some post surgery healing.

Should I start by talking to my regular doctor?

I'd vote yes on that, they might ask the right questions and have other concerns to follow up on, but the neurologist should be able to provide a more definitive answer.

Growing old bites.

But still preferable to the alternative.

I opted to have the left hand done about two months later, as the immediate relief from numbness in my right hand after the surgery was a huge wake-up call. For a couple of months afterwards the incision area was tender - poked myself getting keys out of my pocket one day - that smarted. Now, 6-8 months after the surgery I've got none of that.

 

[Charlotte]

I wore the wrist braces for almost a year, and while they were somewhat helpful, the pain slowly got worse. I then had a cortisone shot in each wrist. The shots took about a week to kick in, and were quite helpful to me. It was a huge relief from the pain, tingling and numbness. However, that bliss only lasted about 4 or 5 months before the cortisone started wearing off. My doctor would only do the cortisone shots once, that was his policy. So, after that, I elected to go for the surgery.

I had both hands done last year, about 6 weeks apart, and had the open CTS surgery on both. You will need someone with you the day of surgery for sure, due to the sedation / anesthesia. They will need to drive you back and forth from the surgery center, and also take you to the pharmacy for the painkillers you'll get after the surgery. While I felt mentally clear the day after surgery, there are many things that are quite difficult with just one hand... You will have almost zero grip strength in your hand for quite a while. It was several days (maybe almost a week?) before I could rip open a paper packet of Splenda to put in my morning coffee. I was not able to get the lid off my prescription bottle or off the tylenol bottle by myself, or able to open a bottle of soda . Fortunately, my husband and children really took great care of me, pitched in all the chores, made my meals, opened things for me, etc.

If it turns out you do have CTS and elect to go with the surgery, I do recommend getting your non-dominant hand done first. That way you'll know what you're in for when they do the dominant hand! I am pretty strongly right-handed, and it was a struggle to manage for almost a month, because I am sort of hopeless with my left hand in normal circumstances...

Best of luck to you on this... Maybe start with your GP, or possibly go straight to a hand specialist /orthopedic surgeon.

 

[chris2008]

Thanks everybody. I just thought about asking here and you have already answered!
I seem to have it, too, since one month. It came surprisingly, with the night pains and now the tickling ants in the fingertips of my right hand.
My doctor recommended to try a wrist support first which helped to sleep again.

What was the point at which you decided to go for surgery?

 

[Charlotte]

Thanks everybody. I just thought about asking here and you have already answered!
I seem to have it, too, since one month. It came surprisingly, with the night pains and now the tickling ants in the fingertips of my right hand.
My doctor recommended to try a wrist support first which helped to sleep again.

What was the point at which you decided to go for surgery?

The surgeon I went to see had a "conservative path" that he typically uses before going the surgical route. First, the wrist braces, ibuprofen and occasional icing for several months, then if little or no improvement, he moves to the cortisone shots. He said that the cortisone shots sometimes last a few weeks and sometimes provide relief for years, it really varies quite a bit. For me, the cortisone lasted 4-5 months before the tingling, numbness and pains returned.

After that, it was just a matter of getting worked into his surgical rotation and coordinating with work to get time off. Certainly, I could have delayed (for months or years even). However, it was disturbing my sleep, it hurt to work/type, and I was taking a lot more ibuprofen than I felt comfortable taking for any long term to deal with it.

It is my understanding that there are risks with waiting too long... There can be nerve damage that won't reverse or heal. That is probably worth googling and discussing more with your doctor.

 

[donheff]

I got CT after I broke my wrist. The biggest symptom I had was that the large muscle at the pad of the thumb wasted away -- it was kinds sickening to look at. I had CT release surgery followed by a few months of exercises and I was back to normal. No serious pain, no problems. YMMV.

 

[Theseus]

What was the point at which you decided to go for surgery?

I am quite sure I waited too long, as I still have some occasional weakness and difficulty in fine control of the right hand. When doing a lot of computer keyboarding and mouse manipulation during busy times that really brought on the pain. Home computer I had in more preferable ergonomic setup, work not so much, but that is a whole different story there. I got pretty good at being ambidextrous with the mouse to give my right hand some relief, and still do that occasionally.

It was interesting at the neurologist’s office, when I was chatting with the not-the-doc technician who performed the testing. We were waiting for the doc to show up to do her 5 minute officiating of the test. I was familiar with most of the symptoms of CT, but the tech showed me a quick visual indicator I had not heard of before – holding your hand, palm towards you, with the thumb-tip pointing towards your little finger – if there is a valley running through the middle of the fatty part of the palm near your thumb, as if the area around the blood vessel were collapsed – that could be an indication of constricted blood flow to the hand, i.e. an indicator of CT. Hardly “proof”, but I did give it some credence, kind of like getting troubleshooting tips from an experienced mechanic. I am by no means offering medical advice, simply noting a conversation I thought interesting.

 

[Live And Learn]

My hubby had this done around age 50. Easy peasy, according to him. Almost 100% better. He used to get a lot of numbness, dropping things etc. Now cured. They did one hand at a time. He really didn't need me to help with anything. Good luck!

I had it done in both hands. I suffered with the first hand for about 3 years before I did the surgery. It was a piece of cake. The actually surgery took 7 minutes. I was in the outpatient center about 4 hours between prep, surgery and recovery. I had the surgeries done on Thursdays and was back at work on the following Monday. No problem.

When the second hand started having symptoms I signed up for the surgery almost immediately.

The incision is less than 2 inches and after 3 years you can't even find them. Other than keeping the incision dry and not doing anything stupid (like lifting heavy objects or playing in the dirt) recovery was a piece of cake. Within 10 days the stitches were out and it was life as usual.

Good luck and let us know what you decide

 

[Khan]

I bought some splints for my wrists and slept with them on last night. Took some getting used to, but hands did seem better in the morning. I will call the doctor Monday and ask for direction.

 

[Live And Learn]

I bought some splints for my wrists and slept with them on last night. Took some getting used to, but hands did seem better in the morning. I will call the doctor Monday and ask for direction.

The wrist braces will definitely help. But, if you are going to continue doing whatever caused the issue in the first place (ie: typing, etc) then you may only be putting off the inevitable, so try to think about it from that perspective. If you can obtain relief with the braces alone that would be great, but if not, don't be afraid of the surgery.