Stabbing Pain After Carpal Tunnel Surgery
Patients with carpal tunnel syndrome (CTS) are often told that they will be fine after surgery — and many do not experience any problems at all. But for those who do have issues, there is a wide range of complications. Some people report no pain or numbness post-surgery; others feel severe stabbing pains immediately following their procedure. Many patients don’t know what’s causing this particular type of pain, so it can be very difficult to treat effectively. Fortunately, most cases resolve themselves on their own within days to weeks.
The pain commonly occurs in three areas: The thumb, index finger, and middle finger. Normal scar adhesions to the perineural tissues (the sheath surrounding each nerve), usually around the median nerve, may cause a sudden, brief electrical paresthesia, typically shooting from the palm out the middle finger tip. It may occur while reaching, grasping, or at rest. Other symptoms include tingling sensations, burning, cramps, pins and needles, weakness, and loss of dexterity.
This condition is called causalgia, which means “pain without injury”. One theory about why some people experience pain after hand/wrist surgeries states that scar tissue has formed between the nerves and muscles. Another suggests that the surgical trauma causes swelling in the area, leading to an increase in pressure on nearby nerves.
Most cases of stabbing pain after carpal tunnel release occur because of scar adhesion formation. Scar adhesions form when fibrous connective tissue attaches itself to the cut ends of injured nerves. When these connections break loose during movements like flexion, extension, pronation, supination, and even passive wrist movement, they pinch off the nervous system by restricting blood flow through the narrow space. As a result, there may be less room for the tiny sensory receptors located along the length of the nerve. If there isn’t enough room, then there won’t be enough stimulation. In other words, if you’re pinching your nerve, you might as well just go back to bed.
If you’ve experienced stabbing pain after CTS surgery, here are some tips for treating it:
Wear gloves whenever you handle objects.
Do not use ice packs.
Take anti-inflammatory medications such as ibuprofen and naproxen sodium.
Wait until you see swelling decrease before resuming normal activities.
Use splints or braces to keep your wrist stable.
Ask your doctor about physical therapy.
Follow up with your surgeon.
In most cases, the stabbing pain subsides over time. However, persistent pain should always be checked out by a medical professional. A follow-up visit to your hand specialist is recommended one week after surgery. Your physician may order additional tests to determine whether there were any complications during the operation.
Pain management options available for carpal tunnel syndrome vary widely depending upon factors including severity of disease, location of affected nerves, and patient preference. Most surgeons prefer local anesthesia, although intravenous sedation is also frequently used.
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