Pain, tingling in fingers, negative CARPAL TUNNEL NERVE TEST.

Resolved question:
My carpal tunnel nerve conduction test was negative, but my ultrasound was 13. I had tingling in all five fingers and pain when I overused my hand. I had some pain up the forearm, but it was never severe. The thing that really bothered me was that I never woke at night with pain. I had surgery on the right hand two weeks ago. The tingling in my fingers has gotten a lot better. I'm going to physical therapy. I questioned why I still have a little tingling in my fingers and was told that not all symptoms disappear immediately after surgery. If I had it done and didn't really need it, have I done damage to my hand?

Submitted: 4 Days
Category: Orthopedic Surgeon

Expert:  Dr. Mukesh Tiwari replied 4 Days.

Hello,
Thank you for your query to DoctorSpring.com
I have read your question with diligence.
There are different clinical signs of complete nerve damage.This include atrophy of muscles of hand,abnormal movements like fibrilliations at hand muscles & these changes are reflected in NCV/EMG investigations which is generally prescribed before doing surgery.
It looks that your NCV is normal so you should not worry in this regard.
Most of major symptoms do resolve right after surgery & other symptoms may take some time to resolve. Therefore I would like to reassure you that it will take some time for your hand to recover after surgery
Hope this helps

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Patient replied :

I don't think having the left hand done is necessary. I do, however, feel tingling/nerve activity in the last three fingers, on the top of my hand, my wrist, up the middle of my forearm, in the crease of my arm and near my elbow. I don't have any pain, but the nerves on the three fingers and top of my hand seem to ripple through my hand. I don't know if it will continue to go up my arm. What nerve would that be? My neurologist said dealing with those fingers would be more invasive and that we should deal with the carpal tunnel first, but I disagree. What kind of test would I get for the areas I described? I would like to try something non-invasive (therapy, splint if that would work). If surgery is required, can it be done endoscopically? Thank you


Expert:  Dr. Mukesh Tiwari replied 3 Days.

Hello,
The half of 4th &, 5th fingers is supplied by ulnar nerve while the outer three & half fingers are supplied by median nerve.Compression of median nerve leads to carpal tunnel syndrome.In your case there may be associated ulnar tunnel syndrome which may be due to compression of ulnar nerve at wrist.
The test which can be done for this are-
-NCV/EMG study
-CT/MRI of wrist
You may take anti inflammatory medicines & wear splint for short term for relief.
Surgery for these conditions may be performed by endoscopic methods.
Hope this was helpful,
Regards.

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Patient replied :

I'm worried I might have quite a bit of nerve damage. The nerve conduction for carpal tunnel in the left hand was done over a month ago and was negative, the ultrasound was 10, I have tingling in all my fingers, but the tingling in the middle of my forearm just started in the last couple of days. Is it possible this is the beginning stages of carpal tunnel? In that case, the surgery might be beneficial. How accurate is an ultrasound when detecting carpal tunnel? I am going to request the wrist and elbow tests at my next visit. I am in a wheelchair due to a loss of balance, but can transfer from my lift chair to my wheelchair and then I use grab bars in the bathroom. Because I am disabled, I would like to do anything I can to put off surgery, if necessary, for as long as possible. I would like to use splints for wrist and elbow, day and night, if they are available. I do wear an elbow splint at night, but would like to cover all my bases. Can a custom splint be made to correct compression of the elbow and/or wrist? About seven hours after I wrote the above question, the tingling in my right hand (the one I already had surgery on) increased and is moving up my arm towards my elbow. I will call the doctor tomorrow. Can you tell me what this means? Is it possible it is temporary and will eventually move back down my arm to my hand? I am very concerned about this and what it means. Fortunately, I postponed the left hand. It was scheduled to be done two weeks after I had my right one done. Since I am handicapped, I don't leave my home unless it is necessary and I only can go with the assistance of my husband. Being able to talk with you has been very helpful. Thank you


Expert:  Dr. Mukesh Tiwari replied 2 Days.

Hello,
Carpal tunnel syndrome do not represent as pain or tingling or other sensation at arm.
If your NCV is normal then there is no damage to nerves.
Custom splints can be made ,you may ask for this to your prosthetic expert.
If investigations are coming normal then you should also consult to your physician for other reasons for your symptoms.
Hope this will help you.
With best wishes.

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Patient replied :

On my right hand (the one I had carpal tunnel surgery on three weeks ago) there is a different feeling for the thumb and index finger compared to the other fingers. I still have tingling on and off in the whole hand. If I had the surgery and didn't really need it, is it possible that eventually, after physical therapy and giving it time to heal, things will just go back to the way they were or have I done irreparable damage to the nerve? The reason I eventually agreed to the surgery is after typing for 20 years I always thought I was headed for carpal tunnel so it was possible by having the surgery it would prevent it. I think that might have been a foolish rationalization. Thank you


Expert:  Dr. Mukesh Tiwari replied 1 Day.

Hello,
It does not look to me that you have done any irreparable damage to your median nerve during surgery,in that case there should be loss of sensation instead of abnormal sensation .Minor damages can be there due to manipulations during surgery and this will be improved with time.
Regards.

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