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Complications after Ulnar Nerve Transposition Surgery

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Posted 4/7/2015 9:14 PM (GMT 0)
Hi. I am Madhur gupta, 28, male. I suffered from Cubital tunnel syndrome (pinched ulnar nerve) for last 8 months, which caused pain in my left elbow's ulnar nerve. I underwent ulnar nerve transposition surgery 4 weeks back. My pain is totally gone but I am experiencing new symptoms post-op, such as numbness, stiffness, tightness and buzzing in the palm of left hand, and slight muscle loss.
Went to surgeon regarding this, but he told me that this could be because of handling the nerve while doing surgery and that I should wait till the blood supply into the nerve recovers back.
Please let me know how common this is in cases of transposition and if you think it is normal phenomenon and nothing to worry about.
Posted 4/7/2015 10:21 PM (GMT 0)
Welcome Madhur, I have not personally had this surgery but I do know others who have had it and I do believe you are very early in your recovery so your surgeon may very well be right. It is a good sign that your pain is totally gone. Good luck.
Posted 4/8/2015 12:20 AM (GMT 0)
I had that surgery a few years ago and it took a while for everything to feel "normal". The surgeon told it takes about a year for there to be enough progress in nerve growth to see a real difference. Not something I wanted to hear-a year is a long time to wait.

There are several nerve medications that could give you some relief.
Posted 4/8/2015 5:43 AM (GMT 0)
Hi Rufous , thanks for the reply

Hi rocckyd , you could be right but I could understand that the nerve takes a year or more to recover if the symptoms of numbness, muscle loss, etc were present before surgery.
However, since these symptoms are entirely new after the surgery , I am more concerned that the surgery may not have gone correctly, and the ulnar nerve might being pressed from surrounding scar tissue or there could be adhesions between the nerve and surrounding tissue which, if it persists may damage my nerve and make symptoms of numbness, muscle loss, etc worse, thereby requiring re-operation.

I tried to get MRI of nerve (also called MRNeurography) to make sure everything was alright with it, but they said that it can't happen now that there is lot of cutting around the nerve preventing the MRI from giving a clear picture of it. So I plan to get a nerve conduction study done 6 weeks post-op.
Posted 4/8/2015 5:48 AM (GMT 0)
rocckyd, please also tell me about any medications or supplements that may help with my post-op nerve symptoms
Posted 4/8/2015 7:37 AM (GMT 0)
Hello & welcome to the forum. As one member mentioned you are quite early in the recovery process. It is a good sign that the original pain is gone.

We see have seen people have pain in a different spot after such surgery. Sometimes people can have what is called referred pain. There are surface nerves that get cut during surgery too & when the nerves start waking up the patient knows it.

There are medications used to treat nerve pain, Lyrica, Gabapentin, Cymbalta & Amitriptiline to name a few.

You sort of sound like you do not trust your drs opinion, if that is true perhaps see about getting a 2nd opinion. A dr may or may not agree to a consult because its not been that long since surgery.

Take care.
Posted 4/8/2015 8:38 AM (GMT 0)
Welcome to Cp, and sorry about the issues but like others and your Surgeon said the nerve is likely acting up over being invaded. As for these symptoms not being present before surgery could be due to the fact it's a entirely different nerve. Possibly one severed or knicked,disturbed in some way during the procedure and it takes them longer to heal than any other human cell. As difficult as it may be try to be patient with yourself and don't push your recovery, allow natural healing because your body will always know what is best for itself time wise to mend. There are medications used to help with nerve issue's and if they become bothersome or too painful speak to your Dr about trying one of those.
Posted 4/8/2015 4:27 PM (GMT 0)
Tightness and muscle loss where? Were you casted after surgery? Considering the length of time we cannot fully use that arm, some muscle loss is expected. Remember that your nerve now has a 'new home', any movement of the muscles it is now buried under can irritate the nerve. Think about bumping a fleshy part of your body, not much pain right? Now, think about bumping the 'funny bone', totally different right? Sharp, tingling, burning? That's the response of the ulnar nerve. Now that nerve is somewhere else and bumping that area will produce those feelings. It does calm down. It just takes as long as it takes.
Posted 4/8/2015 5:24 PM (GMT 0)
Hello MG and WELCOME to our "CP Club" though none of us "chose" membership=)  I certainly empathize with your suffering.  It seems as though others have given you valuable information.  I wanted to offer my support and understanding.  I hope you find the answers you seek.

Dixie

Posted 4/8/2015 6:59 PM (GMT 0)
Welcome!

I had ulnar nerve transposition surgery six weeks ago. I am experiencing all of the same symptoms as you and was advised the same by my doctor. I am not pain free but that is due to other issues with that arm.

Wait, ice (great information I received from the lovely people here), and keep up on your meds.

I am now making notes on what I am feeling and where, so I can give a detailed report to the doctor and not rely on my memory.

I am glad to hear you are pain free and only experiencing an angry nerve.....

Hope this was helpful. Nice to meet you.
Posted 4/10/2015 11:14 AM (GMT 0)
Thanks to all of you for your comments.

By the way, 2-3 days back I did some strength assessment exercises with my palm and fingers to check their strength (which led to exertion in my elbow's muscles), and my elbow has been hurting since then. I hope its not the result of the sutures inside my elbow, which secure the fascial sling which in turn secures my ulnar nerve into place, having come undone as a result of the exercises.

I am a little paranoid about my elbow these days I admit turn
Posted 4/10/2015 11:36 AM (GMT 0)
So who had you doing the exercises? A physical therapist or yourself? Maybe they did things differently in the 90's when I had my surgery. I was casted for 6 weeks and didn't start P.T. for 2 more weeks after the cast was removed. Ice, ice and more ice! Ice reduces swelling which presses on the nerve and also numbs the nerve itself. After all of that surgery and all of that excruciating pain, I made darn sure I didn't do stuff that would screw it all up! Physical therapy used ice on the scar, ultrasound, massage, "points" (electric charges along the nerve) and NO exercises for the first couple of weeks. "Slow and steady wins the race."
Posted 4/10/2015 12:19 PM (GMT 0)
Sadly, it was myself who decided to do the exercises...won't do again...don't want to end up in OT once again. I am also starting today with diclofenac for 5 days to calm down any swelling and stuff

Post Edited (Madhur Gupta) : 4/10/2015 6:22:27 AM (GMT-6)

Posted 4/10/2015 12:38 PM (GMT 0)
Thanks for being honest about it Madhur. Believe me, I know the impatience! Easy does it! You want the BEST outcome you can possibly have. Even today, the more I do, the more it hurts. My surgeon called me 'bones'. I am very slender and have little muscle mass to bury the nerve under. Mine will never be 100% perfect as there is also damage to the nerve itself from the delay in diagnosis and treatment. I want the best for you!
Posted 4/16/2015 3:16 PM (GMT 0)
Hi guys,

Been 12 days since my elbow (in the swelled up area) started hurting again due to my hand exercises. The pain is better now but still bothers me (especially after sitting at computer for long, I don't know why), even though I am on pain medication (diclofenac sodium, 50 mg 2 times a day). The doctor told me that it might be a muscle pull due to which I am experiencing pain. Any comments as to how much time it took you all for the swelling in the elbow to subside fully and how long you were on pain meds after the surgery?

Also for the last 2 days or so, I am experiencing a weird pulsating feeling in the meaty area between my thumb and first finger, and different parts of the hand and upper arm, sometimes during the day. Do you think it is normal?

Also, did you all get this surgery done by hand surgeons? My surgeon wasn't a hand surgeon but a top notch neurosurgeon in India, who however hasn't performed many cubital tunnel releases in his career (he told me the last person he did transposition for was 2 years back)

Thanks

Post Edited (Madhur Gupta) : 4/16/2015 9:26:34 AM (GMT-6)

Posted 4/16/2015 3:30 PM (GMT 0)
Declofenac sodium is an anti-inflammatory. Joint stiffness for Arthritis or in my case I take it as a non steroidal option for Pericarditis.

I had my surgery on Feb 27th and I am still swollen.

I have what I call being "electrocuted" pains and painful goosebumps .... I still have not had that worked out.

I am also still sore and stiff with tenderness and irritation at too much movement. I did find out recently that the ulnar nerve also goes across the the palm of the hand. This I didn't realize till after the surgery lol.... but I know it well now.

I sure hope that you receive some relief! Blessings and healing
Posted 4/16/2015 3:37 PM (GMT 0)
Being on a computer very long may not be a wise thing to do either. Time is going to be your best friend while recovering from this surgery. Trying to push it will only set you back. When you have nerve issues that involve surgery there will be many different sensations going on until the nerves settle down. Patience is something you will need to have to in order to have the best outcome from your surgery.

Take care.
Posted 4/16/2015 4:00 PM (GMT 0)
Leila, straydog, thanks for the replies. I get your point.
Posted 4/17/2015 5:23 AM (GMT 0)
By the way, susie, any thoughts on how sitting at computer for long time may be harmful for the ulnar nerve? If I know how, then maybe I may be able to treat this through exercise, etc, since my job requires me to spend a lot of time at my computer
Posted 4/17/2015 6:26 AM (GMT 0)
Are you using a mouse or keyboard?
Posted 4/17/2015 8:25 AM (GMT 0)
vickie, i'm using mouse mostly, but with my healthy right hand, not the left hand on which surgery was done. I think it has something to do with my cervical region which gets strained when I sit a lot at the computer.
Posted 4/17/2015 11:08 AM (GMT 0)
What are you doing with the surgical arm? Positioning is important. I can't rest my forearm on the edge like I used to. I usually push the elbow outward and rest the whole forearm on the surface. This is how I discovered that 'cold' is read as 'wet' by my brain now! 'Hot' is still 'hot' thank goodness! If you can, cushion the forearm as much as possible. Rest it on a pillow on your lap. Support it, don't let it 'hang'.

I've been very busy in the garden. Weeding and planting pots full of flowers. The 'small motor activity' has my forearm aching again! My daughter massaged it for me last evening. Even all these years later, I find it can still get irritated. Such is life. My heating pad is once again my best friend! The garden looks absolutely fabulous! So at least there is a nice pay off!
Posted 4/17/2015 11:28 AM (GMT 0)
I had this surgery last year. Due to oddly formed joints, the procedure was a bit more complicated than expected. I did have similar symptoms after. I would have a buzzing feeling in my hand along with numbness. I had significant muscle wastage before the surgery.

From my experience, positioning is important. The nerves are very sensitive for a while so anything even slightly pressing can be a big deal.

I'd definitely stay away from the exercises. Your Dr will tell when its safe to do those. I did pt after mine but it wasn't right away. He did tell me to limit my computer use for a while.

My symptoms got better with rest and pt so I think your Dr is probably right. Its hard to be patient but pushing it too son can cause damage. Give it some time and just try to stay cognizant of the way you hold or lie the arm down.
Posted 9/18/2015 12:17 AM (GMT 0)
Hello folks,

It's been 6 months since my Left elbow Ulnar Transposition surgery. I still get pain and numbness on sleeping with my elbow straightened. A hand surgeon sent me to get an MR Neurogram (advanced MRI specially for nerves) done. Bad news - the nerve is under heavy scar entrapment! Now I'm trying to find a hand surgeon with expertise specifically in Ulnar Transposition surgeries, but it's very hard to find one on the internet in India since people here don't post their reviews of doctors very often. Any advice on how to find such a doctor specialising in Ulnar Transpositions here in India? Also, how are your own post-op recoveries shaping up?
Posted 9/18/2015 11:59 AM (GMT 0)
Hello again Madhur. Sorry to hear you've been having ongoing problems. I have no idea how you would go about finding a surgeon there. Can the doctor that sent you for the test be of any assistance? Please keep us posted.
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