HealingWell
Search Close Search
☰

2 yrs post ulnar nerve transposition & worse than before

Support Forums
>
Chronic Pain
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/26/2017 6:55 PM (GMT 0)
I am new to this and don't really know how this works so please bear with me. I had ulnar nerve transposition surgery in January 2015. The surgeon explained to me that the numbness and pain in my pinkie and ring finger could take 12-18 months to get better. Well, that timeline has long passed and I am in worse pain than before surgery. I've had a couple of stellate ganglion blocks and ketamine - twice - and narcotics which do and did nothing.To say I'm frustrated is an understatement and wonder if anyone else has suffered with this type of outcome. I've changed doctors because I wasn't happy with the lack of answers. I have new doctors now and so far, they haven't given me much hope for new treatments that will work either. I've even asked them to please just kill the nerve(s) altogether so the unrelenting pain will allow me to have a better quality of life. Thoughts, anyone?



I have given your post a heading.

Post Edited By Moderator (straydog) : 3/26/2017 6:10:59 PM (GMT-6)

Posted 3/27/2017 12:14 AM (GMT 0)
Hi paula & welcome to Healing Well. Can you share with us what led to this surgery? What type of dr did your original surgery? Do you have a copy of your op records? If not I would obtain a copy. You mentioned you have a new dr, what type is he? Have you thought about consulting with a specialist that deals with upper extremity issues only?

Sorry for so many questions, just trying to get a little more info. Thanks.
Posted 3/27/2017 1:02 AM (GMT 0)
Yikes! Two years and not any better? That stinks!

I too am wondering what the original injury was and what type of surgeon did your transposition?

Have you tried any of the meds for nerve pain? Back when I had my injury (traumatic blunt force) I was put on Elavil.

What modalities were used in your physical therapy, post op?

I had considered a second surgery a few years after the first, because my nerve was still causing quite a bit of discomfort. The odds of a second surgery giving me much benefit were slim and I decided not to try. Since then, the nerve has continued to calm down and now is not much trouble. It sounds like you are in a worse state than I was and I don't blame you for trying to find a way to resolve this.
Posted 3/27/2017 1:15 AM (GMT 0)
Hello Paula,

I am glad you are writing here. I came here when I started going through my surgeries back in 2013 or so. I have had 5 surgeries on my right arm do to an accident at work. One of my surgeries was ulnar nerve transposition. I had that surgery February 27 2015. I am just now two years later starting to feel some relief. I still have major coldness and tingling but it doesn't wake me as it did. I have taken Gabapentin, Lyrica, opioid, muscle relaxers, mood stabilizers, and seizure medication..... What they have found out is that the nerve is or could be pinched in my collar bone. I have had three nerve conduction tests since the injury. I have an appointment with a new doctor on the sixth of next month. I know the pain you are feeling believe you me and I am so sorry you are experiencing this. After three years on all these crazy drugs, I walked in and asked the doctor to take me off. Please keep in mind this doesn't work for everyone and I can only say that I felt all the drugs they were pumping through me were making it worse. I didn't know what was me and what was the drugs. It was a horrible horrible time, lack of sleep, depression, sadness, crankiness.... I got of everything but the muscle relaxers and sleeping pills. It was one of the worst weeks of my life. What I found is that all the mixture of drugs were wreaking havoc on me and my body. What I did was request from my doctor was to fix it not drug me. This got me my next nerve test and an appointment with a never specialist..... Believe it or not, my pain is manageable at times and unmanageable at others. But it is no longer constant.... Try to get yourself in to a Nerve specialist and get some nerve conduction studies done. You may have a pinch in another area, shoulder, wrist, collar bone, neck etc.... Keep the faith that there will be a solution! Advocate for yourself as you did changing doctors! I did not feel relief till January this year when I went off of everything but what I listed.... Please don't think that my answers are yours but remember always you are in control of your care. You know you best! Blessings and healing to you xxxx Don't lose hope!
Posted 3/27/2017 1:54 AM (GMT 0)
Thank you all for your support and understanding. The surgery was done because of a repetitive motion injury at work which caused cubital tunnel syndrome. I had a labral tear in my left shoulder which was repaired in July 2014. I was very happy with the outcome of that surgery and agreed to have the ulnar nerve surgery the following January thinking I'd get the same great results. I was sorely mistaken. I just started seeing a new orthopedist, hand specialist and pain management doctor and like I mentioned before, not much happening to fix this. It is getting very difficult to maintain any optimism. I tried Neurontin and the side effects included severe anxiety and suicidal thoughts so I stopped that immediately. My new orthopedist put me on Celebrex last month and I feel no different. I asked my new doctors if they thought something could've happened during my surgery and they are non-commital which isn't surprising. The pain doc said I should get a nerve conduction test but because my arm is so sensitive, I am terrified of doing it (I had it before surgery and it was very uncomfortable then!) and asked if they would sedate me to do it. I haven't gotten the authorization for it yet anyway...I haven't seen the op records but my worker's comp attorney has them. I'm going to ask my new orthopedist if he's read the surgery notes next time I see him.
Posted 3/27/2017 2:30 AM (GMT 0)
paula, if Neurotin is the only medication you have tried for the nerve pain there are many others used to treat nerve pain. The reason narcotics didn't help is they do not have any effect on true nerve pain. I don't think Celebrex would have much of an effect on your arm pain either. It may help a tad with inflammation, however, your problem is nerve related.

Drs will not admit another dr messed something up. It is extremely rare for one to stick his neck out that far. A nerve conduction study would be really helpful, however, I doubt they could sedate you for one. You don't want to see surgery notes, you need a copy of the actual op records.

I hope you can get some answers.
Posted 3/27/2017 3:12 PM (GMT 0)
Well, the 'good news' is you found the E.M.G. to be uncomfortable. That means your nerve was much more active than mine was! I felt nothing until my neck.

You didn't say what sort of physical therapy was done after the transposition surgery. I credit my good outcome to p.t..

You say your arm is still very sensitive. What has been done to desensitize it? Anything?

Now that the nerve is buried under my muscles, keeping in mind that I am very tiny (4'11", 94 lbs) whenever I use my left hand alot, the nerve gets irritated and can ache terribly. Sometimes, I even get the nerve twitching. I seldom get the 'lightening bolt' pain anymore. When in this condition, the only things that truly help me with relief are Ibuprofen and my heating pad. I've also soaked my forearm in Epsom salt bath.

I awake every morning with tendonitis pain stemming from the 'back' of the elbow. For this, the only thing that seems to help is naproxen.

Both ibuprofen and naproxen are anti inflammatories, but one works for one type of 'pain' and the other works better on the other type of 'pain'. There was a period of time I was given Celebrex, and when that didn't produce much benefit, they tried Mobic. The point is, if we don't try different meds, we won't know what truly helps.

Ibuprofen helps my headaches and other 'aches'. Naproxen helps my tendonitis and bursitis. Nothing helps the 'nerve' pain much except ice. Whether it's in my arm or shooting down my leg.

Your nerve could be entrapped again, by scar tissue this time. I've heard the term 'tethering' in here, not sure if it applies, but something to look at.

I would get a consult with a neurologist as well as an upper extremity specialist. While the prospect of another E.M.G. isn't appealing, it may be the only way to figure out what is going on and where!
Posted 5/6/2018 6:41 PM (GMT 0)
Hello Everyone,

RIGHT DOMINANT HAND

I am new to this forum and seeking a little guidance.

I am in 3 months with an ulnar nerve injury which happened January 2018 due to a bad fall which resulted in either a half cut or sheared ulnar nerve I have and ultra sound test in place which will hopefully diagnose the injury in some more detail the laceration is 5 cm cut but deep above my elbow 2 inches. I was taken to ER and the doctor did stitch the cut and i had lost sensitivity immediately on my pinky and ring finger i did also mention this at that time. Cut the long story short I think he should have immediately called a plastics surgeon or conducted further tests to determine whats going on. Instead i was referred to an Orthopedic who I visited on multiple occasions who also should have guided me to do an EMG TEST when he noticed no improvement on my visits multiple times finally I got an EMG done which was not a very good report and its severe and I am getting mild muscle atrophy now after waiting all this time I finally met with an Orthopedic Surgeon who ordered an Imaging/Ultra sound test and there after suggested they might need to super charge the ulnar nerve which is a fairly new technology seems like a nerve graft but its NOT apparently. I have been seen my PT multiple times as well took a second opinion from an Orthopedic and he said it can take upto 1 year I understnad nerve injuries take a long time but i should have noticed some improvement. when I tap under the laceration i feel like zing connecting to my pinky finger. I do have movement and can make a fist but no fine movements and fingers crawl up. I am little concerned because I can notice loosing muscle mass slightly between the thumb and first finger.

IN SHORT THE ER DOCTOR AND THE ORTHOPEDICS SHOULD HAVE REFEREED ME IMMEDIATELY FOR FURTHER TESTS AND TREATMENT INSTEAD OF WAITING SO LONG WHICH I MY CONCERN.


AFTER THE STITCHES AND HEALING PROCESS I WAS GETTING SHOOTING PAINS TO MY PINKY AND RING FINGER WHICH WERE GOOD SIGNS BUT ITS NOW STOPPED AND I DID OVER WORK MY MUSCLE AT ONE POINT WHICH HAS ALSO RESULTED IN A SWELLING ON MY PALM WHICH DOES NOT SEEM TO BE GOING DOWN EITHER IN 5 WEEKS. NOT SURE IF I HAVE TORN A MUSCLE OR MESSED SOMETHING FURTHER. MY RIGHT PALM FEELS HEAVY AND ALSO WHEN I TAP UNDER THE LACRETION ABOVE MY ELBOW WHERE THERE IS NO CUT I FEEL A PAIN.

HAS ANYONE GOT THIS TYPE OF TREATMENT DONE AND HOW SUCCESSFUL IS THIS SURGERY AFTER 3 MONTHS INTO THIS INJURY.

THANK YOU,

ALI
Posted 5/7/2018 1:09 AM (GMT 0)
Sorry to hear about all of this.

I would suggest a consultation with a neurologist.

I injured my ulnar nerve when unloading an industrial washing machine in March of 1996. My elbow was mashed into the metal opening of the washer. This caused me to tear the rotator cuff in my shoulder and gave me a severe bruising of the elbow area. I was seen in the ER and sent home in a sling.

The doctors paid attention to the shoulder first, as this was the only area 'authorized' by the insurance company. I did 6 weeks of p.t. with what turned out to be a 3/4 thickness tear of the supraspinatus tendon and a partial tear of the bicep tendon! It was only after not making 'significant progress' that I was sent for the MRI that diagnosed the tears!

I had the shoulder surgery in June and healing time and then more p.t.!

It wasn't until July that the insurance company finally authorized an examination of the elbow, which I had been complaining about the entire time! An e.m.g. was finally ordered and showed I only had 25% nerve function of the ulnar nerve! Every time I bent and straightened my elbow, you could literally SEE the nerve rolling over the bone! I had been shredding it with every move!

I had my sub muscular transposition done finally in August of that year. I've experienced the pains you describe but I don't remember palm swelling from it.

I hope you get the answers you are seeking and some relief!
Posted 5/21/2018 1:28 AM (GMT 0)
Ali

I had this surgey you had about 3weeks ago and I have noticed nothing. I had the same shooting pains at first but then they stopped. I too can make a fist but it's week and I have muscle loss and can't make fine finger movement's.
I was told St least 4months before a connection from the AIN transfer to ulnar nerve and then I was told a year and was told I might be a hand transplant candidate all by different Drs. Mine all began from a compressed nerve and got worse literally two months and I had muscle wasting numbness and all fine movements gone. Now all I can do is wait as I can't do my shoelaces up or sign my name on just waiting day by day for I don't know what. Sometimes I even think of suicidal thoughts so I know your pain
Posted 6/22/2018 5:01 AM (GMT 0)
Ulnar nerve injuries and compression are the worst. Whatever you do atleast get therapy or treatment with an occupational dr or therapist. They can ultrasound it to see if there is scar tissue impimging the nerve along the pathway. Whether it takes injections or another reoease surgery you have to keep up on it. Nerves heal but not if constantly irritated. I had monster nerve pain for two years after a transposition and dreamed nightly of chopping my arm off. Occupational therapy and injections or steroids near nerve help for a few wekks but wear off. Just had it re released a elbow where there was massive amounts that f scar tissue around the nerve. So far two weeks later, way better at elbow but forearm to pinky a bit rough. Combo of lidoderm patches, tramadol, and 1200 mg gabapentin knock pain down like 30%. Nothing else works. Hot/cold alternating water can distract nerve for a bit. Good luck all. I find that not much has improved in treatment plans with ulnar nerves. Gotta be your own guide. Workers comp issues definitley add to the problem. Losing job and eventually benefits is another issue. Pain in the ass.
Posted 7/9/2018 4:06 PM (GMT 0)
Seeking a little guidance.

I am in 7 months with an ulnar nerve injury which happened in January 2018 due to a bad fall which resulted in either a glass that cut the ulnar nerve above the elbow towards the hand.

MRI reports show it has been cut but after doing a surgery for nerve exploration/repair it was compressed with scar tissue and this was removed and I am now experiencing sever pins and needles and a ZING which has also increased from the cut area towards the wrist when I tap on. Pins and needles get worse at night and my pinky and ring finger are still crawling with no fine movements and 10% of sensitivity after the surgery which was done in May, 2018. Surgery was done by an orthopedic hand surgeon.

I went to see a neurologist and neurosurgeon for a second opinion first week of July, 2018 and repeated an ultra sound and second EMG test which are negative and show no signs of the ulnar nerve firing through the muscles. Ultra sound still shows that ( Neuroma growing from the ultra sound reports and no continuity either for the ulnar nerve but not painful as yet) although a scar tissue was already removed in the first surgery they still suspect some fibers have connected that's why I started getting pins and needles and more zings after the surgery.

Neurosurgeon recommends to do a AIN surgery to super charge the ulnar nerve motor components near the wrist towards the palm to get motor and strength function back.

Neurosurgeon also doesn't want to go back inside to the initial cut to remove the Neuroma because he thinks it will only take away the little sensation I have been getting and start all over again.

Has anyone done this type of a surgery? how are the pains after surgery? Recovery time? will it make my case worse then it is already? I am little confused whether if this will ever recover again or is it worth doing the AIN surgery. I was advised by the Neurosurgeon that he can only make it better and my right hand will never be 100% again.

thank you,

Ali
Posted 9/13/2018 5:01 AM (GMT 0)
Hey Aj110

I can give you a little guidence, have you had the surgey of the AIN as yet? As I have seen you mentioning it In previous posts. Let me know and I would like know how you are going with everything.
✚ New Topic ✚ Reply