Stabbing Pain After Carpal Tunnel Surgery

A carpal tunnel surgery is supposed to relieve pain, but what if you still feel pain post-procedure? Unfortunately, pain after the surgery can be severe and even present with burning in some cases. However, you are not alone.

Pain after carpal tunnel surgery is quite normal, and a physical therapist can help you manage that pain. This article explores why you may feel pain after carpal tunnel surgery and how physical therapy can help.

Why Is Carpal Tunnel Surgery Necessary?

Several non-surgical treatment options for carpal tunnel syndrome include using ice packs, undergoing physical therapy, and getting corticosteroid injections. However, surgery is usually the last resort when conservative treatments fail to alleviate the symptoms of carpal tunnel syndrome.

Carpal tunnel surgery is ideal for relieving symptoms of carpal tunnel syndrome. Carpal tunnel syndrome is when there is swelling in the narrow carpal tunnel, compressing the median nerve and causing pain.

What Is Carpal Tunnel Surgery?

Doctors use carpal tunnel surgery to relieve pressure in the carpal tunnel by cutting the ligament that pressurizes the median nerve. After the surgery, the ligament gradually grows back without pressing the nerve.

Although the skin heals within a few weeks, it may take several months for the internal healing process to complete. In addition, soreness and weakness should relieve you within a few months. However, if your symptoms are severe, they may not go away after the surgery.

There are two ways to carry out carpal tunnel surgery – endoscopic and open surgery. In endoscopic surgery, your surgeon will use an endoscope, a small device attached to a camera, to see inside the carpal tunnel. The surgeon then makes one or two small incisions on your wrist to cut the ligaments.

In open surgery, on the other hand, your surgeon will make the incision directly on the palm of your hand over the carpal tunnel and cut through the ligament.

Types Of Pain After Carpal Tunnel Surgery

Regardless of your surgeon's technique, experiencing pain after carpal tunnel surgery is normal. However, the intensity of the pain depends on the technique. For example, open-release surgery is associated with more intense pain than endoscopic release.

The types of pain you may experience after carpal tunnel surgery are incisional and pillar pain.

Incisional Pain

You should feel this stabbing pain right on the cut. Incisional pain may last for a few days. Nevertheless, you can ease the discomfort by using pain medications, lifting your hands as often as possible, and limiting forceful hand movements.

Pillar Pain

You will feel pillar pain on the fleshy sides of the cut. Because the ligament your surgeon cut is attached to the wrist bone, a muscle disruption contributes to the stabbing pain. Recovering from pillar pain takes several months, and in some cases, the pain may be excessive due to surgical complications.

The extent of your pain after carpal tunnel surgery determines how long it would take to recover. Nevertheless, you can treat this pain by taking pain medications, getting a wrist massage, and resting with your hand elevated. You can also undergo physical therapy to help alleviate the pain.

Why Do You Feel Stabbing Pain After Carpal Tunnel Surgery?

As mentioned earlier, pain after carpal tunnel surgery is normal and should subside over time. However, this isn't always the case. Sometimes, the pain may persist due to several reasons, including;

Incomplete Cut

Feeling numbness and tingling after your surgery may result from the surgeon not cutting the ligament entirely. Therefore, the median nerve is still compressed. That is often the case with endoscopic surgery.

Another reason you may feel tingling or numbness is that other tissues surrounding the nerve still compress it. So, cutting the ligament does not change anything. This situation often leads to nerve damage, and the pain may never completely disappear.

Infection

Although not common, you may get an infection post-procedure. The infection causes pain; if severe, you may need another procedure to clean the infection from the wound's site. But if mild, your doctor will prescribe antibiotics.

You can prevent infection by following post-operative instructions, including keeping your bandages clean and dry, especially in the first week of the surgery.

Nerve Injury

Nerve damage may also cause pain after carpal tunnel surgery. This surgical complication is more common in endoscopic techniques. Although the stabbing pain may go away in a few months, you may experience a tingling and burning sensation.

Nerve injury may occur to the nerve branch controlling the thumb muscles or carrying sensations to the palm. Consequently, nicking or accidentally cutting a nerve branch during carpal tunnel surgery may cause pain in the nerve control area.

Surgical Failure

Surgical failure is another reason for stabbing pain after carpal tunnel surgery. The pain may go away and come back in a few weeks or months. A failed carpal tunnel surgery is when a patient still feels the same symptoms after undergoing the procedure.

Usually, a doctor would recommend a revision surgery, but the chances of success are slim. Unfortunately, patients typically have to cope with the pain of the failed surgery.

Physical Therapy After Carpal Tunnel Surgery

Physical therapy can help with recovery after carpal tunnel surgery. Although physical therapy in Bedford may take several months to a year, it helps to speed up the healing process and to prevent stiffness in the hands and arms.

A physical therapist will determine the underlying cause of pain and create a treatment plan to help patients deal with the pain. Other benefits of physical therapy after carpal tunnel surgery include restoring the range of motion and improving the grip strength of the fingers.

After the surgery, many patients experience pain without their hands returning to normal function. Therefore, physical therapy after carpal tunnel surgery includes motion exercises for the best results.

These exercises often include wrist range of motion, tendon glides, and thumb range of motion exercises. You may also carry out finger opposition exercises. Scar desensitization and mobilization focus on reducing stiffness and sensitivity around the scar tissue.

Healing After A Carpal Tunnel Surgery

A physical therapy treatment plan after carpal tunnel surgery occurs in stages. Each stage has its peculiarity and exercises to help you regain muscle strength and re-establish function.

Week 1 – 4

During the first month post-surgery, you should still use your wrist splint. Your physical therapist will focus on helping you manage pain during this stage. The treatment plan may consist of passive and active exercises to improve your range of motion.

Your physical therapist will also encourage you to rest, ice, and compress your affected wrist. You may also have to elevate your hand.

Avoid lifting objects heavier than 2 lbs. at home with your hand. You should also avoid repeated hand movements like typing, chopping food, or vacuuming. Also, keep your bandage and splint dry.

Week 5 – 8

The second month of your treatment plan will include gentle strengthening exercises for your affected arm. You may also try hand grip strengthening exercises and rehabilitation that help increase muscle strength.

You can carry out heavier tasks like gardening and mowing the lawn at this stage.

Week 9 – 14

At this stage, your physical therapist will include activities that improve your muscle endurance and fitness. Flexibility exercises, hand grip strengthening exercises, and arm cycles are part of this recovery stage. Your physical therapist will also recommend mobilizing your wrist joints and range of movement exercises for your hand, forearm, and wrist joints.

After Week 14

After three to four months of rehabilitation, pain and swelling after your carpal tunnel surgery must have subsided. You must have also experienced improvements in your lower arm's function and range of motion.

Nevertheless, your physical therapist in Bedford will still include activities that improve your range of motion and cardiovascular fitness in your affected and unaffected arm.

It is essential to note that your physical therapy program after the surgery can only be as successful as your commitment to the program. In addition, the condition of your wrist before the procedure also dramatically impacts how fast you heal.

How Soon Can You Return To Work After Carpal Tunnel Surgery?

The hand where the surgery took place and the type of work you do will determine how soon you can return to work. For instance, if you had endoscopic surgery on your non-dominant hand and your job does not require repetitive hand movements, you may be able to return to work within two weeks.

On the other hand, suppose you had open-release surgery on your dominant hand, and you carry out repetitive hand movements at work. In that case, it may take longer to return to work. Your doctor will re-assess your hand and let you know when it is safe to return to work.

Conclusion

Nerve injury and other complications may result in burning pain after carpal tunnel surgery. Fortunately, the physical therapists at Barkman & Smith Physical Therapy in Bedford, TX, can help with the pain. Although it may take a few months to recover fully, our physical therapists will work with you to manage your symptoms.