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Cubital and Carpal Tunnel Syndrome
Bones, Joints & Muscles | Last Active: Sep 22 11:04am | Replies (8)Comment receiving replies
I am an 81 YO male who has been diagnosed with both cubital and carpal tunnel syndrome.
The first and necessary step is to have a nerve conduction study done. I did.
The first highly rated surgeon I went to wanted to do both surgeries in two separate open procedures, one for each arm, under general anesthesia. I had told him I was terrified of general anesthesia and he essentially ignored me.
I went to my neurologist whom I completely trust. He reviewed the nerve conduction study (which incidentally had been performed by a very good retired Mayo neurologist) and noted that while the carpal tunnel was pretty severe, the cubital was described as "moderate" and he thought I could probably get away with just doing the carpal. He thinks very highly of the other top rated hand surgeon in greater Phoenix, Shelley Noland, at the Mayo Clinic and he referred me to her.
I had the same conversation with her and she agreed to do minimally invasive endoscopic carpal tunnel surgery on me. My worst hand was my non-dominant right hand and she did that one on August 31st. I am still in the recovery phase but I haven't had any problems on that side since the surgery. The cubital controls the top of the second to last finger and the last finger and I have not had any problems since the surgery in that regard. I am actually hoping I can work with my occupational therapist and avoid doing my dominant hand which I have as of now postponed to early December.
If you have a neurologist, ask her to do a nerve conduction study. If you don't, ask your internist/primary care provider to make a referral for you. That is your first step. No reputable hand surgeon would do any such work without such a study. Depending upon the results you might be treatable with non surgical methods (e.g., PT) or you might need surgery but might be able to avoid the cubital part like I am.
My second point is that you don't have to accept the proposed actions from the first surgeon you see. You can find another if you don't like his approach. I did and I am very glad I did.
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@steveinarizona your reply certainly conveys how a symptom can be misinterpreted and you’re correct in that surgeons need to understand exactly where all the problems are before operating. There is another scenario that causes pain in the pinky and ring fingers; thoracic outlet syndrome. It is a compression syndrome between the collar bone and rib cage or between the scalene muscles on the side of the neck. It compresses both blood supply and nerves including the ulnar nerve which I think is also compressed by cubital tunnel syndrome when bending the elbow. This does make it confusing for doctors with overlapping symptoms that can affect the same nerve in different places. TOS is often treated with physical therapy and stretching and myofascial release. I have TOS, and often patients with this are misdiagnosed for several years. One test was the doctor listened to my pulse in my neck and when I turned my head, it stopped because of compression when the muscles tighten. TOS can be confused with carpal tunnel and I had both at the same time, and the surgeon for the carpal tunnel procedure accused me of malingering when his surgery didn’t fix the problem. My hands would turn blue or purple and get cold because of poor blood supply from TOS. Physical therapy and specifically myofascial release has helped me a lot.