I have a patient whi is 4/52 post carapl tunnel release and jus tin the pat 1/52 or so, her pain has increased to the point where she only has to lightly touch herhypothenar eminance or palmer aspect of her writs and it can shoot terrible terrible pains. is this normal, i felt too inexperienced to advise her whether she needed further review fom her surgeon or just to reassure this that this is normal and thoug movement is painful, it will do no harm, and the pain should start to resolve with regaining of function. I havent seen many carpal tunnels, and certainly arent an expert on hand therapy, am i missing something. She has gone backto work full time caring for a boy with CP which involves alot of manual handling so i gave her a splint just to provide protection, keep wher wrist inneutral and remind her not to use it too much really. It was great for the first week but her symptoms seemed to have worsen since she has been coming to see me. Am i stirring her symptoms up by too much gentle mobilisation. I am a little stumped and would appreciate any advice, or comments by those who have seen similar presentations.
I have liased witht he OT's who have lots of experience in the area, and they seem to think im doing all the right things, but my query is given the surgeon doesnt visit very often and only takes priority cases when he does, should i refer back for an opinion on this excessive pain, or keep going the way i am?
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hey ash, she is only 4 weeks post op so keep in mind some general healing principles. she could be experiencing generalised hypersensitivity to the area due to the nature of the surgery. im not sure, but if she had a long history of carpal tunnel, then those nerve endings would be so used to being compressed they wont be used to sending normal light touch or pressure signals. maybe try doing some tactile desensitisation techniques for a few treatments to see if it settles down, then meybe begin your mobilisations again in a few weeks??
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