Ask the Expert: Dr. Steve Lee, Orthopedic Surgeon, Answers Questions on Nerve Injury & Compression in the Upper Extremity
by Dr. Steve Lee
Q1. I was in a car accident that damaged my brachial plexus and now I have chronic pain. Are there non-surgical treatments for the pain?
Chronic pain after brachial plexus injury is relatively common. There are non-surgical treatments available. A pain management specialist can help decide which medications and other treatments may be beneficial.
Q2. I have tingling and numbness in my arm and hand caused by a fall. How do I know if I have nerve damage in my wrist?
A detailed physical examination can help determine if there is nerve damage. To confirm nerve damage, electrodiagnostic studies (EMG and nerve conduction studies) may be performed to test the function of your nerves. The location and severity of nerve damage can be assessed, and a treatment plan proposed.
Q3. When I keep my elbow bent for a long time, especially at night, I wake up with numb fingers. Is that normal?
That is not normal and may be an indication that you have a compressed nerve. Consult a physician for a detailed physical examination and electrodiagnostic study to help confirm the location of the nerve compression. Non-operative and operative treatments are available for such a condition.
Q4. I am a college pitcher and have nerve damage in my shoulder. My doctor and I are discussing surgery. What is the likelihood that I will be able to go back to pitching?
Dr. Steve Lee, Orthopedic Surgeon
This depends on several factors, including the condition of the shoulder joint and the severity of nerve injury. Recovery from such surgery can take a long time. You should have a discussion with your doctor about returning to pitching.
Dr. Steve Lee is an orthopedic surgeon at Hospital for Special Surgery. He specializes in treating conditions of the hand, wrist, forearm and elbow.
Comments
Dr. Lee,
I suffered a rolling traction injury to my right shoulder resulting in a grade 3 shoulder separation, thoracic outlet syndrome as well as a cervical plexus and brachial plexus injury to my right upper extremity. Most damage is at the nerve roots. I am going to pain management but wanted to know if you have any suggestions on what might be helpful. I have had bi-lateral carpal tunnel surgeries and as surgery to my right forearm radial nerve entrapment release. Can you help or recommend a doctor to take another look at my condition who specializes in such an injury?
Thank you Doctor.
Hi Bill – We have a Center for Brachial Plexus and Traumatic Nerve Injury at HSS that would be able to evaluate you. For help scheduling an appointment, please contact our Physician Referral Service at 877-606-1555 or visit them online at https://www.hss.edu/secure/prs-appointment-request.asp
I was in a car accident 14 months ago. I had herniated disc c5-6 with impingement, herniated c6-7. I still have trouble throwing a ball overhand. Do you think i Will I be able to? Discussion of fusion was discussed early on but bc pain level is down not an option, also received spinal injections. In addition following accident I have this cascading cracking of my sterumn. What might this be?
Hi Dinene, thank you for your question. Dr. Bernard Rawlins, Orthopedic Surgeon, says, “People with a herniated disc at C5-6 are likely to be able to throw overhand if they”re appropriately treated, either surgically or non-surgically. You should consult with a physician about the best treatment method. Cracking of the sternum is likely not related to the spine.”
If you”d like to make an appointment, please call our Physician Referral Service at 877-606-1555 or visit them online at https://www.hss.edu/secure/prs-appointment-request.asp. They are knowledgeable about the capabilities of all the physicians and can help find a doctor who will be the best match for your condition.
Question: for about 6 weeks now, the thumb and forefinger on my left hand have been numb. There is also some occasional aching pain in the left arm. I visited the neurologist for tests and he determined that the C6 vertebrae in my neck was the source, he thinks there is nerve root damage, but I am awaiting an MRI soon to get a better picture of what is going on. If it is nerve root damage, what is the prognosis and typical course of treatment?
Hi Andrea, Dr. Lee says, “The prognosis and course of treatment depend on the extent of nerve damage. Some types of damage are irreversible, some are not. Therefore, in some cases the symptoms will not go away completely no matter the treatment. Typical treatment is performed by a spine specialist, but can include cortisone injections and possibly surgery to remove the pressure from the nerves.”
Please consult with a physician to determine the best course of treatment. Our Physician Referral Service can help you with an appointment. They can be reached at 877-606-1555 or online at https://www.hss.edu/secure/prs-appointment-request.asp.
For a few years from arond 2005 till 2009 I had a threaded wristband which I always kept on my wrist. Naturally after I bathed or got wet, my wristband would remain wet. I took it off in 2009 after I noticed that once in a while I would get a sharp pain of the dorsal side of my wrist close to the part my middle fingers bones touch my wrist on sudden occassions.
I stopped wearing the wristband and later started wearing a metallic bracelet made of pure copper. This reduced the frequency and severity of my wrist pain, but I am not a 100% okay yet.
Please advise if this situation can be cured with physiotherapy, medicine, acupuncture or surgery,
Thanks
Hi Sudev, thank you for your question about wrist pain. It is difficult for a physician to comment on your condition without a physical examination and x-ray at a minimum. You should see a hand surgeon for an assessment. If you’d like to make an appointment with a hand surgeon at HSS, please call Physician Referral Service at 877-606-1555 or visit them online at https://www.hss.edu/secure/prs-appointment-request.asp
I have moderate to severe carpal tunnel symdrome as diagnosed by an orthopedist and neurologist based on emg and cat scan testing in March 2011.The numbness has improved a great deal without treatment.Shall I still go ahead with surgery?
Hi Shelley, Glad to hear your symptoms are improving. You should speak with your orthopedists about your concerns. If you’d like to speak with an HSS physician about this or any topic, please contact our Physician Referral Service at 877-606-1555 or visit them online at https://www.hss.edu/secure/prs-appointment-request.asp.
i have had radial nerve release surgery done on my right arm which resulted in finger drop that has improved with post surgical pt but i still have some parathesia in that hand why is this and the surgery was done in 2003?
Hi Mary, Thanks for your question. Orthopedic surgeon Dr. Lee says, “It could be scar tissue around the superficial (sensory) radial nerve, and an examination would have to be done to better determine.” If you’d like to make an appointment with an HSS physician, contact our Physician Referral Service at +1.877.606.1555 or https://www.hss.edu/secure/prs-appointment-request.asp?pageid=6463.
I suffer from loss of use to my right hand. two year”s ago i had surgery was told i would had 90% use back my hand is now weaker than before surgery.” personly think i have brachial plexus and ulnar nerve damage due to a fall had ten year”s ago.
Dear Gertrude, We’re sorry to hear you’re having trouble. We cannot make any recommendations without a medical consult. If you’d like to make an appointment with an HSS physician, please contact our Physician Referral Service at +1.877.606.1555 or https://www.hss.edu/secure/prs-appointment-request.asp?pageid=6463.