Numbness in fourth and fifth fingers after IV in back of hand?

[xltjim]

Hello.  Some background......I had to have a vitrectomy to correct a retina detachment on my right eye on 10/1/18.  They had to put a gas bubble in my eye which required me to position on my left side.  I had to lay with my head pointing inwards towards the mattress.  I had to do this for 3 weeks (2 weeks down 2 hours up for 15, 1 week down 2 hours up 2 hours).  I still have the gas bubble and only am positioning for when I sleep.  The results of the surgery are so far positive.

Now since the surgery I have numbness in my right hand fourth and fifth fingers, and a little bit to the outer palm of my hand.  I am not sure if this is from the positioning I had to do, it started within a few days of the surgery.  I have no pain other than a very occasional ache in my right forearm.  I can move the fingers fine, strength is good, can feel things although fingertips are I would guess 60 percent numb.

One thing to note is that the iv prior to surgery was started in the back of my hand.  When they injected the anesthesia (propofol) I felt intense pain in the same area of my hand that is now numb and tingly.  Before I could say anything to them I was unconscious.   I have since discussed with the anesthesiologist who said that what I experienced before being put under was normal.  He thought a nerve may have been nicked when doing the IV and that it will take time to heal.  So far it hasn't gotten any better or worse that I can tell.

Saw my GP and have gotten a referral to a neurologist in a couple weeks.  Has anybody had any experience with an IV nicking a nerve?  I guess I will find out more in a couple weeks.  Thank you,  Jim

[xltjim]

Hello, thank you for your helpful post.  The surgery and when all this started was  going on 5 months ago.  Never had any swelling or bruising at the IV site.  The EMG showed Carpal tunnel both hands and didn't have any symptoms (now that I know about it I can sometimes feel aches pains of wrist).  The other finding with the EMG was what the dr stated as the ulnar nerve compression at the elbow.  While I have constant numbness of ring and pinky fingers, I have no weakness, very mild tightness/pain sometimes.  I now wear wrist splints and night but nothing for the elbow.  I guess I will look into a brace for that in the future.  If you would have any recommendations or experience on what type is best that would be awesome.    The nsaids do seem to help a little.   Planning to give it time at least a couple more months as I have cataract surgery to get past first.  Jeez getting old ain't for the weak thats for sure...lol.  Thanks again.

[Tickiemctickface]

Alright, thank you for your response/input.

This sensation you're describing is more directly associated with Cubital Tunnel Syndrome instead of Carpal Tunnel Syndrome, which is more accurately aligned with your chief complaint.

While I am not doubting your Primary healthcare professional as far as a diagnosis of Carpal Tunnel Syndrome, which tends to be pretty common, that's not your chief complaint.

Personally, I prefer taking an external approach to therapy before considering more invasive approaches. Other than Anti-inflammatory medicines, what other therapy approaches have you taken to help relieve this condition?

[Tickiemctickface]

Allow me to rephrase that last question, other than Anti-inflammatory medicines and splinting, what other approaches have you taken to relieve this condition?

[xltjim]

Yes I would rather exhaust all options before going the surgical route.

Primary care sent me to neurologist who did the EMG and said i had Carpal Tunnel in both hands as well as Ulnar Nerve compression.   When I take the Anti-inflammatory meds  they really help a lot to relieve the numbness and any aches (which are mild).  Between the meds and splinting the wrist is all i have done.  Dr. did mention splinting the elbow at night, but I haven't gotten a splint yet for that (not sure which one is best).   At first I took the meds at maximum dose for a week which helped.  I could keep taking the meds but would think they can't be good for long term use.  I take them on particular days when the condition seems worse.

[Tickiemctickface]

What i neglected to mention previously is that since there is no loss of strength, this tells me that the issue is aggrivating sensory nerves and not motor nerves, which is good and it sounds like it's a mild issue which will not even require surgery.

Something that is pointing out to me is the last part - "days when the condition seems worse". This indicates to me that soft tissue is being aggrivated by a misalignment of one or more joints in the arm. If your ulnar nerve is compressed at the elbow, then you're looking at entrapment in the area of the cubital tunnel (a nerve channel in your elbow that creates an anchored pivot point for the nerve). If you are able to, I would suggest seeing a chiropractor, and get everything from your the neck down to the fingers adjusted and then ice the area (I recommend this as your sleeping position may have affected other parts of your body). This will need to be taken care of over the course of several sessions. This will help with the misalignment, but since the injury occurred almost half a year ago, your muscles will inevitably fight back and try to put the joints back to their misaligned state. Due to this, you will want to look up stretching exercises for your triceps, elbows and forearms.

On a side note, this may also benefit you with treating your carpal tunnel syndrome as well.

I hope this helps!

[xltjim]

Thank you.  This has given me some direction.  Much appreciated.  Will update as to how things progress (hopefully for the better).

[xltjim]

Well I did see the neurologist and I had an EMG.  He says mild carpal tunnel in both hands and nerve by elbow is compressed.  Could be from the positioning I had to do from the eye surgery I had and to give it time.  Its what I would call as mild numbness in the ring and pinky fingers.  No weakness or pain.  Still curious though if anyone had an issue like this appear after having an IV in the back of the hand.

[Tickiemctickface]

The hand contains two main nerves - The Median nerve and the Ulnar nerve.

The Median nerve will travel to the hand through the carpal tunnel and is associated with the thumb, index, middle, and half of the ring finger that is closest to the other of the previously mentioned fingers.

The ulnar nerve is located on the outer section of the wrist, outside of the carpal tunnel. As carpal tunnel syndrome occurs due to compression of the median nerve (directly or indirectly) by way of the carpal ligament, it would not affect the fingers on the outside of the hand.

That said, it is this writer's opinion that issues with the carpal tunnel are unlikely.  What may likely is that there may be swelling at the injection site that may be placing pressure on the ulnar nerve causing this pain. Have you taken any NSAIDs yet to see if this helps?

[specialmom]

I just want to say you are VERY helpful!  I hope you come back to help people on the neurology forum!  

[Tickiemctickface]

Specialmom,

That's the idea! :-)