Ulnar nerve - trying to understand

[SueMcK]

Hello,

I'm new. Four months ago I had unlar nerve simple decompression surgery. I am a pianist. There is some improvement, however, I'm still having some numbness in my LH little finger and that side of my ring finger (typical with ulnar nerve problems). Yesterday I had a nerve conduction velocity test which was compared to the one I had in May before the operation (operation was in late July). The surgery in July was two hours of neurosurgery at the elbow, removing scar tissue and moving a branch of the artery there to a better position. Here's my question: If the NCV test yesterday shows great improvement in the ulnar nerve at the elbow, why would the Guyon's Canal area still read low normal? I understand there may be some pressure on the nerve in the Guyon's area, but I don't understand the relationship betweeen the nerve being improved between the elbow and the wrist, and then the rest of the way from the wrist to the fingertips. My neurosurgeon doesn't always answer all my questions, but he said there may be another surgery for the Guyon's Canal in the future after waiting another 3 months, if things don't improve. Why does it seem like I have more strength to play the piano, yet the NCV is reading low for the Guyon's Canal. I don't know if anyone here can shed light on this, or not, but I'm having trouble understanding the way this nerve works. Thank you.

[keithy02]

had the same surgery 5 years ago it took 1 full year to get back to normal
it gets better worked for me:) :) :)
keith

[SueMcK]

keith,

Thanks for your thought. So it probably would be wise to wait longer like the neurosurgeon wants, to consider surgery, because maybe what looks a Guyon's Canal problem could resolve itself. I have considered a 2nd opinion, and that's always an option, but I'm thinking even that may be premature just 4 months out from the ulnar surgery at the elbow. Maybe what I need to do is study anatomy to see how the ulnar nerve branches off in the hand to help me understand the nerve itself. Being a pianist has made this whole experience traumatic for me. I am back to playing piano, and the numbness is less than before surgery but still there in a lesser form. I do have more strength post surgery than before.

[curiousforever]

Give it more time. I had both elbows done...

It can take up to a year or so for it to recover as much as it's going to.

[SueMcK]

curious..., thanks. I have to be patient and also if you see the other post nearby, the kinesio tape was counterproductive, probably. The ulnar nerve and the arteries are right there. I didn't even question my therapist's judgment.

[lucidmaster]

Sue, I've read that nerves tend to regenerate at about 3 cms per month. So, if some axons of your ulnar nerve were damaged at the elbow, it would take about a year for the them to regenerate and reach all the way to your fingers. This data seems to be consistent with other posters' comments about waiting for a year to see significant improvement. I have some minor weakness in the fine muscles of my hand (the ones that give you fine motor control) due to the ulnar nerve compression at the elbow, and my surgeon told me that it would not only take several months for the nerves to regenerate, and also a few years for me to regain all or most of the lost strength (the nerves need to be back in place first for the muscles to regrow).

[SueMcK]

lucidmaster,

Thank you for your thoughts. I just met with the neurosurgeon this morning and he thinks I'm going through a healing process and need to give it more time, which is basically what you said. I'm slowly getting more feeling in the affected fingers.

[Sonic]

Hi Sue,

I have had two ulnar nerve decompression surgeries on the same elbow. One was subcutaneous, and the second was sub muscular. I have had some improvement over the last year, but many of the symptoms remain. Although much of the feeling has returned, the coordination part has not. I also still have a lot of pain, including shooting pain down the inside of the forearm into my pinky and ring ringers. Apparently, it can take 2-3 years before the full extent of improvement is reached.

I'm not sure I totally trust the NCV tests, and neither does my surgeon. I have now had a total of 5 NCV/EMG tests, and the results have been nearly identical each time. All show low-normal results at the elbow. That doesn't explain the improvement I saw after surgery 1, or the decline in function between surgery 1 and 2. So anyways, it's really difficult to predict how much function will return, and it can take a really long time.

All the best to you, but be patient, and expect full function to take some time to return.

Graham