Ask the Expert: Dr. Steve Lee, Orthopedic Surgeon, Answers Questions on Nerve Injury & Compression in the Upper Extremity

by Dr. Steve Lee
Elbow pain

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

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.

 

Topics: Facebook Notes, Featured, Orthopedics
Tags: , , ,
The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

Comments

Bill says:

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.

HSS on the Move says:

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

Dinene says:

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?

HSS on the Move says:

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.

Andrea Mullin says:

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?

HSS on the Move says:

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.

Sudev says:

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

HSS on the Move says:

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

Shelley says:

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?

HSS on the Move says:

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.

mary says:

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?

HSS on the Move says:

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.

Gertrude Rocchio says:

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.

HSS on the Move says:

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.

pat cataract says:

I had arthoscopic shoulder compression followed by rotation cuff repair as well as they repaired some bi-cept & tri-cep as well three months ago. I am still in tremendous pain, unable to sleep more than 1-2 hours at a time at night, still going thru physical therapy 2Weekly & have shooting pain down my arm to my wrist not to mention it goes numb. Is this normal or is something wrong? I”ve mentioned it to my orthopedic surgeon but he just says it could take up to 4 months for the pain to go away. Just would like to know if I should get a second opinion. Plus I cant lift more than 4-5 pounds for more than 5 mins & still cant get my arm behind my back & the pain in my elbow is excruciating! HELP!

HSS on the Move says:

Hi Pat, thank you for reaching out. Dr. Joshua Dines, Sports Medicine Surgeon, says: “It is always difficult to comment on surgical procedures when we don’t know exactly what was done. That said, while pain for the first few months after surgery is normal, shooting pain down the arm with occasional numbness is not. I would recommend following up with your doctor to see if they want to further work up those symptoms.” It is always best to consult with your treating physician. If you are interested in receiving care at HSS, please reach out to our Physician Referral Service at 877-606-1555 for assistance.

dave mcbane says:

Hello Dr. Lee. Many years back i was chipping away some concrete and a piece of concrete bounced up and hit my middle finger. It hurt a lot and it swelled up right at the middle knuckle. It lasted for a long time and it actually came so it was hard to flex my finger. A few years later, i was just rubbing my sore knuckle and a bone spur popped through the skin. That was then. Now i have extreme pain in my wrist and there is a bump too. If bent at all it feels like my wrist is broken. Any ideas what this may be?

HSS on the Move says:

Hi Dave, thank you for reaching out. It is best for you to be evaluated in person. If you are interested in care at HSS, please contact our Physician Referral Service at 877-606-1555 for assistance.

Eden A Nokes says:

Hi I Have Been Having Major Knew Pain For A Week. I Weent To The Dr He Did A Xray Said Hr Thinks Its A lLigament Sprang. I Have ThrobbingTo Knee Cap, Tingling Down The Leg, I Can”t Straighten My Leg All The Way, And NoW I Have Swelling In My Upper Shin . Should I Go To An Orthopedic Surgeon For A Second Opinion

HSS on the Move says:

Hi Eden, thank you for reaching out. It would be best to consult with an orthopedic specialist for a second opinion. If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555.

john bayliff says:

hi dr lee
i have a full avulsion of the brachial plexus which is total paralyse of the arm .i have contacted a surgeon in america that i know and he directed me to you ,i am wanting to come to america for surgery and i wanted to know if it is possible to do surgery on a full avulsion. my accident happened 4months ago, i do have a professor that is going to do surgery on the upper part of my arm to get some movement back but i want to try and get my full movement back and it seems the only place to go is america i was wondering what are the procedures i have to take to be able to get all the right information to you and also i do know time is a key factor . my name is john and i am from the uk thanks

HSS on the Move says:

Hi John, thank you for reaching out. We have sent your inquiry over to Dr. Lee’s office and they shall be contacting you shorty.

fortunate says:

greetings
i was injured in early day of my age on my finger, the doctors could not do anything they had to cut my ring finger, now i would like to find out if it possable to do surgery or something to have a finger again,

HSS on the Move says:

Hello, thank you for reaching out. It is best to seek an in-person consultation to determine the best course of treatment. If you are interested in receiving care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

Emilie says:

I pulled my tricep at work but prior to that happening, I was seeing a chiropractor for neck and pelvis corrections. I had a sling on for 3 weeks, as I couldn”t drop my arm without getting this shock feeling. In two sessions with the chiropractor, he had grabbed my thumb on the arm I had injured and told me to pull my body in the opposite direction and he popped my thumb both times. My arm was burning for days after he had done this the second time. I have been experiencing a numbness sensation in my thumb and it is spreading into my forearm. My tricep seems to be healing, but my forearm has not progressed. Is it possible that the chiropractor did something wrong? These two appointments that the chiropractor did this was a month and a half ago.

HSS on the Move says:

Hi Emilie, thank you for reaching out. It is best to consult with your treating physician in person so that they can give you a better diagnosis. If you wish to seek consultation at HSS, please call our Physician Referral Service at 877-606-1555 for further assistance.

Delvin says:

Hi Dr. Lee I had a procedure 2 years ago for a broken scaphoid in which a screw was placed in my wrist. I still have terrible pains in my wrist and I just wanted to know if I will ever regain my full range of motion I”m my wrist and would it feel better to have the screw removed?

HSS on the Move says:

Hi Delvin, thank you for reaching out. Dr. Steve Lee, Orthopedic Surgeon, says: “It is difficult to know without getting at least a set of x-rays of the wrist. It is possible that the scaphoid is not healed or that you have arthritis and simply removing the screw may not be enough.” It is best to consult with your treating physician. If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

Jim McGehee says:

Hello Dr. Lee,
I am a 50 year old triathlete, writing from Blacksburg, VA and have recently sent up some of my medical records for your review. I’m wondering if my elbow contracture (post surgery for olecranon fracture) is a type of problem you deal with frequently? I am concerned about my range of motion as well as my ulnar nerve which seems mildly compromised. My local surgeon tells me I need an Elbow Contracture Release and I’m hoping to have that done arthroscopically by someone that is very familiar with the procedure. Thanks for your consideration.

HSS on the Move says:

Hi Jim, thank you for reaching out. We have sent your inquiry over to Dr. Robert Hotchkiss’ office and someone shall be reaching out to you shortly.

Nancy Pittman says:

wrist injury 7 mo ago. Arthrogram MRI showed pinhole defect in distal tfcc, schapolunate ligament tear, bone bruise & cyst. Dr. said surgery would not help, nothing else he could do. I am in extreme pain

HSS on the Move says:

Hi Nancy, thanks for reaching out. It is best you consult with your treating physician, as they best know your case and can better guide you. If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

Anup says:

Hi sir,
i have an accident 1week earlier
(fallen from bike),
and injured my right leg”s foot smallest finger(toe).
In x-ray report it shows that mild displacement occurs.
I have consulted an orthopaedist about this then he straighten my finger and bandage it with the help of other nearby finger and give some painkilling tablets.

Does this treatment is right.
Or i should consult another one!
And what precautions i should take?

Thanks

HSS on the Move says:

Hi Anup, thank you for reaching out. It is best for you to consult with your treating physician so they can advise with the best course of treatment. If you wish to receive care at HSS, please contact our Physician Referral Service at 877-606-1555 for further assistance.

Leave a Reply

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>