What is Palmar Cutaneous Neuroma after Carpal Tunnel Surgery?
I have read that these represent over 50% of the possible complications from Carpal Tunnel Surgery. It sounds scary, but I don’t know what that means. Can you help me with this?
Rochester, New York
Answers From The Doctors at First Hand Medical
Great question Alice. You have done your research and that is impressive. You are right, Palmar Cutaneous Neuromas (PCN)are documented in the medical literature in a 12-year study in the Journal of Neurosurgery as the most common complication post-Carpal Tunnel Surgery. The authors of this article were practicing surgeons at the University of Michigan Medical School Hospital. They published their findings in the Journal of Neurosurgery, Publication 62.
The University of Michigan Medical School Hospital is one of the leading medical centers in the world where leading edge medical research is performed to the highest standards. It produces research you can trust.
In this study, 54% of the complications reported by Patients post-surgery were PCN. Patients reported tenderness at a discreet point along the incision which felt like an “electrical sensation” upon touching it
The nerve pain was coming from the patient’s palm or forearm. A symptom they did not have prior to the original Carpal Tunnel Surgery, indicating that it was most likely caused by the 1st attempt at Carpal Tunnel Release Surgery. In all cases these PCN had to be addressed by performing a second surgery.
A Neuroma is a benign growth of nerve tissue. Benign meaning – it is not cancerous. However, it can be quite painful and emits what has been described as an “electrical sensation” or a “burning sensation” with tingling and numbness in the palm and or fingers. Often, the symptoms can be like Carpal Tunnel Syndrome, but are emanating from the excess growth of nerve tissue this time, usually in the palm, or forearm, rather than from the Median Nerve being pinched in the Carpal Tunnel passage.
Neromas are more common in the feet than in the hand, but they tend to cause similar symptoms. They are common in the feet because of the constant pounding and intense weight load constantly experienced by a patient’s feet, especially in patients that are over-weight.
Neromas sometimes happen after an amputation where the nerve has to be severed, such as the amputation of a finger as shown in the diagram above.
It can be complicated to deal with Nerve Repair, because nerves do not regenerate themselves, it is best to disturb a nerve as little as possible. When surgical repair of a Nerve is required, as is the case in a Neuroma, it is best to go to a leading neurosurgeon in a top medical center to assure best practices are followed. Do your research to find a neurosurgeon in which you have the highest confidence to repair a Neuroma in your hand.
Hands are so basic to every task we do, we often taken them for granted until we do not have access to their miraculous dexterity and accurate precise movement.
Link to the full Technical Paper as Published in the Journal of Neurosurgery in a pdf is available for reading or printing here:
Complications of Carpal Tunnel Surgery – Dean S. Louis, MD, Thomas L. Greene, MD, Raymond C. Noellert MD. Journal of Neurosurgery Publication 62
There is no reason to be scared. Just get the facts and know that there are other viable alternatives treatment options to Carpal Tunnel Surgery that are clinically documented and work for over 97% of patients. Treatments like the Carpal Solution Nighttime Stretching Treatment offer viable alternative treatment of Carpal Tunnel and allow you to avoid the risks and down time.