Desperate for Advice: Seeking Answers for Persistent Hand and Arm Pain
I'm a 34-year-old male grappling with intense discomfort in my right hand and arm. The pain primarily concentrates around my wrist, pinky, and ring fingers, stretching through my wrist and often extending up my forearm toward my elbow. It feels akin to an internal tugging sensation, almost like something is being pulled. While the pain isn’t relentless, its intensity can become overwhelming. Alongside this, I experience tingling and numbness, particularly in my pinky finger, as well as lingering pain in my elbow. This situation began a couple of decades ago. When I was a child, I broke my elbow, but the injury wasn’t managed correctly—no cast or appropriate care was provided. Someone simply aligned it, and since then, my arm has never regained full straightness. For many years, I coped with that limitation, but after more than 20 years, I started facing additional challenges, such as weakness in my right hand, muscle atrophy, numbness, tingling, and excruciating pain. Eventually, I was diagnosed with ulnar nerve neuropathy. I have undergone several surgeries including: - Anterior interosseous nerve to ulnar nerve motor transfer (April 2024) - Right ulnar nerve release with subcutaneous anterior transposition - Right cubital tunnel release - Neurolysis of the right ulnar nerve at Guyon’s canal - Neurolysis of the right anterior interosseous nerve in the distal forearm - Sagittal band reconstruction of the ring finger (October 2024) - Sagittal band reconstruction of the middle finger (May 2025) Prior to surgery, my fingers were curled in a claw-like position, and I was unable to straighten them. Although I can now achieve some straightening, the pain remains severe and, at times, seems to intensify. Recently, I underwent another nerve conduction study last month, which still indicates ulnar nerve neuropathy. I'm uncertain if the nerve has sustained further damage or if it simply never healed properly. Currently, my pain management regimen includes: - Gabapentin at a total of 1800 mg per day (600 mg taken in the morning, afternoon, and evening) - Duloxetine 60 mg at night - Tylenol 3 as needed for elbow pain Unfortunately, these medications are not providing sufficient relief. The pain impacts my sleep, mental well-being, and overall quality of life. It feels as though my concerns are falling on deaf ears, and my next consultation is scheduled for mid-March. I would greatly appreciate any insights regarding whether such pain is typical following extensive surgeries. Can ulnar nerve damage still result in significant pain even when functionality improves? What additional inquiries should I be making during my doctor's visit? Any guidance would mean a great deal to me as I try to comprehend what is occurring with my health. Thank you for your help.
Answers (1)
2/9/2026, 9:10:34 AM
OpenHealth AI
I'm sorry to hear about your persistent and intense pain; that sounds incredibly challenging. It’s clear you have gone through a lot with your hand and arm issues, including multiple surgeries and ongoing symptoms. Let’s break down your situation and identify some steps you can take while you await your consultation.
Main Points:
- Post-Surgery Pain: Ongoing pain after extensive surgeries can occur and might be related to nerve healing, scar tissue, and inflammation.
- Ulnar Nerve Issues: Continued symptoms may indicate that while the nerve could have improved in function, pain signals can still persist due to various reasons, including nerve sensitivity.
- Next Steps: Adjusting your pain management approach and preparing for your upcoming doctor’s appointment is crucial.
Explanation:
The pain you feel, especially with the history of ulnar nerve neuropathy and multiple surgeries, can stem from a few sources:
- Nerve Healing: After surgery, nerves can take time to heal, and it's possible that nerve irritation or scarring is contributing to your pain.
- Phantom Pain: Sometimes, even when there's improvement in functionality, nerves can continue to send pain signals even if there's healing.
- Pain Sensitization: Chronic pain can lead to changes in how your brain and body process pain, which may explain why the pain persists despite surgical interventions.
Actionable Steps:
-
Pain Management Adjustments: Discuss your medication with your doctor. It may be beneficial to explore alternative pain relief options, such as:
- Adjusting dosages or timings of gabapentin or duloxetine.
- Considering topical treatments (like lidocaine or capsaicin) for localized pain.
- Investigating additional medications, such as other anticonvulsants (like pregabalin) or non-opioid pain relievers.
-
Physical & Occupational Therapy: If not already included in your treatment plan, ask about a referral to a physical therapist specialized in nerve injuries or hand therapy to help strengthen your hand and alleviate pain.
-
Pain Management Specialist: Inquire if your doctor can refer you to a pain management specialist who can provide a more tailored approach, potentially including nerve blocks, acupuncture, or other modalities.
-
Prepare Questions for Your Upcoming Visit: Here are some suggested questions to discuss with your physician that can help clarify your condition:
- What are the reasonable expectations for pain management following these surgeries?
- Are there specific signs that indicate whether my nerve has sustained further damage versus just not healing properly?
- What additional therapeutic options do you recommend given the persistent pain and other symptoms?
- Should we consider imaging studies or additional tests to evaluate nerve function more closely?
Final Thoughts:
It’s understandable to feel frustrated, especially with the impact pain has on your quality of life. Focusing on retrieving and incorporating new pain strategies alongside your ongoing relationship with your healthcare team can help you regain a sense of control. If you have any more questions or need further explanations, feel free to ask!
Related Questions
Concerns About Persistent Swollen Lymph Node
Greetings. I'm a 23-year-old woman without any notable medical issues prior to this situation. In December, I discovered a swollen lymph node in my neck, which I believe is connected to an infection from a helix piercing I had done just four days earlier. By January, a month after I first observed the lymph node swelling, I consulted a medical professional. After examining the piercing, he determined it appeared infected and removed it, prescribing antibiotics as treatment. Although I completed the antibiotic course around three weeks ago, the swollen lymph node remains. The doctor recommended an ultrasound and an X-ray for further investigation, but unfortunately, financial constraints have prevented me from proceeding with those tests. For additional context, I had the piercing for about a year, and it never fully healed, remaining red throughout. I suspect it may have flared up in December, coinciding with the appearance of the swollen lymph node. Overall, I feel fine, which leaves me puzzled about the persistence of the swollen lymph node. Is it typical for a lymph node to remain swollen after finishing a course of antibiotics? To clarify, the lymph node is soft (similar to an inflatable tire, not hard) and can be moved around. Any insights would be greatly appreciated. Thank you!
Understanding My Optic Nerve Issues and Neurological Symptoms: Seeking Answers
I'm a 28-year-old female dealing with IBS, asthma, and anemia. **Currently, I am experiencing these symptoms:** - Occasional muscle weakness, - Shortness of breath (SOB), - Chest tightness, - Tingling sensations, - Pressure in my head, - Shakiness, - A feeling of constriction in my body, - An uncomfortable sensation often described as the "MS hug." **Persistent symptoms include:** - A "black curtain" effect in my peripheral vision, - Blurred sight, - Occasional dark spots or flashes of light, - Visual distortion, - Difficulty swallowing. **Clinical findings include:** - Paleness in the bilateral temporal optic discs (verified by a neuro-ophthalmologist), - Thinning of the RNFL and ganglion cell layer as observed in OCT imaging, - Positive ANA result at a dilution of 1:80 with a speckled pattern, - Brain MRI with contrast showing no abnormalities. **Lab results reveal:** - Standard MG antibodies test returned negative, - Comprehensive autoimmune panel was negative aside from the positive ANA. **My questions are:** 1. What could lead to structural damage in both optic nerves when the MRI results and visual fields appear normal? 2. Is it possible for MOG/NMOSD to manifest without severe vision impairment? 3. Should I consider testing for MOG/AQP4 antibodies even with a clear brain MRI? 4. Would it be advisable to request an MRI of the spine? 5. Which type of specialist should I consult for these issues? 6. Are there additional tests I should pursue? I would greatly appreciate any insights or guidance on my situation!
Inquiry About Stitch Appearance After Cyst Removal
At age 30, I underwent the removal of a significantly large Pilar cyst on January 28. My girlfriend has expressed some worry regarding the appearance of the stitches. I will include an image link at the end for reference. To care for the area, I've been using a combination of polysporin and gauze secured with a mesh tube overlay. I've adhered closely to the care guidelines provided by my dermatologist, changing the dressings daily. My girlfriend has kindly helped by cleaning the stitches as instructed during these changes. Around the eighth day post-surgery, I experienced a minor dehiscence, which resulted in one stitch coming loose. This understandably caused some alarm for my girlfriend, but upon contacting my healthcare provider, they reassured me that as long as there’s no infection or significant opening, I should simply keep it covered. She is particularly anxious about the discoloration in the center of the V-shaped stitch area. I believe it might just be dead tissue and that overall it appears to be healing well. Nevertheless, she has urged me to seek further advice. I would appreciate any insights from those who have dealt with stitches healing—does this seem alarming? I’m just two days away from having them removed, and I have already invested additional funds for a follow-up visit. Here’s the link for the image: https://imgur.com/a/tv5N6Iv Thanks in advance for any thoughts you can share! **Summary**: Do the stitches shown in the imgur link appear to be healing normally, or is there cause for concern?
Understanding Sacroiliac Joint Dysfunction: What Steps to Consider Next?
I’m a 33-year-old female, weighing 70 kg and standing 170 cm tall, with a background of being an ex-smoker and an occasional drinker while on holiday. My medical history is quite extensive, which I’ll summarize with my medications later, although most of it may not be particularly relevant. I also experience moderate levels of joint hypermobility. Back in 2014, I was heavily involved in long-distance running until I started experiencing a piercing pain in my right buttock. This discomfort intensified whenever I bent down or carried something on that side, leading to sharp sensations with each step. An X-ray showed no abnormalities, and the physiotherapist attributed my issue to weakness in the glutes, but unfortunately, this problem has persisted. The pain is particularly acute during my menstrual cycle, gradually lessening afterward. Just before my period, it feels more like sharp jabs, and at other times, the sensation resembles IT band discomfort, extending from the outer thigh down to the ankle, with additional sharpness in the hamstring and knee areas. - While imaging never pinpointed any specific problems, anti-inflammatory medications tend to alleviate the symptoms. - Orthopedic specialists ruled out any hip-related issues but identified FAI (femoroacetabular impingement), which explained some of my hip pain. - A gynecologist dismissed the possibility of endometriosis, stating that even if it were present, there would be little that could be done—a disappointing revelation. - I was referred to a sports medicine doctor who diagnosed me with sacroiliac joint dysfunction and recommended strengthening my glutes, along with considering a cortisone injection. - A podiatrist fitted me with orthotics, which provided some relief, though they are not a definitive solution. - Symptoms have been manageable on birth control, but I can no longer use hormonal contraceptives. - Since 2022, I have been engaging in Pilates and strength training supervised by both a physiotherapist and an exercise physiologist. - Both X-rays from 2014 and 2024 returned normal results. - An MRI of my lumbar spine conducted in 2024 revealed mild kissing spine, although only the S1 vertebra was examined, leading me to believe the real source of discomfort lies further down. - An MRI of my hip in 2024 mentioned FAI and some bone spurs, but the area of concern was not adequately captured in the imaging. - A laparoscopy performed in 2021 discovered deep bowel endometriosis. - Stretching occasionally alleviates IT band discomfort, but the acute stabbing sensation can only be managed through anti-inflammatory medication and patience. - Ponstan has proven to be the most effective, and I recently noticed that ibuprofen sodium dihydrate has been significantly more beneficial than regular ibuprofen—I’m perplexed by this improvement, yet the symptoms persist. After enduring a challenging five years with my health, I am finally regaining my sense of normalcy, and I’m eager to move forward with my life. This persistent pain is hindering my progress. **What should my next steps be?**
Prospects for Mumford Procedure
At the age of 45, I have been grappling with pain in my AC joint for the past six months. An MRI has revealed significant arthritis, edema, and a bone spur on the upper part of my acromion. Two months ago, I received a cortisone injection that provided considerable relief, but that effect is starting to diminish. I have consulted with a surgeon who mentioned that the Mumford procedure could be a viable option, depending on the level of pain I find manageable at this moment. Currently, my discomfort is minimal. Prior to the injection, I was consuming high doses of paracetamol daily to manage the pain. How can I ascertain whether it’s time to consider surgery as the most suitable option? What does the long-term prognosis look like? Is it common to experience pain following recovery from surgery? (I am eager to avoid any chronic pain!) Overall, my health is good; I engage in regular exercise, averaging around 10,000 steps daily, along with cycling, although I do not perform much upper body workout. I also spend much of my day sitting at a desk, yet my weight is within a healthy range. Being quite tall could contribute to increased mechanical wear due to longer limbs. Fortunately, there are no issues with muscles or ligaments; one physician noted that I possess greater mobility in the joint compared to the average person. I maintain a full range of motion and my strength appears to be adequate.