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Will I be disabled due to arm and carpel tunnel surgery?

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Posted on Fri, 10 Jan 2014
Question: I have surgery on 1-7 for carpal tunnel on r hand, I also have severe pain in shoulder and arm, I had a ct scan and nerve testing that I did not do well on, I have results from ct scan and can share, I feel the pain in my arm is more important than my hand. I have ct scan results but do not understand them and the ct scan was of my cervical spine, the pain in my arm is severe and my job requires me to lift & transfer patients in a nsd home, will I be disabled due to arm & carpel tunnel surgery?
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Follow up: Dr. Chander Mohan Singh (14 minutes later)
CLINICAL HISTORY: RIGHT SHOULDER PAIN AND UPPEREXTREMITY RADIATING PAIN REPORT: CT CERV SPINE C- 72125 . CLINICAL HISTORY: Bilateral arm pain and numbness. TECHNIQUE: Thin section axial CT is performed from the posterior fossa through the entire cervical spine. Sagittal and coronal reconstructions are performed and images are reviewed in standard and bone algorithm. The bones are well mineralized and in normal alignment. There is no fracture or dislocation. There is disc space narrowing at C4-C5, C5-C6 and C6-C7. There is anterior and posterior osteophyte formation at those levels. The facet joints appear normal. There is calcification of the posterior longitudinal ligament which is most pronounced behind C5. There is no evidence of severe central spinal stenosis. The prevertebral soft tissues are normal. There is minimal posterior protrusion at C3-C4. There is mild bilateral foraminal narrowing at C4-C5. There is a broad-based left posterior protrusion at C4-C5, maximal diameter of the protrusion is approximately 3 mm. There is a left-sided osteophyte protruding into the central spinal canal also at C4-C5. There is broad-based disc bulging at C5-C6. There is a prominent posterior calcification in the midline which probably represents ligamentous calcification. This protrudes into the central spinal canal but does not cause significant central stenosis. There are no lytic or blastic findings. IMPRESSION: Moderate multilevel degenerative change. No severe central spinal stenosis or foraminal stenosis. Disc protrusions and bulges but no evidence of a focal disc extrusion. No fracture or dislocation. No lytic or blastic finding. what does this mean?
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Answered by Dr. Chander Mohan Singh (1 hour later)
Brief Answer: You have multiple disc-protrusions in neck region Detailed Answer: Hi, I have read your query.You have multiple disc-protusions in cervical (neck)region. But you should not worry for this although you have carpel tunnel surgery .This will not make you to loose your job, nor you will become disable . When muscles around vertebrae are weak disc protrusion and bulges occur. Then these dics press upon nerves which surround them . This leads to pain , numbness in areas supplied by these nerves.This is main cause of pain in your arm as nerves which supply arm are pressed in your neck region by disc-protrusions and bulges . I don't know why your CT scan was done . But one thing, which is important is that you should get your MRI cervical spine done to see the condition of your cervical nerves. Then send us the report . Only then your further treatment can be planned. Till then apply hot packs in cervical ares for 30 mins in morning and in evening . Take painkiller + muscle relaxants only while discussing your doctor. Also you must avoid heavy work or lifting weight or lift & transfer patients at-least for a month. I hope you have get your answer. Thanks for your query. Be positive in life, believe in god and trust your doctor.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Chander Mohan Singh (2 hours later)
I had ct scan because MRI was not possible due to stent in pancreas from 1996 and unable to find out if metal or plastic. ct scan was done because of severe pain in arm. at this time I am working however in severe pain, unable to raise my r arm. Thank You, I am also unable to see neurologist until after surgery with ortho. in XXXXXXX I had nerve testing & cortizone shots in shoulder and both wrists due to carpal tunnel with no relief.my fear is in the future the plan may include injections in the spine and I will refuse them.
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Answered by Dr. Chander Mohan Singh (7 hours later)
Brief Answer: Yes the plan may include injections in the spine Detailed Answer: Hi, first of all thanks for the query and trusting me . If you have not lost your past record of stenting you can see the operative notes on discharge card in which the surgeon must have written whether the stent was plastic or metallic. But even if you have lost the past record then do not go for MRI scan. You have not mentioned any report of blood test e.g fasting blood sugar level , fasting ESR level ,fasting CRP level. These test are very important especially before cortizone shots in shoulder and both wrists due to carpal tunnel . So get your these tests done send me reporting only then further treatment can be advised. You have not mentioned about fever , weight loss , history of trauma in running days . You can also have your ultrasound of shoulder done by discussing it with your doctor and then send me reports. I am assuming that you are taking medicine which your doctor prescribed too you and not by yourself especially adderall , because it need strict monitoring by doctor. Till then apply hot packs in cervical ares for 30 mins in morning and in evening . Take painkiller + muscle relaxants only while discussing your doctor. Also you must avoid heavy work or lifting weight or lift & transfer patients at-least for a month. I hope you have get your answer.You are welcome to ask any type of health query in future also. Thanks for your query. Be positive in life, believe in god and trust your doctor.
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Chander Mohan Singh

Orthopaedic Surgeon

Practicing since :2003

Answered : 1041 Questions

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Will I be disabled due to arm and carpel tunnel surgery?

CLINICAL HISTORY: RIGHT SHOULDER PAIN AND UPPEREXTREMITY RADIATING PAIN REPORT: CT CERV SPINE C- 72125 . CLINICAL HISTORY: Bilateral arm pain and numbness. TECHNIQUE: Thin section axial CT is performed from the posterior fossa through the entire cervical spine. Sagittal and coronal reconstructions are performed and images are reviewed in standard and bone algorithm. The bones are well mineralized and in normal alignment. There is no fracture or dislocation. There is disc space narrowing at C4-C5, C5-C6 and C6-C7. There is anterior and posterior osteophyte formation at those levels. The facet joints appear normal. There is calcification of the posterior longitudinal ligament which is most pronounced behind C5. There is no evidence of severe central spinal stenosis. The prevertebral soft tissues are normal. There is minimal posterior protrusion at C3-C4. There is mild bilateral foraminal narrowing at C4-C5. There is a broad-based left posterior protrusion at C4-C5, maximal diameter of the protrusion is approximately 3 mm. There is a left-sided osteophyte protruding into the central spinal canal also at C4-C5. There is broad-based disc bulging at C5-C6. There is a prominent posterior calcification in the midline which probably represents ligamentous calcification. This protrudes into the central spinal canal but does not cause significant central stenosis. There are no lytic or blastic findings. IMPRESSION: Moderate multilevel degenerative change. No severe central spinal stenosis or foraminal stenosis. Disc protrusions and bulges but no evidence of a focal disc extrusion. No fracture or dislocation. No lytic or blastic finding. what does this mean?