Shortly after having a bowel operation I discovered that both my little fingers were numb — the one on the right being particularly bothersome. The orthopaedic doctor examined the nerves of the elbow regions for a possible cause, promising further appointments. Is the numbness I’m referring to common, and can it be put right?
Brian Woods, Manchester.
I suspect that this numbness relates to damage done during your operation.
Your description fits with a diagnosis of ulnar neuropathy, the second most common form of tingling fingers (after carpal tunnel syndrome). It occurs when the ulnar nerve — which runs the length of the arm and, among other things, conveys sensation to the little finger, part of the ring finger and the palm — becomes pinched.
Typically, the nerve becomes compressed in a groove close to the elbow causing tingling and numbness of the little finger and half of the adjacent ring finger.
This is in contrast to carpal tunnel syndrome, which is also caused by a pinched nerve but in this case it is the median nerve — the other main nerve supplying the hand. It becomes trapped close to the wrist joint, causing symptoms in the thumb and index finger.
The ulnar nerve can be damaged at the elbow by acute trauma, such as a fracture, or it can be irritated by compression from leaning on the elbow — or, most commonly, by keeping the elbow flexed for a prolonged period of time.
I suspect this is the cause in your case.
During your recent abdominal operation, it is likely that once you were anaesthetised and on the operating table your arms were flexed at the elbow and laid on your chest, away from the area of the surgery.
Nerve damage is not uncommon after an operation. According to the Royal College of Anaesthetists, minor symptoms as a result of peripheral nerve damage (the nerves that run between the spinal cord and the rest of the body) may occur in 1-in-1,000 people who have a general anaesthetic — and the ulnar nerve and the peroneal nerve in the leg are the most commonly affected.
This damage may occur, for example, as a result of positioning — such as lying on your front, or if (as in your case) a limb is flexed, or if a tight tourniquet is needed to stem bleeding (and the pressure irritates a nerve).
Your symptoms should improve within weeks and resolve fully within a year.
In the meantime, anti-inflammatory painkillers may help with discomfort, and avoiding prolonged elbow flexion by wrapping a towel around each elbow at night may hasten the resolution of the symptoms.
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