Post-Surgery Numbness in Hands and Feet: Seeking Solutions

Q: Post-Surgery Numbness in Hands and Feet: Seeking Solutions

Hello： If you experience persistent pain and numbness, it is advisable to consult a neurologist for pain management. <br>Additionally, after surgery, patients often experience muscle atrophy due to prolonged bed rest. <br>It is recommended to continue physical therapy with a reha

Numbness in the hands and feet and inability to walk normally after lumbar spine surgery?

Hello, doctor.
My mother went to the emergency department at Dalin Tzu Chi Hospital last July due to pain that prevented her from sitting up and weakness in her legs.
During her visit, the emergency physician found bacteria and viruses in her blood, as well as granulation tissue at the L4 and L5 vertebrae.
At that time, the orthopedic surgeon consulted deemed it not urgent enough for immediate surgery.
She was hospitalized in the infectious disease department for sterilization for three weeks, during which her pain persisted.
After three weeks, the vice president of Dalin Tzu Chi Hospital, along with the infectious disease specialists, examined her and discovered pus at the L4 and L5 vertebrae, leading to an immediate surgical intervention.
Post-surgery, she experienced numbness in her fingers and the soles of her feet, with the right foot being more severely affected.
She was discharged in October, but the numbness has continued since then.
Over the past few months, she has returned for follow-up visits, but there has been no improvement in her numbness.
MRI and X-ray imaging have not revealed any causes for the numbness in her hands and feet.
During her last follow-up in June, she informed the doctor that her numbness had not improved, and the physician could only adjust her medication and scheduled another X-ray for September.
Two days ago, I noticed slight atrophy in her right calf, and honestly, we cannot wait until September for another appointment.
What should I do in this situation? I am unsure which specialist or hospital would be most suitable for her condition.

Zhang Jiabin, 30~39 year old female. Ask Date: 2017/07/04

Dr. Jiang Junyi reply Neurology

Hello: If you experience persistent pain and numbness, it is advisable to consult a neurologist for pain management.
Additionally, after surgery, patients often experience muscle atrophy due to prolonged bed rest.
It is recommended to continue physical therapy with a rehabilitation physician to prevent atrophy.
Wishing you health and safety.

Reply Date: 2017/07/04

More Info

Post-surgery numbness in the hands and feet can be a concerning issue, especially following significant medical interventions like spinal surgery. Your mother’s case, involving a history of infection and subsequent surgery on the lumbar spine, suggests that the numbness may be related to nerve involvement or damage during the surgical process or due to the underlying condition that necessitated the surgery.

Understanding Numbness Post-Surgery
Numbness in the extremities can arise from several factors, including:
1. Nerve Compression or Damage: During surgery, nerves can be compressed or inadvertently damaged, leading to numbness or tingling sensations. This is particularly relevant in spinal surgeries where nerves may be manipulated or repositioned.

2. Postoperative Swelling: After surgery, swelling in the surrounding tissues can put pressure on nerves, causing temporary numbness. This usually resolves as the swelling decreases.

3. Neuropathy: Conditions such as diabetic neuropathy or other systemic issues can exacerbate numbness, especially if there were pre-existing conditions that were not fully addressed during surgery.

4. Circulation Issues: Reduced blood flow to the extremities can also lead to numbness. This can be due to positioning during surgery or other vascular issues.

Recommended Actions
Given the complexity of your mother's situation, here are some steps you can take:
1. Consult a Neurologist: Since the numbness persists and has not improved with time, it would be prudent to consult a neurologist. They can perform a thorough evaluation, including nerve conduction studies and electromyography (EMG), to assess the function of the nerves in the hands and feet.

2. Physical Therapy: Engaging in physical therapy can help improve circulation and nerve function. A physical therapist can provide exercises tailored to your mother's needs, focusing on improving strength and mobility in her hands and feet.

3. Pain Management Specialist: If the numbness is accompanied by pain, a pain management specialist may offer additional treatment options, including medications or interventions that can help alleviate discomfort and improve quality of life.

4. Follow-Up Imaging: Since previous imaging did not reveal the cause of the numbness, it may be necessary to repeat MRI or other imaging studies to check for any changes or new developments in the spinal area that could be contributing to the symptoms.

5. Lifestyle Modifications: Encourage your mother to engage in light physical activity as tolerated, maintain a healthy diet, and manage any underlying health conditions (like diabetes or hypertension) that could contribute to nerve issues.

6. Regular Monitoring: Keep a close watch on any changes in her symptoms, including the degree of numbness, any new symptoms, or changes in strength. Documenting these changes can be helpful for her healthcare providers.

Conclusion
Persistent numbness following spinal surgery is not uncommon, but it warrants thorough investigation and management. By consulting with the appropriate specialists and considering a multidisciplinary approach, you can help ensure that your mother receives the best possible care. It’s essential to advocate for her health and seek timely interventions to address her symptoms. If you feel that her current healthcare providers are not adequately addressing her concerns, seeking a second opinion from a different hospital or specialist may also be beneficial.

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