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Friday, April 25, 2014
Carpal Tunnel and Lymphedema
I had a lumpectomy almost two years ago. Shortly after my chemo treatments were finished, I was diagnosed with moderate carpal tunnel in both hands. The neurologist sent me to a surgeon. After that appointment, I chose to have stim treatments instead from a chiropractor. This did get rid of the symptoms for almost a year, but then they started to reappear. My family doctor, oncologist, and surgeon all said I would need surgery if I really wanted rid of the carpal tunnel. I recently did have the carpal tunnel release on the hand on my non-operative side. However, after going through this surgery, I am concerned about the surgery on the hand on my operative side triggering lymphedema. (I had three lymph nodes removed.) Should this be a concern?
I think carpal tunel surgery is safe and should not cause lyphedema especially since only 3 lymph nodes were removed. Discuss with your surgeon the use of anesthesia that minimizes or does not use tourniquet pressure during surgery. Are you on an aromatase inhibitor (AI) such as letrozole, anastrazole or exemestane as part of your breast cancer treatment? These have been shown to increase the risk of carpal tunnel syndrome. Sometimes a switch in AI or change to tamoxifen can reduce the symptoms of carpal tunnel syndrome without surgery. I would discuss that with your medical oncologist.
Paula Silverman, MD
Associate Professor of Medicine
School of Medicine
Case Western Reserve University