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Carpal Tunnel Syndrome
With this common condition patients experience uncomfortable feelings of pins and needles and numbness in their fingers and thumb. Typically the little finger is spared. Often worse at night, it can affect sleep and be quite debilitating.
It is caused by compression of the median nerve as it enters the base of the hand.
Some patients find relief by wearing a wrist splint and occasionally an injection into the wrist can go a long way towards settling things down. The definitive treatment however is a carpal tunnel release.
This is a day case procedure performed under local anaesthetic that releases the tight ligamentous structure that pushes down on the nerve. With successful surgery the vast majority of people will go to sleep the following night with significant improvement in their symptoms. Though the last residual twinges may take longer to disappear as it is dependent upon your bodies capacity to heal your nerve.
Common Hand and Wrist Conditions
Dupuytren's Contracture
Dupuytren's is a benign condition within the fascia of the palm and fingers, a specialised layer of tissue below the skin. Patients intially experience nodules within the palm. These can sometimes be painful. Some will progress to thickened "cords" which can extend into the fingers and cause them to curl over and 'contract'.
It mostly affects the ring and little fingers but can be found in other parts of the hand and even in other areas of the body.
Non surgical treatments have not been shown to be reliably effective. Surgery is generally indicated when the finger is contracted to about 30 degrees.
Surgery can either consist of simple 'needle fasciotomy' if the cord is only within the palm.
However with significant contracture a more involved excision operation under general anaesthetic is usually required. In rare cases I may even need to use a skin graft.
Base of Thumb Arthritis
The base of our thumb is one of the most common sites in the body to get wear and tear. If you experience pain on the thumb side of your wrist when gripping objects it may well be because of degeneration in the joint between your trapezium and thumb metacarpal bones.
There are a wide variety or treatments; from simple anti-inflammatory medications and physiotherapy, to pain-relieving injections, to surgical procedures such as joint excision or joint replacement. Not everyone is suitable for every available treatment but I will go through everything thoroughly with you and we can arrive at a plan together.
Wrist Pain
Our wrist and the way it moves is hugely complicated. A wide variety of issues can lead to some sort of wrist pain.
Most of the time I should be able to get to the source of the problem by talking with you about it and carefully examining you however we may need to make use of further tests such as X-Rays, Ultrasound scans or even MRI, all of which I have ready access to.
Once we arrive at a diagnosis we can discuss treatment options
Hand and Wrist Trauma
Firstly for anything acute please go to your nearest Accident and Emergency Department or Urgent Care Centre.
If it is less urgent and you are able to wait to come and see me then I can take a look, get up to date investigations and together we can work on getting you better with pain-free function as soon as possible
Trigger Finger
This is a very common condition of the fingers, often related to overuse or some sort of repetitive strain type injury.
You may experience anything from a vague pain when moving a specific finger, to troublesome clicking when bending and straightening it. In severe cases the finger can get stuck after you bend it and you need to use the other hand to snap it straight again.
It occurs when the tendon that bends your finger swells slightly as it runs into its sheath at the base of the finger. This tight tunnel restricts movement leading to irritation and eventual triggering.
The condition can sometimes resolve by itself but if it is becoming a nuisance then in the first instance I would offer a theraputic injection. This can often be curative but if it fails to resolve I can perform a very simple procedure to release the tunnel or "A1 pulley". This is performed under a local anaesthetic through an incision about 15 mm across and is almost always curative.
Repetitive Strain Injuries
The tendons and ligaments that control movement of all the bones in your hand and wrist can suffer form overuse or repetitive strain.
Through careful examination with or without further investigations we can arrive at a diagnosis for what is causing your pain.
Many of these injuries can be treated reliably with a course of physiotherapy but occasionally you might need an injections. Rarely is surgery required.
Ganglion
A ganglion is a small balloon of fluid that forms next to your wrist joint or a tendon in your hand. Completely benign they can often resolve by themselves but occasionally can cause a deep ache or grow to a size where they become troublesome.
Years ago thy were treated by hitting the area hard with a large flat object such as a heavy book, which is where we get the term 'Bible Basher' from but these days we treat either with injection or surgical excision.
There are other causes for lumps and bumps around the hand, the vast majority of which are benign and nothing to be concerned about.. If I feel that it i not a ganglion we will investigate thoroughly and can talk about treatment options once we have a diagnosis.
To Schedule An Appointment
Call 02082438598