Hand and wrist

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The dexterity and complexity of human hands make them one of the most amazing parts of the human body. There are 27 small bones in each hand and wrist. Each finger contains three bones, the thumb has two and there are five bones in the palm of your hand. More than 30 different muscles control the hand and wrist, located in the hands, wrists and forearms. These are attached to the bones by tendons which pass through a bony passage in your wrist known as the carpal tunnel. The median nerve also passes through here. The many different bones, muscles and ligaments in the wrists and hands are what enable humans to make precise and complex movements, setting us apart from the rest of the animal kingdom.

Examinging hand and wrist in bandages

Hand and wrist conditions

Most of us use our hands and wrists continuously throughout our waking hours, from cleaning our teeth to tying our shoelaces. Some of these tasks can be repetitive, putting us at risk of repetitive strain damage. Tendons and ligaments may become inflamed from overuse and, as we age, there is a risk of arthritis in the basal joint at the base of the thumb. If we have a trip or fall, we tend to put out our hand to try and break the impact which can cause trauma-related injuries. Fractures can affect the bones of the wrist (radius and ulna) or hand (phalanges, metacarpals and carpals). The narrow structure of the carpal tunnel can also lead to problems if nerves and tendons become compressed. Hand and wrist pain can be debilitating and may have a significant impact on our day-to-day activities.

Private hand and wrist treatment at Harley Street Specialist Hospital

Harley Street Specialist Hospital is a leading team of world-renowned orthopaedic surgeons, offering the very latest approaches to diagnosis, treatment and prevention of hand and wrist problems. We take a holistic approach and always recommend non-invasive treatments wherever possible to avoid the risks of surgery. Where surgery is needed, we used the latest, minimally-invasive techniques to ensure the most speedy possible recovery. Our surgeons specialise in:

Hand/wrist arthritis

This is caused by the loss of cartilage, which normally cushions the joints and stops bones from rubbing together. Arthritis can affect the wrist and hands, particularly at the base of the thumb joint, resulting in pain, stiffness and a loss of movement. Depending on the severity of your condition, you may be advised to wear a wrist splint, given anti-inflammatories or surgery may be required.

Carpal tunnel syndrome

The carpal tunnel is a narrow passageway inside your wrist through which the median nerve passes. This nerve can become compressed, resulting in numbness and tingling in your hands and arm. Women are more often affected than men. Regular rest breaks, ice packs, anti-inflammatories and a corticosteroid injection can all help, as can wearing a wrist splint at night, however, severe cases may require surgery to relieve the pressure on the median nerve.

De Quervain’s syndrome

Also called De Quervain’s tenosynovitis, this is a painful condition that affects the tendons on the thumb side of the wrist. It causes problems grasping, turning the wrist or making a fist. Repetitive movements tend to exacerbate the pain. Treatment can involve wearing a splint or brace, taking painkillers, corticosteroid injections, and physio, but serious cases may need surgery.

Intersection syndrome

This is a form of wrist tendonitis, also called tenosynovitis of the radial wrist extensors. It is inflammation of the tendons in the wrist and back of the forearm at the point where two major tendons cross. The condition causes pain around the back of the wrist joint. Resting your wrist, wearing a brace, ice-packs, cortisone injections can all help, but severe cases may require debridement surgery to free the tight tissue surrounding the tendons.

Trigger finger

Also called stenosing tenosynovitis, this causes one of your fingers to become stuck in a bent position. The finger may bend or straighten with a snap or may be completely locked in a bent position. The condition is caused by inflammation which narrows the sheath surrounding the tendon, restricting movement. Anti-inflammatories, rest, wearing a splint at night, mobility-improving exercises, corticosteroid injections are among the treatments for less severe cases, but a percutaneous release procedure (tissue around the tendon is broken up using an ultrasound guided needle) may be necessary.

Ulnar nerve entrapment

The ulnar nerve travels from your shoulder to your little finger. It is located close to the skin’s surface and is particularly vulnerable to compression. This most commonly occurs inside the elbow (cubital tunnel syndrome) but it can also occur in the wrist (ulnar tunnel syndrome). Physio, ice-packs, anti-inflammatories and wearing a wrist splint may be recommended, but for severe cases, surgery such as ulnar nerve compression, may be required.

Wrist tendonitis

This is inflammation of the tendons in the wrist which control the movements of the fingers, hands and wrists. It is normally caused by repetitive movements or injury which cause the tendons to become inflamed and rub against the bone. Wearing a splint or cast, ice-packs, anti-inflammatories, cortisone injections, hand therapy and electrical stimulation/ultrasound are all effective treatments, however surgery to free up the tendon may be advised for the severest cases.

Why choose Harley Street Specialist Hospital?

At Harley Street Specialist Hospital, you can expect:

  • Our team of expert hand and wrist surgeons to offer rapid assessment and the latest treatments in comfortable central London surroundings, as well as video consultations from the comfort of your own home.
  • Holistic care, where you are an equal partner in the creation of your individualised treatment plan.
  • State of the art diagnostic imaging – you don’t need to go elsewhere as we have in house X-ray, ultrasound and image intensifiers.
  • Day-case and outpatient investigations and surgical procedures in a modern clinical setting.
  • No waiting lists and your treatment can take place at a convenient time for you.

We welcome patients with private medical insurance or those wishing to pay for their own treatment.

Our hand and wrist consultants