Shoulder, elbow, wrist and hand problems are common yet complex, and can have a significant impact on our ability to work, play sports or enjoy a good quality of life. In order to move our arms and hands freely, many different joints and muscles must work harmoniously to permit normal, pain-free motion. Symptoms such as pain, stiffness, weakness and paraesthesia (tingling) may be due to a number of different underlying conditions.
My primary goals are to provide an accurate diagnosis, and to formulate a treatment strategy to help ease, and wherever possible, eradicate your symptoms, in a patient-centred manner.
BSc(Hons), MB BS (Lond), MRCS (Eng), FRCS (Tr&Orth), PGCME
Symptoms arising from the shoulder are very common. Almost 1 in 3 of us will experience problems with the shoulder at any given time. Pain and stiffness are the most frequent symptoms people experience. Pain may be in the joint itself or radiate down the arm to the elbow. Certain movements of the arm may exacerbate the pain, such as using the hand stretched away from the body or reaching for something overhead. In severe cases, sleep may be disturbed, as it can be difficult to lie on the affected side. Stiffness often accompanies pain, frequently during rotational movements when the arm is held away from the body. Injury or degenerative changes in the joint and the surrounding muscles, tendons and ligaments are usually responsible for such symptoms.
A feeling of instability can also arise in the shoulder, often after an injury such as a dislocation, which may have damaged the fibrocartilage that supports the joint.
Disorders of the elbow can manifest as pain, stiffness, instability, weakness or a sensation of tingling in the hand (paraesthesia). Degenerative changes in the joint whereby the surface of the joint has become worn (arthritis) present predominantly as pain deep within the joint and stiffness. The stiffness may affect the flexion and extension (bending movements) or the rotation of the forearm and hand, depending on which part of the elbow is affected.
Pain on either the inside or outside of the elbow is commonly due to degenerative changes (tendinopathy) within the large tendons attached to the muscles responsible for movements of the wrist and gripping. Tingling (paraesthesia) affecting the fingers on the inner aspect of the hand can be due to compression of a nerve around the elbow. In severe cases, hand strength and co-ordination may be affected.
Symptoms in this area are frequently a combination of pain, stiffness, weakness and tingling (paraesthesia). Pain can be due to degenerative changes with the wrist joint itself, either of the cartilage that normally covers the small bones of the wrist or of the strong ligaments that help support the wrist. This can result in stiffness or instability and weakness depending on the pattern of damage.
Weakness and tingling (paraesthesia) can result from compression of the large nerves in the hands, that are responsible for the touch sensation and fine movements of the fingers.
Any of the complex structures in the upper limb may be damaged through injury, causing bony fractures, and/or muscle or tendon tears. Depending on the pattern of injury and the combination of structures involved, a variety of symptoms can arise.
I provide treatments for all fractures of the Shoulder, Arm, Elbow, Forearm, Wrist and Hand. In addition, I also treat problems that sometimes arise some time after a fracture, including when the bone does not heal properly (a so called "non-union") and joint stiffness (which is particularly common in the shoulder and elbow).