Diagnosis and treatment

Our hand and wrist specialists have access to the latest equipment and technology to support your diagnosis and treatment, including high-tech implants and joint replacements.

We can use specialist x-ray machines and equipment to record the electrical activity of the nervous system in scans such as a nerve conduction study (NCS). We also have a peripheral MRI scanner, which uses electromagnetic waves to produce computer images of internal structures.



Arthritis is the name for a number of conditions affecting the joints. Depending on the type of arthritis you have, it can cause pain and swelling, reduced movement, and breakdown of the bone and surrounding tissue.

Conditions affecting the tendons

Tendons connect bones with muscles. Common tendon problems include

  • tendonitis - where a tendon is swollen and sore
  • De Quervain's tenosynovitis - tendon irritation over the thumb side of the wrist
  • trigger finger - this is when a finger or thumb gets stuck in a bent or straight position, as a result of a knot forming in the tendon that is connected to the finger
  • tennis elbow - where the tendons in the elbow have been slightly torn
  • tendon ruptures, such as jersey finger, a flexor tendon rupture common in rugby players, and biceps tendon ruptures at the elbow seen in middle-aged men.

You can find out more about tendonitis and other tendon injuries on the NHS website.

Other common hand conditions

  • Ganglions - these are synovial swellings that can be found at the wrist and in the fingers. Only painful ganglions need treatment.
  • Dupuytren's contracture, where the tissue in the hand thickens so that the small joints of the hand develop contractures and can't move freely.

Nerve (neurological) conditions

This includes conditions such as carpal tunnel syndrome (pain, tingling, or numbness in the hand caused by a compressed nerve) and nerve tumours (growths on the nerves).

Other musculoskeletal disorders

These are problems with bones or muscles, such as fractures (broken bones) and crush injuries.

Treatments and services


Our hand and wrist specialists perform surgical procedures including

  • repairing a broken bone with screws, plates or rods
  • joint replacement (arthroplasty) - we replace joints such as wrists and thumbs. We may replace the distal interphalangeal joint (DIP joint, closest to the fingertip) or the proximal interphalangeal joint (PIP joint, or knuckle) to treat arthritis.
  • tenolysis - surgery to help a tendon move freely, which may be needed after an injury to the tendon or plating of finger fractures
  • a dermofasciectomy, used to treat Dupuytren's disease. The skin and thickened tissue is removed to enable the tendons to move, then a skin graft is applied.
  • carpal tunnel release, where some of the ligament in the wrist is cut to reduce the pressure on the nerve that causes carpal tunnel syndrome
  • tendon grafts and transfers. These may be required after a stroke or brain injury, or to reconstruct a joint after a major traumatic injury.

Non-surgical treatment

Our specialist physiotherapists and occupational therapists can treat some conditions as an alternative to surgery, depending on the type of problem and how severe it is.

Therapists also provide, fit and train you to use support equipment, such as a wrist splint to help treat mild carpal tunnel syndrome.

Tennis elbow treatment can include exercises to stretch and strengthen the forearm muscles, combined with supports to encourage the tendons to heal.

Our therapists also help you to recover from surgery, for example re-learning how to use your hand, wrist or elbow. They might work with you on a range of movement strengthening and control exercises, helping you to return to a fully functional everyday life.

Useful links

The Electronic Textbook of Hand Surgery explains common hand problems in plain English, with diagrams.