Numb hands and fingers
Many conditions affect the nerves in our body, but the most common area for nerve dysfunction is around the elbow and at the wrist. At these points, the nerves get compressed and the result is numbness and tingling (‘pins and needles’) in the hands. This is associated with night waking, pain and weakness, which causes the dropping of objects or a generalised ‘clumsiness’. If the symptoms and signs are classical, treatment can be started immediately. If the situation is more complex or atypical then testing the nerves to identify the locality of the problem may be advised.
Wearing of a splint to prevent positional exacerbation of the condition can often alleviate the early symptoms, especially with a period of behaviour modification and nerve glide exercises to allow the nerve to recover. Occasionally if this is not successful, a steroid injection can be administered. If the symptoms and signs completely resolve on a permanent basis, then no other treatment is necessary and the need for a surgical intervention is prevented. Otherwise the steroid injection can be repeated or surgical release of the local pressure on the nerve can be performed. This is called a tunnel release.
Steroid injections are usually painful for 1-2 days and then take approximately six weeks to take effect. The results of steroid injections can be permanent although most are temporary (lasting 6-9 months). Some of the symptoms may remain if the condition is severe. In these cases, the steroid injection can be repeated, but if the steroid injection fails, or an immediate solution is required, surgical alternatives can be explored if appropriate.
There is a small theoretical risk of an allergic reaction to the steroid injection, if a person has not had these injections before. The injection sites occasionally bruise and can swell. Infection is a small risk and like with any injection would be treated with antibiotics. When injecting around the tendons, infection may require an emergency operation, but this is extremely rare. Like with all other surgery, bleeding is also a theoretical risk. Tender scar tissue occasionally takes a few months to settle down with massage. The condition rarely recurs.
Steroid injections are very good at temporarily relieving symptoms and success is occasionally permanent. Releasing the pressure on the nerve surgically is very effective at relieving the symptoms of numbness and tingling permanently. Pain is usually improved although some scar tenderness and pillar pain (wrist discomfort) can occasionally prolong recovery.
The indicative prices below include the surgical fee, any anaesthetic used and the associated fees from the consultant administering this, in addition to the hospital fee and all tests and follow up. An accurate breakdown and a detailed quote will be given following the initial consultation.
From £250 for a steroid injection in the clinic
From £3,000 for nerve tunnel release
Following any injections or surgery on the hand, swelling and discomfort is inevitable. Elevation of the affected arm and non-steroidal anti-inflammatory medication helps. Early immobilisation for 48 hours helps recovery but must be followed by appropriately gauged mobilisation. Simple pain relief (paracetamol and/or ibuprofen) taken one hour before hand therapy rehabilitation allows more exercises to be undertaken. Desensitisation with moisturiser and massage helps scars to soften and become less painful.
- Surgery duration: 30 minutes
- Type of anaesthesia: Local anaesthetic
- Time in hospital: Day case
- Time off work: 2 weeks
- Recovery time: 6 weeks
- First follow up appointment: 1 week
- Total number of follow up appointments: 3
- Pain management: Simple pain relief (paracetamol and/or ibuprofen)
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