• Carpal Tunnel Syndrome
• Dupuytren's Contracture
• Ganglion Cysts
• De Quervain's Stenosing Tenosynovitis
• Stenosing Tenosynovitis (trigger finger/thumb)
• Acute tendon trauma (flexor/extensor)

Carpal Tunnel Syndrome can occur in either one or both hands and is a result of a pinched nerve (the median nerve) at the wrist, causing tingling (or even pain) and numbness of the fingers in the affected hand. The exact causes are unknown but it occurs when pressure builds up in the carpal tunnel which houses the median nerve, thereby pressing on the nerve. Symptoms can worsen during pregnancy, in patients with diabetes or arthritis, or as a result of overuse of the hand.

If non-surgical treatment fails to alleviate the problem, surgery aims at increasing the size of the carpal tunnel, thereby relieving the pressure on the nerve contained within the tunnel. The procedure is performed as a day only procedure in hosptial and sutures are removed on Day 10 post-operatively. Recovery can be aided by hand therapy and patients usually return to work the next day in non-clerical roles, and manual work after two weeks.

Dupuytren's Contracture is an inherited disorder of the hand where bands of thickened tissue form under the skin of the palm and pulls the fingers towards the palm.

Treatment is by way of surgery in hospital to cut and seperate the bands to allow free movement of the fingers. The procedure is a day only procedure with most patients returning to work after two to three weeks. Hand therapy can assist in the recovery following surgery.

Ganglion cysts are benign lumps which can occur on the hand, fingers and wrist. There is no known cause and they vary in size and degree of pain, the majority being painless unless aggravated by strenuous use of the hand.

Treatment may include splinting of the hand to restrict movement and alleviate pain or removing fluid from the cyst. Surgery would aim at removing the cyst altogether and is usually considered if the cyst is too painful or is too large and unsightly. This can be done under local anaesthetic and can be done at the practice rooms in Epping. Recovery takes 2-3 days and most patients will return to work when comfort permits.

De Quervain's disease is characterised by pain in the thumb and the thumb side of the wrist especially when making a fist and bending the fist in the direction of the little finger. The pain is caused by swelling of the tendons on the thumb side of the wrist.

Splinting of the thumb and wrist and anti-inflammatory medication may help, but if symptoms do not improve, surgery is indicated to open up the compartment surrounding the tendons. Surgery will be done in hospital as a day only procedure. The hand is then splinted for two weeks and combined with hand therapy , normal function of the hand will be attained.

Trigger finger is a "catching" of the tendon when a finger or thumb is extended due to swelling of the tendon sheath. Causes are unclear but do commonly occur in people with diabetes or arthritis.

Non-surgical treatment is by way of splinting the finger and anti-inflammatory medication, but if this is unsuccessful, surgery may be indicated. Surgery to relieve the triggering is usually done as a day only procedure under a general anaesthetic with torniquet control, releasing the spot where the tendon catches. Patients can usually return to work within the week.

Injuries to the tendons in the hand rarely fix themselves without surgery. Tendons require their ends to be sutured together when they are cut. This also may require some minor probing and repair following injury to ensure full use of the finger will return.

Minor surgery can be done at Epping in the practice but if more complex surgery is required, this can be arranged through hospital. Recovery will depend on the extent of the injury and it may be assisted by occupational hand therapy.