The Hand, Wrist and Elbow Surgery Service at Nottingham Road Clinic provides specialist assessment and management of conditions affecting the upper limb from the elbow to the fingertips. Disorders in this region are common and can significantly affect function, independence, work capacity and quality of life, particularly where pain, stiffness, weakness or altered sensation interfere with everyday activities.
Hand and upper limb conditions may arise from overuse, trauma, degenerative change, nerve compression, inflammatory disease or congenital variation. Even apparently minor problems can have a disproportionate impact, as the hands are central to most daily tasks, fine motor activities and work-related functions. Early, accurate diagnosis and timely management are therefore essential to minimise long-term disability and prevent avoidable progression.
The service is consultant led and delivered by clinicians with specialist training in hand, wrist and elbow surgery. Care follows evidence-based protocols and recognised UK clinical standards, with a focus on accurate diagnosis, appropriate use of conservative and interventional treatments, and clear explanation of management options.
The Hand, Wrist and Elbow Surgery Service is closely integrated with Nottingham Road Clinic’s diagnostic imaging, rheumatology, musculoskeletal and rehabilitation services. This supports a holistic approach, ensuring that underlying systemic conditions, occupational demands and functional goals are considered in planning care.
The Hand, Wrist and Elbow Surgery Service at Nottingham Road Clinic provides specialist assessment and management of conditions affecting the upper limb from the elbow to the fingertips. Disorders in this region are common and can significantly affect function, independence, work capacity and quality of life, particularly where pain, stiffness, weakness or altered sensation interfere with everyday activities.
Hand and upper limb conditions may arise from overuse, trauma, degenerative change, nerve compression, inflammatory disease or congenital variation. Even apparently minor problems can have a disproportionate impact, as the hands are central to most daily tasks, fine motor activities and work-related functions. Early, accurate diagnosis and timely management are therefore essential to minimise long-term disability and prevent avoidable progression.
The service is consultant led and delivered by clinicians with specialist training in hand, wrist and elbow surgery. Care follows evidence-based protocols and recognised UK clinical standards, with a focus on accurate diagnosis, appropriate use of conservative and interventional treatments, and clear explanation of management options.
The Hand, Wrist and Elbow Surgery Service is closely integrated with Nottingham Road Clinic’s diagnostic imaging, rheumatology, musculoskeletal and rehabilitation services. This supports a holistic approach, ensuring that underlying systemic conditions, occupational demands and functional goals are considered in planning care.
The service is suitable for adults with symptoms affecting the hand, wrist or elbow that require specialist assessment beyond routine primary care or general musculoskeletal management.
Typical presentations include:
Specialist assessment is particularly appropriate where symptoms interfere with work, driving, sport, caring responsibilities or daily activities such as gripping, lifting, typing or self-care. It is also indicated where there is diagnostic uncertainty, concern regarding structural damage or suspicion of nerve involvement.
The service supports both insured and self-pay patients. Referrals are welcomed from GPs, physiotherapists, rheumatologists, occupational health services and other healthcare professionals seeking specialist surgical opinion, diagnostic clarification or guidance on further management.
The Hand, Wrist and Elbow Surgery Service assesses and manages a wide range of upper limb conditions, recognising that symptoms may be driven by joint, tendon, ligament, nerve or soft-tissue pathology.
Common conditions include:
Nerve compression syndromes
Such as carpal tunnel syndrome and ulnar nerve compression, typically presenting with numbness, tingling, nocturnal symptoms, weakness or clumsiness affecting the hand.
Tendon disorders
Including trigger finger, De Quervain’s tenosynovitis, extensor or flexor tendon pathology and overuse-related tendinopathy causing pain, catching or restricted movement.
Degenerative and arthritic conditions
Osteoarthritis or inflammatory arthropathy affecting the small joints of the hand, thumb base, wrist or elbow, often causing pain, swelling, stiffness, reduced grip and functional limitation.
Post-traumatic conditions
Malunion, non-union, ligament injury, instability or stiffness following fractures, dislocations or soft-tissue trauma.
Elbow disorders
Including lateral or medial epicondylitis, elbow arthritis, instability and stiffness, with associated pain, weakness and reduced range of movement.
Masses and cysts
Such as ganglion cysts or other soft-tissue lumps, which may cause discomfort, cosmetic concern or functional interference.
Red-flag features
Red-flag symptoms such as severe unremitting pain, signs of infection, rapidly progressive deformity, acute loss of function or neurological deficit are prioritised for urgent assessment and investigation.
Assessment begins with a detailed clinical history, focusing on symptom onset, pattern, aggravating and relieving factors, occupational and recreational demands, and impact on function. Previous injuries, treatments and relevant systemic conditions (for example inflammatory arthritis or metabolic disease) are explored.
Physical examination is tailored to the affected region and may include
Diagnostic pathways are aligned with UK practice and may include ultrasound, X-ray, CT or MRI imaging where indicated to clarify joint, bone, ligament or soft-tissue pathology. Nerve conduction studies may be requested in suspected nerve compression or neuropathy. Blood tests are considered where inflammatory or systemic conditions are suspected.
Investigations are requested judiciously, with the aim of supporting clear diagnosis, planning management and avoiding unnecessary or duplicate testing.
Management is individualised and based on diagnosis, symptom severity, functional demands and patient preference. Treatment pathways typically progress from conservative to interventional options where appropriate.
Conservative management
This may include activity modification, splinting or bracing, targeted physiotherapy, occupational therapy input, analgesia and non-steroidal anti-inflammatory medication where clinically appropriate.
Injection therapies
Image-guided or landmark-guided steroid or other injections may be used in selected cases to reduce inflammation and pain, with clear discussion of benefits, risks and expected duration of effect.
Surgical management
Where conservative measures are insufficient or where structural pathology requires operative correction, surgical intervention may be recommended. Procedures are planned in line with current evidence and individual risk–benefit assessment.
Postoperative care and rehabilitation
Post-surgical management may involve splinting, wound care, physiotherapy and graded return to function. Follow-up appointments are arranged to monitor recovery, review outcomes and address any complications.
Throughout the pathway, care is taken to ensure that interventions are proportionate, evidence based and aligned with the patient’s functional goals and occupational needs.
The Hand, Wrist and Elbow Surgery Service works closely with radiology, rheumatology, physiotherapy, occupational therapy, pain management and primary care to provide joined-up care.
Diagnostic imaging and clinical sciences services support accurate assessment and monitoring. For patients with underlying systemic or rheumatological disease, joint working with rheumatology ensures that local surgical management is aligned with overall disease control.
Pain management or psychological support may be considered for patients with complex, persistent pain or significant functional impact. Where appropriate, onward referral to NHS secondary or tertiary services is coordinated for complex surgery, specialised rehabilitation or shared care.
Clear communication with referrers and GPs supports continuity of care, safe prescribing and long-term follow-up.
Appointments are structured to allow sufficient time for detailed assessment and discussion. Patients are encouraged to bring information on previous injuries, operations, imaging reports and any splints or supports currently used.
During the consultation, symptoms and their impact on daily activities, work and hobbies are explored. Examination findings and the likely diagnosis are explained in clear, accessible language. Where investigations are required, the rationale, process and expected timescales are discussed.
Management options, including conservative and surgical approaches where relevant, are outlined with explanation of expected benefits, risks and recovery timelines. A personalised care plan is agreed, and follow-up arrangements are confirmed. Written correspondence is provided to the referrer and GP to ensure shared understanding of the plan.
Do all hand or wrist problems require surgery
No. Many conditions can be managed with conservative treatments such as splinting, physiotherapy or injections. Surgery is considered only where clinically indicated and after discussion of alternatives.
Will I need a scan or X-ray
Imaging is requested when it is likely to change diagnosis or management. Not all patients require scans, and some conditions can be diagnosed on clinical assessment alone.
How long is recovery after surgery
Recovery time depends on the procedure, the condition being treated and individual factors. Typical recovery and rehabilitation expectations are discussed before any operation.
Can I continue working during treatment
This depends on the nature of the work and the condition being treated. Advice is tailored to individual circumstances, and phased return to work may be recommended.
Are there risks associated with injections or surgery
All procedures carry some risk. These are explained clearly in advance, and decisions are made jointly based on the expected benefits and potential complications.
Will my GP be kept informed
Yes. Detailed correspondence is shared with the GP and referrer to support ongoing care and coordination.
To book an appointment or discuss which clinician you should see first:
Phone: 01623 624137
Location: Nottingham Road Clinic, 195 Nottingham Road Mansfield NG18 4AA
