Nerve Palsy
Expert Care for Nerve Palsy
Affecting the Hand and Wrist
The hands rely on a complex network of nerves to control movement, sensation and strength. When these nerves are damaged or compressed, it can result in nerve palsy, leading to weakness, impaired function and difficulty performing everyday tasks.
Nerve palsy in the hand and wrist can develop from various causes, including nerve compression, trauma, or underlying neurological conditions. Without appropriate treatment, symptoms can worsen over time, impacting dexterity and grip strength.
At UK Hand and Wrist Surgery, we provide specialist treatment for nerve palsy, helping patients regain movement and function through advanced medical and surgical techniques. Led by Specialist Hand Surgeon Mr Patrick Goon, our team offers personalised care, ensuring each patient receives the most effective treatment for their condition.
What is Nerve Palsy or neuropathy ?
Nerve palsy refers to a condition where certain nerves controlling muscle movement become impaired, leading to weakness or paralysis in the affected side. It can affect different nerves in the upper limb, resulting in loss of function in the wrist, hand, or fingers.
Common types of nerve palsy affecting the hand include:
- Radial Nerve Palsy – Causes difficulty extending the wrist and fingers, leading to wrist drop.
- Ulnar Nerve Palsy – Weakens grip strength and finger coordination.Can result in ‘clawed’ appearance. Sensory disturbance
- Median Nerve Palsy – Affects the ability to flex the thumb and fingers, making fine motor tasks difficult. Thumb opposition is affected. Sensory disturbance.
- Brachial Plexus Palsy – Results from damage to the nerve network controlling the arm, leading to weakness or paralysis in the affected side.
Each type of nerve palsy requires a tailored approach to treatment, depending on the severity and underlying cause.
Symptoms of Nerve Neuropathy
Recognising symptoms early can help prevent the condition from worsening. Common signs of nerve palsy affecting the hand include:
- Weakness or Paralysis – Difficulty moving the wrist, hand, or fingers due to loss of muscle control.
- Tingling or Numbness – Reduced sensation in the affected side, often caused by nerve compression.
- New Nerve Pain – sometimes pain is a significant presentation, indicating nerve injury, or ongoing pathology like ischaemia.
- Loss of Grip Strength – Difficulty holding or manipulating objects due to impaired sensation, movement and coordination of the hand.
- Muscle Wasting – In long-standing cases, reduced use of the hand can lead to muscle shrinkage.
- Chronic Nerve Pain – sometimes nerve pain becomes chronic and refractory to medical treatment: surgery with advanced microsurgical techniques can help treat these difficult cases. CRPS (Complex Regional Pain Syndrome) can occasionally be included in this latter category.
Nerve palsy can affect hand function, causing weakness, loss of grip strength and difficulty with everyday tasks.
Diagnosing Nerve Neuropathy
At UK Hand and Wrist Surgery, we use a detailed diagnostic process to evaluate nerve palsy and its severity. This may include:
- Clinical Examination – Assessing control of movement in the hand, identifying muscle weakness and checking for sensory loss. Specialist clinical tests may be useful.
- Imaging Tests – A Brain MRI or MRI scan of the upper limb may be conducted to detect structural issues, such as nerve entrapment or inflammation.
- Nerve Conduction Studies – These tests measure the electrical activity of certain nerves, helping to determine the extent of nerve dysfunction.
Early diagnosis allows for timely intervention, improving the chances of restoring function and preventing further nerve deterioration.
Treatment Options for Nerve Palsy
Non-Surgical Treatment
Many cases of nerve palsy can be managed with conservative treatments, including:
- Splinting and Bracing – To stabilise the hand and improve function while the nerve recovers.
- Physical Therapy – Targeted exercises to strengthen muscles and enhance coordination
- Medications – In cases where inflammation is a factor, anti-inflammatory medications may help reduce swelling around the affected nerve.
Surgical Treatment
If non-surgical options do not provide sufficient improvement, surgical intervention may be recommended. Surgical options include:
- Nerve Decompression Surgery – Relieving pressure on compressed nerves to restore function.
- Nerve Transfer surgery – Sometimes transferring a nearby healthy nerve to the affected nerve may restore function, or speed up recovery
- Tendon Transfer surgery – In cases of severe palsy, healthy tendons may be rerouted to compensate for lost function.
- Nerve Grafting – If a nerve is extensively damaged, a graft from another part of the body may help repair it.
Both surgical and non-surgical treatments for nerve palsy aim to improve strength, coordination and overall hand mobility.
Benefits of Early Intervention
Seeking timely treatment for nerve palsy can offer numerous advantages:
- Prevents further muscle weakness and joint stiffness
- Increases the likelihood of nerve recovery
- Improves hand function and overall dexterity
- Reduces discomfort and enhances quality of life
Ignoring symptoms may lead to permanent loss of function, making early diagnosis and intervention essential.
Recovery and Aftercare
Recovery from nerve palsy treatment varies depending on the severity of the condition and the treatment method used. A structured rehabilitation plan may include:
- Immobilisation – Bracing or splinting to protect the nerve during the initial healing phase.
- Physical Therapy – Progressive exercises to strengthen muscles and improve mobility.
- Regular Follow-Ups – Monitoring nerve recovery with periodic assessments.
Mr Goon and the team at UK Hand and Wrist Surgery provide individualised recovery plans, ensuring that each patient regains as much function as possible.
Why Choose UK Hand and Wrist Surgery for
Nerve Palsy Treatment?
At UK Hand and Wrist Surgery, we offer specialist expertise in treating hand and wrist conditions, including complex nerve palsy cases. Microsurgical experience and expertise is imperative when dealing with surgical nerve pathology, and patients can be confident that their surgeon can provide both. Under the guidance of Mr Patrick Goon, patients receive personalised treatment plans, whether through non-surgical rehabilitation or advanced surgical techniques.
With a commitment to cutting-edge treatments and patient-centred care, our team ensures that every individual receives the highest standard of treatment for nerve palsy affecting the hand and wrist. If you are experiencing symptoms of nerve palsy, book a consultation today to explore your treatment options and take the first step toward recovery.
Meet Mr Patrick Goon
Mr Goon, a highly trained Specialist Hand Surgeon, leads our clinic with expertise and a commitment to excellence in care. His experience spans a range of simple to complex procedures, from carpal tunnel release to wrist fusion and tendon repair. His focus on minimally invasive techniques supports optimal recovery and reduces post-operative discomfort, ensuring patients achieve the best possible outcomes.
Find out more
Book an Appointment with Mr Goon
If you are suffering from a hand or wrist problem, please use the online form to contact us and arrange an appointment with Mr Goon. Alternatively, you can call us on 07355 571488 or email us at enquiries@handwristsurgery.co.uk
Frequently Asked Questions
What are the main causes of nerve palsy in the hand and wrist?
Nerve palsy in the hand and wrist can result from nerve compression, trauma, or underlying neurological conditions. Common risk factors include repetitive strain, direct injuries, diabetes (affecting small blood vessels that supply nerves) and inflammatory disorders. In some cases, nerve palsy may also develop following surgery or prolonged pressure on the nerve.
How is nerve palsy diagnosed?
Diagnosis involves a clinical examination and testing for muscle weakness, sensation loss and impaired movement in the affected side. Additional tests, such as nerve conduction studies, MRI scans, or magnetic resonance imaging, may be used to assess nerve function and identify underlying causes.
Can nerve palsy in the hand improve without surgery?
Yes, many cases of nerve palsy can improve with non-surgical treatment, such as splinting, physical therapy and addressing risk factors like underlying health conditions. However, in cases of severe nerve damage, surgical intervention may be necessary to restore function.
Is nerve palsy related to cranial nerve palsies?
While nerve palsy in the hand affects peripheral nerves, cranial nerve palsies, including sixth cranial nerve palsies, impact cranial nerves controlling functions such as eye movement. Conditions like sixth nerve palsy, which affects the lateral rectus muscle of the affected eye, are distinct from nerve palsy in the hand but share similarities in terms of nerve dysfunction and treatment approaches.
What Our Patients Say
Written by a NHS patient at Lister Hospital
5th July 2024
I managed to dislocate one knuckle and badly break another knuckle in the same finger into multiple pieces, an injury which every Healthcare Professional that saw the X-ray told me was not only severe damage but also a particularly rare injury. Mr Goon and his team screwed the knuckle back together, which was particularly fiddly given the multiple small pieces.
After the operation I was given a number of exercises which were progressively added to over a series of regular appointments, both with Mr Goon and multiple Hand Therapists, to check and monitor my progress. I followed their instructions as closely as I could, both in frequency of exercising and how far to push the injury (I did want to actually recover fully after all, so why would I have not listened to the experts!), even though this was sometimes inconvenient or sore.
I’m delighted to say that I now have full use and movement of the finger and a scar which is unnoticeable unless you look very closely for it. Mr Goon and his team are all a credit to the NHS, not only due to their expertise, but all kept a very friendly and positive attitude at all times not just about the potential recovery but also with their general demeanor, were always supportive and happy to answer any question I had, even if I was worried they may have been obvious answers, and were always clear about the next steps I needed to take.
It’s also worth mentioning for anyone that may be critical of the NHS which is clearly currently under intense pressure based on the number of patients in the Hospital ever time I went in, I sustained the injury on a Wednesday evening, had the dislocation sorted at a Hospital walk-in clinic within 1.5 hours and had met the surgeon, gone through the options and procedure and was in surgery by Saturday morning. Mr Goon even came to see me himself and tell me how the procedure had gone as soon as I was fully awake. This shows what an amazing service the NHS actually provides, and I didn’t have to pay a penny.
The whole experience has far exceeded my expectations and I can only thank Mr Goon and his entire team for the amazing work that they have done to ensure my full recovery.
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Written by a NHS patient at Lister Hospital
3rd October 2024
I had an accident at work that led to part of my finger being cut off. Mr. Goon has been treating me, and thanks to his skill, I’ve actually got that part of my finger back, including the nail. Honestly didn’t think that’d be possible, especially not so soon. I’m really grateful to have had such a great doctor during such a rough time. It couldn’t have gone better. Joe Efford
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Written by a NHS patient at Lister Hospital
10th October 2024
I saw Dr Goon following an accident with a horse which resulted in numerous breakages in my thumb. Having had numerous visits and having experienced terrible pain I was not sure if Doctor Goon could help. How wrong I was, he was extremely good in every aspect of his work getting my pain under control pretty quickly. He reassured me, listening to my concerns and always made me feel completely at ease. He has a very positive attitude at all times with every visit exceeding my expectations. I will require further surgery but I am not concerned as I cannot fault the care from Mr Goon and his great team to date. I know I will be in safe hands. He is indeed “The Miracle Man”.
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