Ortho surgeon recommendations for carpal tunnel?

A snowHead

Evening snowheads!

I'm aware a fair few regular posters are either in the medical profession or direct experience of orthopaedic surgery (ouch!) so thought I'd ask the collective brain trust for any recommendations on surgeons for carpal tunnel syndrome....

My 83 year old father has been diagnosed with acute CTS in his dominant hand (6 on the severity scale). Following that assessment the hospital has recommended surgery and suggested he look around for the best specialist he can find - apparently it's a bit of a one-shot deal in terms of needing to get it right?
Will likely be via the NHS but depending on waiting list times private may be an option. He is in North Lincs (on the border with South Yorks and East Yorks) so potential area could include Hull, Doncaster, Lincoln etc.

My sister and I are helping him with this and we have a couple of weeks to look around. Any personal experience or professional recommendations would be gratefully received!

Thanks in advance!

A snowHead

Hi @largeyorkshireman,

I had my right (dominant) wrist done about 10 years back then chose a couple of years later not to have my left one done. The op was done at a private clinic but paid for by the nhs, with a local anaesthetic. The surgeon was a GP who`d had specialist training and did nothing much but that op every day. She allowed my wanna be doctor son (he now is a GP) to observe.

A friend of mine had hers done under general anaesthetic at our local hospital coincidentally the same week.

Both ops were deemed a success, I had a minor allergic reaction to the stitches but otherwise we both recovered pretty much as predicted. We were given different post op care plans, with mine seemingly involving much more exercise and wrist usage from day one and hers more rest and gentle exercise, both of us had to work on de-sensitising the scar. In spite of the quite different care plans our recovery was similar. Do not underestimate the weakness in the hand at first though, and indeed for me slight ongoing weakness in one direction (my wrists are made a bit weird anyway) but not for my friend.

I wanted to watch my op but flaked out when I was given the local (the doc should have warned me how much it would hurt!) so had to lay down in stead of sitting in the chair. My son said it was fascinating and I was jealous I did not get to watch.

The op did stop the most of the night time pins & needles and numbness but not all of it. I still can not use equipment like a lawnmower or hedge trimmer for more than a few minutes at a time without getting pins & needles in both hands and I doubt this op would have been recommended for me today. I understand it was a common 'fix all' 10 years or so ago and now it`s no longer viewed in that way, though it must still have relevance for some.

I hope you find a good surgeon for the procedure, I would expect there are still many very practised at this op, surgeons out there.

Well, the person's real but it's just a made up name, see?

I have mild CTS (numbness and pins and needles at night, worse in left hand) and occasionally very mildly during the day - like right now, for instance, typing on laptop. My wrists are problematic - I use special stands for exercises like planks. On the rower I have to be careful how I use my wrists, to keep my hands in line with my arms, not drop them on the forward stroke.

I e-consulted my GP who suggested wrist splints. Bought from Amazon - a cheap and very effective solution but they are a bit of a pain. I don't always use them, and am conscious of the need to keep my wrists in the right position, but the problem definitely exacerbates other reasons (including old age) why I don't sleep as well as I once did.

Some years ago now I took my mother in law to Southampton hospital for a series of tests involving electrical stimulation of the nerves, to ascertain the extent of her problem. She had dementia even back then, but seemed to understand what was going on and was prompt and clear in her responses. They said she had the "worst level" of CTS in both wrists and she was subsequently told it would get worse if not dealt with and she could become quite disabled.

She did have some surgery subsequently - but only on one wrist I think.

As it stands, I'll just stick to the wrist splints, but I guess I'd have to consider surgery if it got substantially worse. I get the impression it's a very common problem. I'll be interested to follow this thread. I can't imagine CTS release surgery is a high priority for the NHS at the moment!

You need to Login to know who's really who.

Thanks both. Dad is 83 and lives alone but currently can't do up buttons and struggles to pick anything up. He was assessed earlier this week as having the worst level of CTS. Not directly life-threatening and I agree the wait for NHS surgery will likely be very long! We are in the fortunate position of being able to stretch things and fund private treatment if necessary, especially given the impact on his independence and quality of life. Fingers crossed someone will be able to recommend some surgeons in the region and we'll look into all options.

Anyway, snowHeads is much more fun if you do.

Presumably it's not too expensive an op? Not being able to do up buttons and similar tasks must be really undermining his independence.

You'll need to Register first of course.

@pam w, I wore night splints for many years, they mitigated the night time issues to a certain extent, I also had some steroid jabs which helped short term, but the best solution for me to avoid pain and numbness was to to stop doing the things that caused most problems, ie using certain types of machines. That being said I still now struggle. I can`t feel thread when I try to sew (always hated sewing anyway), struggle to tie knots in string, and particularly irritating for me I can`t ice cakes very well anymore (I did love doing that!). I was in my 50`s when I had my op! Wear and tear on the body happens to all us and sometimes there is help, and sometimes not.

@largeyorkshireman, I really hope that this particular surgery helps your Dad.

Then you can post your own questions or snow reports...

@largeyorkshireman, I know a couple of people who have used Mike Hayton for various hand/wrist issues inc CTS

After all it is free

Thanks all for the good wishes and @srobbo for the name, much appreciated. Will take a look at Mike Hayton.

I had both mine done about 6 years ago mainly because it impacted my sleep so badly with the line and needles. I was offered both to be done at the same time but declined as I was a busy parent at the time. Glad I did as I just don’t know how anyone copes with both at the same time. All I’ll say is that I was so pleased I had the ops - they improved my life dramatically. Good luck to your dad, I’m sure he’ll be glad he had it done. My surgeon was Jeremy field but we’re down south so probably no good to you.

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@largeyorkshireman,
As that age be sure non op measures have been tried.
Simple splints at night can be very helpful, especially as symptoms often most troublesome at night. The wrist splint just needs to hold the wrist slightly extended. Ie cocked back a few degrees as the Carpal tunnel is tighter as you flex the wrist.
Also steroid injections can be helpful.
If he wishes to proceed with surgery it is definitely one to be done under local anaesthetic. There should be someone in your areas doing lots as it’s a common operation. Hand specialist surgeon and in our area the neurosurgeons do them.
Jonathan Bell

snowHeads are a friendly bunch.

Many thanks all for your replies, advice and good wishes. Mike Hayton in Manchester was a bit far, as were those down South but the recommendations are very much appreciated. We have had a few personal recommendations in our region and Dad has a consultation with Joe Garcia in Sheffield next month.

And thanks @Jonathan Bell for the additional advice. Dad's NHS consultant who did the initial assessment said one wrist is already too bad for cortisone or other non-surgical treatment. I assume Mr Garcia will do his own assessment so will see what comes of that. Any surgery will definitely be under a local, but better to avoid any cutting at all if possible!
In the meantime Dad's using some sort of split at night and that seems to make him more comfortable.

snow reports

Anyone working out of the Pulvertaft unit at Derby. They’re all fab, would do carpal tunnel releases on a daycase basis and it’s not too far from Lincolnshire.

Not sure that it is relevant, years ago had numb fingers and went to see nerve guy at St Richards at Chichester, who suggested pinched nerves at my elbow and could operate with non guaranteed outcome, so left it. A few years later I had a crocked (other) arm and visited an osteopath, he did some clicky stuff with my back, he didn’t fix the crocked arm, but numb fingers cured!

You know it makes sense.

Hi all,

Quick update to close this off: Dad has his op with Joe Garcia couple of weeks ago. All seems to have gone really well - he's already able to do much more than before and feeling is returning to his fingers. Entire experience was excellent and post-op comments from the local nurse/GP are very positive in terms of comparisons with others they've seen. Would recommend Mr Garcia to anyone in the Sheffield(ish) area looking for a hand specialist.

Many thanks to everyone who offered advice and shared their experiences - much appreciated!

Otherwise you'll just go on seeing the one name:

Very good news @largeyorkshireman - thanks for the feedback.

Help!!

Ortho surgeon recommendations for carpal tunnel?

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