Upper Limb

Shrewsbury and Telford Hospital Upper Limb Service provides a wide range of Orthopaedic treatments for the shoulder, elbow, wrist and hand. This includes support from Nurse Practitioners, Hand Therapist and dedicated Upper Limb Physiotherapists.

The Upper Limb Team at Princess Royal Hospital prides itself for the comprehensive service that they provide patients, including the award-winning ‘One Stop Carpal Tunnel Screening Clinic’ led by Nurse Practitioners.

Conditions treated include:

  • Shoulder replacement for Osteoarthritis
  • Arthroscopic (key-hole) shoulder surgery, including rotator cuff repair, shoulder stabilisation and ACJ reconstruction
  • Elbow replacement, elbow instability and arthroscopic elbow surgery
  • A wide range of hand surgeries, including carpal tunnel decompression, dupuytrens surgery, osteoarthritis of the thumb and fingers, Joint replacement and arthroscopic wrist surgery.
  • Sports related injuries to the upper limb

We run an award-winning Practitioner-led Carpal Tunnel Screening Service.

What are Nerve Conduction Studies (NCS)?

These are simple, routine tests that specialists perform to investigate how your nerves work.

Why am I having the test done?

Your Consultant/GP has asked for you to have the test to assist in making a diagnosis of carpal tunnel syndrome.

Where will I have the tests done?

The tests are performed in the orthopaedic out patient department at the Princess Royal Hospital (PRH), Telford.

How long does it take?

The tests usually take 30-45 minutes but can occasionally take up to an hour. We hope you appreciate that due to this variation, some appointments occasionally run late.

Please arrive promptly for your appointment.

Who will do the tests?

The test will be carried out by either a Nurse practitioner or Hand therapist both specialising in upper limb/carpal tunnel assessment & diagnosis. The room used to carry out the test is quite small. However, there is room for someone to come with you, should you wish.

What do the tests involve?

As you are taken into the recording room you will be asked to warm up your hands in warm water. It is essential that your hands are at the correct temperature for the nerve conduction test to be carried out. An infra red thermometer will be used to check the temperature of your hands.

The Nerve Conduction Study (NCS)

This involves placing felt or sticky pads along certain parts of your hand/fingers and elbow. The practitioner will then stimulate your nerve(s). During this short time you will feel a throbbing sensation – a similar feeling to a TENS machine or muscle-toning belt. Most people can tolerate this, but some may find it uncomfortable or painful. It is only on for several seconds at a time. A number of nerves are tested. During the recording it is important to be as relaxed as possible. This enables us to record clear signals and helps lessen electrical interference when stimulating your nerves.

Do I need to bring anything?

No, you do not need to bring anything to these tests.

Do I need to do anything?

Please inform us if you have a cardiac pacemaker, if you are diabetic or if you have ever had MRSA.

Please try to wear loose clothing around the upper part of your body and loose sleeves so we can easily get to these areas to test your upper limbs. You are not normally required to undress but please be advised this is a possibility if you are wearing restrictive clothing over the areas to be tested.

We will ask you to remove any bracelets and watches before we start the tests.

Feel free to eat and drink before the test as you would do normally.

What happens afterwards?

The NCS should not leave you with any side effects.

When will I receive my results?

You may not get any results on the day as your results may need to be discussed with a colleague/ consultant before a diagnosis can be made.

A small percentage of patients may require further testing either on the same day or at a later date. This will normally be the case if the practitioner is unable to obtain sufficient information about your nerves and wishes to obtain further testing and a second opinion. If this should occur a referral may be made for you to have further nerve tests at Telford under the care of a Consultant Neurophysiologist or a colleague at the PRH to verify the results.

Further information

If you require any further information please feel free to contact one of the practitioners direct and we will do our very best to answer your questions. We would also be grateful if you could inform us if you are unable to make your appointment on the date given to you and an alternative date/time will be arranged.

We also run specialist Osteoporosis Clinics  – Contact Jan Flavell for further information.

Jan Flavell

Nurse Practitioner Orthopaedics/Trauma – Tel. 01952 641222

Available Monday – Friday (except Wednesdays) 07.00-16.00

Email: janet.flavell-raybone@nhs.net

Suzanne Sharp

Clinical Specialist, Occupational Therapy (Hand Therapy) – Tel. 01952 641222 Ext: 4102

Available Tuesday, Thursday & Friday 8.00-17.00

Email: suzanne.sharp1@nhs.net

Meet the Team

Upper Limb – Consultants

Upper Limb – Nurse Practitioner’s