Less invasive surgery eases pain

CHENNAI: Twenty two year- old Priyanka (name changed) had been suffering from severe pain on her wrist due to rheumatoid arthritis for several years.But in the past two years, the pain had grown unbearable and she could not even more her hands freely.Just when there was no solution in sight, Priyanka came across a rare form of wrist surgery that reduces the pain and could make her limbs active again.Commonly called ‘wrist denervation’, it is a minimal invasive surgery in which the sensory nerves are tampered with.Dr N Ragunathan, the Orthopaedician who conducted the surgery on Priyanka said, “Even as the patient was under medication for last eight years for RA, her right wrist was completely crippled when she came here.” The procedure involved removal of terminal branches of nerves that carry the sensation of pain from respective parts to the brain.“We’ll block nerves in the wrist sequentially with local anesthesia to single out the pain fibres and cut them permanently. Other sensory nerves between fingers and the brain will function normally and there won’t be any side effects,” said Dr Ragunathan. He added that the patient could leave the hospital in two days and start work in a week.He was not far from the truth. Priyanka can now lift more than a kilogram of weight barely two weeks after her surgery without feeling even a slight pinch of pain.According to him, wrist denervation was a blind procedure and required conscious participation of patients. “They have to say when they’’re feeling less or no pain while we block the nerves, and after the surgery they can feel the same or better, relief”, he assured.The only option that was available earlier was fusion that arrests the movement of the wrist by inserting plates, which involves a major surgery. “It will leave a big scar and movements will be completely restricted.Possibilities of failure of surgery and infections are also high, whereas, with wrist denervation, patients can still move hands freely and the small scar will vanish very soon too,” he says.Ragunathan says wrist denervation is a boon for young people with arthritis, as they can work after the surgery. “In case the pain resumes after 20 years, they can go for fusion.” When asked about the low popularity of the wrist denervation, despite it being a simple procedure, Dr Ragunathan blames it on the lack of awareness among doctors.He says, “The awareness level is very low even among orthopaedicians about wrists and they usually prescribe pain killers, without giving it a second thought.”