Chronic wrist pain can significantly limit daily life, from work tasks to simple activities like opening a jar or typing on a keyboard. For some individuals, conservative treatments such as physical therapy, medication, or injections don’t provide sufficient relief. In such cases, surgical options like wrist denervation may offer a promising path toward reducing pain while preserving motion. At Lake Country Plastic and Hand Surgery in Waukesha, WI, Dr. Tracy McCall and her team often educate patients about surgical solutions for persistent wrist pain. This blog aims to provide a thorough understanding of wrist denervation, how it works, and what patients can expect from this specialized procedure.
Understanding Wrist Denervation
Wrist denervation is a surgical procedure aimed at reducing chronic wrist pain by selectively cutting or removing small sensory nerve branches that carry pain signals from the wrist joint to the brain. Importantly, the procedure targets only the nerves responsible for sensation, not those controlling movement, meaning patients typically retain wrist mobility and strength. The goal is to alleviate pain without resorting to more extensive surgeries such as joint fusion or complete wrist replacement.
The most common reason patients undergo wrist denervation is arthritis, particularly when joint surfaces are worn down and causing persistent discomfort. However, it can also be considered for pain from prior injuries, mild instability, or early stages of degenerative joint disease. By interrupting pain pathways, denervation can offer substantial symptom relief for those who might otherwise face more drastic surgical solutions.
The Wrist Denervation Procedure
Wrist denervation is typically performed under regional or general anesthesia, depending on the patient’s overall health and the surgeon’s recommendation. The operation usually takes one to two hours. Through several small incisions, the surgeon carefully identifies and removes or severs specific sensory nerves around the wrist joint. Common targets include branches of the posterior interosseous nerve and anterior interosseous nerve, among others. Precision is key, as surgeons aim to eliminate pain signals while preserving as much normal sensation and function as possible.
Compared to other surgical options, wrist denervation is less invasive and often involves shorter recovery times. Because the bones and joint structures remain intact, the wrist maintains its range of motion, an important advantage over procedures like partial or total wrist fusion, which restrict movement significantly. Still, it’s essential for patients to understand that denervation is primarily aimed at pain reduction, not restoration of damaged cartilage or joint surfaces.
Recovery and Rehabilitation After Denervation
Recovery following wrist denervation is generally quicker than for more extensive wrist surgeries. Patients may go home the same day or after a short hospital stay. A soft dressing or splint is usually placed on the wrist to protect the surgical sites for several days. Early gentle movements are encouraged under the guidance of a hand therapist or surgeon to prevent stiffness and maintain mobility.
Pain levels typically decrease in the weeks after surgery, although some patients may experience temporary numbness or tingling due to nerve manipulation. Most individuals can resume light activities within a couple of weeks, though returning to more physically demanding tasks may take several weeks to a couple of months, depending on the nature of their work and overall healing.
While many patients report significant pain relief, it’s important to recognize that denervation doesn’t “cure” underlying arthritis or joint degeneration. Pain can return over time if nerves regenerate or if joint damage progresses. However, for many people, denervation offers meaningful symptom relief and delays the need for more aggressive procedures.
Who Is a Good Candidate for Wrist Denervation?
Not everyone with wrist pain will benefit from denervation. Ideal candidates are individuals with chronic wrist pain that has not responded to conservative measures, whose primary complaint is pain rather than significant joint instability or deformity. Imaging studies, such as X-rays or MRI scans, help confirm the diagnosis and ensure there’s no severe joint collapse or widespread damage that would make other surgeries more suitable.
Patients considering wrist denervation should have a thorough discussion with a hand surgeon to weigh the benefits and limitations of the procedure. Realistic expectations are crucial; while many experience substantial pain relief, denervation isn’t guaranteed to eliminate all discomfort. Additionally, some patients may eventually require further surgical intervention if symptoms recur.
Potential Risks and Complications
Though generally safe, wrist denervation, like all surgeries, carries certain risks. Possible complications include infection, bleeding, nerve injury leading to unintended numbness or altered sensation, and persistent or recurrent pain. Some patients might experience scar tenderness or hypersensitivity in the surgical area.
It’s also possible for pain to return over time as nerve fibers regenerate. In such cases, further treatments—including repeat denervation, pain management strategies, or more extensive surgeries—might be necessary. Fortunately, many patients report high satisfaction rates and significant improvements in quality of life after the procedure.
Long-Term Outlook and Patient Perspectives
The long-term success of wrist denervation varies among individuals, depending on the underlying condition and personal healing response. Studies suggest that many patients achieve substantial pain relief lasting several years. However, because arthritis and joint degeneration can progress, the procedure is sometimes viewed as a way to “buy time” and delay more invasive surgeries like fusion or replacement.
Patients who’ve undergone wrist denervation often report that even partial pain reduction significantly improves daily functioning, allowing them to return to hobbies, work, and activities that were previously limited. Continued collaboration with a hand specialist, including regular follow-ups, ensures that any recurring symptoms are addressed promptly.
At Lake Country Plastic and Hand Surgery in Waukesha, WI, Dr. Tracy McCall and her team are dedicated to helping individuals explore surgical and non-surgical options for chronic wrist pain. Whether considering wrist denervation or other treatments, patients are encouraged to gather information, ask questions, and work closely with their medical team to find the best path toward relief and improved quality of life.
Resources
Chung, K. C., & Pillsbury, M. S. (2010). Surgical Denervation for the Painful Wrist: Indications and Outcomes. The Journal of Hand Surgery.
Vilkki, S. K. (1993). Partial Denervation of the Wrist for Chronic Pain. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery.
Berger, R. A. (2001). Surgical Techniques in the Management of Degenerative Wrist Disorders. Hand Clinics.