Our team provide specialist care to adults and children from Greater Manchester and Lancashire with the following conditions:
Clinicians who wish to refer patients with any of these conditions are asked to look at our referral guidance page.
The brachial plexus is the name we give to the web of nerves that start from the neck and provide all of the sensation and movement to the shoulder, elbow, wrist and hand.
These nerves are well protected, but can occasionally be damaged when people sustain significant injuries including shoulder dislocations or in vehicle accidents. Rarely these nerves can also be affected by infection or inflammation. The result of such nerve damage is loss of feeling and movement in parts or all of the affected arm.
We all share a very similar pattern of these nerves, so with detailed examination and special tests our surgeons can diagnose the problem and discuss options for treatment.
It can be helpful to think of the nerves like the fine fibres in a telephone cable, which each little strand carrying information up or down the nerve. However, when a phone cable is plugged back in the phone starts working immediately, but nerve injuries take a much longer time to recover.
We know that coming to the plexus clinic can be a daunting experience. Nerve injuries are complicated, and there can be a lot of information to take in.
It is very common for you to be seen by one of our excellent senior resident doctors. They may examine you and report back to one of the consultants. Most patients are seen by the consultants on every visit to the plexus clinic, and it’s quite normal to see different consultants (between Mr Duff, Mr Mishra and Mr Bedford).
During your visit, if necessary, you may have some nerve tests including nerve conduction studies and electromyography. Please let us know if you are taking any blood thinners as this may affect the tests we’re able to do.
Brachial plexus injuries in new born babies are very uncommon. If a midwife, neonatal doctor, paediatrician, physiotherapist or GP notice signs of Erb’s palsy they can refer babies in to our service for assessment.
Our Erb’s palsy specialist surgeon, Mr Winterton, runs clinics every fortnight. He is supported by specialist children’s physiotherapist Anthony Brothwood.
Our team is experienced in treating patients with other complex nerve injuries including injuries in the forearm and hand and injuries to the nerves of the lower limbs including the sciatic nerve and the common peroneal nerve.
Upper limb spasticity refers to the increased muscle stiffness and resistance to movement commonly seen in conditions like stroke, cerebral palsy, or spinal cord injury. This stiffness is caused by an imbalance in signals from the brain and spinal cord, leading to overactivity in certain muscles. The condition can interfere with movement, hygiene, and function, and it may also cause discomfort or pain.
Our multidisciplinary clinic runs every 8 weeks and is led by Mr Mishra and Mr Bedford, who are experts in plastic and reconstructive surgery. They work closely with physiotherapists, occupational therapists, and other specialists to provide holistic care. Treatment options include physiotherapy, splinting, botulinum toxin injections, and in some cases, surgery to address severe contractures or restore balance in the upper limb.
Thoracic outlet syndrome (TOS) describes a group of conditions where nerves or blood vessels are compressed in the space between the collarbone and first rib. This can cause pain, tingling, and weakness in the arm, as well as possible swelling or colour changes in the hand due to vascular involvement. The causes of TOS include trauma, repetitive movements, or anatomical variations, and it can significantly impact daily life.
Our specialist clinic, held every 4 weeks, is led by Mr Duff and Mr Ghosh, who bring expertise in peripheral nerve and vascular surgery. Diagnosis may involve clinical examination, imaging, and specialised tests. Treatment can range from physiotherapy to surgical decompression in severe cases, tailored to each patient’s specific needs.