When to seek a
specialist assessment
Have you seen someone about your hand, wrist, elbow or shoulder and still not sure why you are not getting better?
Something is still
not right
It is not uncommon for people living with hand or upper limb conditions to have tried Physiotherapy, perhaps had a scan, even surgery and something is still not right. If that sounds familiar, this page is for you.
Understanding why that is the case, and knowing when to take a different approach, is often the missing step between prolonged frustration and a clear path forward.
Why some conditions do not resolve with initial treatment
Hand, wrist, elbow and shoulder conditions are a specialist area. Tendons, ligaments, nerves, joints and bones must work in precise coordination. In the hand and wrist, they are particularly complex. Getting to the root of what is wrong requires a depth of clinical knowledge that can go beyond general practice.
Some conditions can be missed on initial assessment when there may be time constraints. Others are correctly identified but only partly treated or not treated with the level of specialist input and duration they require.
Post-surgical rehabilitation may be under-resourced or not take precedence over other areas. This can leave people with stiffness, weakness or pain long after they expected to have recovered. Fractures are particularly susceptible to under-rehabilitation, with patients often provided with only an exercise handout.
There are good clinical reasons why certain conditions do not resolve with initial treatment. Understanding that is the first step toward finding the right solution. For many people, the missing piece is not more of the same treatment. It is a specialist who looks at things differently.
Knowing when to make that step is the difference between months of frustration and a clear path to recovery.
What makes specialist
Hand Therapy different
Hand Therapy is a distinct clinical specialism. It is not simply Occupational Therapy or Physiotherapy applied to the hand, but a focused area of practice built around the rehabilitation of the hand, wrist, elbow and shoulder.
Rather than applying a standard protocol, the focus is on understanding what is happening in your specific case. Exploring which structures are involved, why symptoms have persisted and what the right course of action is for you individually.
Ms Razo is a Certified Hand Therapist (CHT) with extensive experience in differential diagnosis: the process of identifying precisely what is wrong when the picture is not immediately clear. More than one condition may be present, and the correct clinical sequence must be followed. Addressing each piece in the right order creates a pathway to a clear resolution.
This approach also reduces the need for further scans in most cases and additional referrals can be avoided, saving time and getting you on to the correct course of treatment sooner. View Ms Razo's qualifications and credentials.
"Many patients arrive having already been treated elsewhere. What I look for is what may have been missed. Each case is a puzzle. I aim to piecing together the correct sequence of treatment to help my clients reach a clear resolution."
Ms Michelle Razo CHT, Consultant Hand Therapist
When is specialist assessment
the right next step?
A specialist examination with Ms Razo may be the right next step if any of the following apply.
Symptoms have not improved after a course of Physiotherapy or other non-operative treatments.
Surgery on your hand, wrist, elbow or shoulder has not progressed as well as expected.
You have been told that nothing is wrong but something clearly is. Pain, weakness or restricted movement is real and affecting daily life.
You have been advised that further improvements to grip strength or range of movement are not possible, but feel that under the right specialist guidance progress can still be made.
Different diagnoses or conflicting guidance have been received without a clear explanation.
The condition has been managed rather than resolved. Injections or medication have provided temporary relief but the underlying problem remains.
A complex, chronic or trauma-related condition that has not had the sustained specialist focus it requires.
Conditions regularly seen where previous
treatment has not resolved symptoms
The following conditions are among the most commonly seen in this context. If your condition is not listed, that does not mean specialist assessment cannot help.
Including TFCC injuries and scapholunate ligament damage, which are frequently missed on initial assessment.
Commonly under-rehabilitated, often leaving patients with lasting stiffness, weakness or reduced function.
Particularly where symptoms have returned or not fully resolved following surgery or non-operative treatment.
Frequently confused with other conditions and often undertreated as a result.
One of the most commonly misdiagnosed conditions affecting the shoulder, arm and hand.
Where treatment at the wrong stage of the condition has slowed rather than supported recovery.
Across all hand and upper limb procedures where progress has stalled or function not fully restored.
Including partial and full finger amputations where the initial injury has been managed but full function and independence have not been recovered.
A clearer picture starts
with one appointment
Book a specialist assessment with Ms Razo. No GP referral needed. Same-week appointments are usually available.