Ask a Hand Surgeon: Dr Jacqueline Tan from Mount Elizabeth Novena Hospital Singapore

Ask a Doctor ForumCategory: Hand SurgeryAsk a Hand Surgeon: Dr Jacqueline Tan from Mount Elizabeth Novena Hospital Singapore
Dr Jacqueline TanDr Jacqueline Tan asked 2 years ago

I am Dr Jacqueline Tan, Hand Surgeon practicing at Mount Elizabeth Novena Hospital Singapore. Ask Me Anything!

I was the former Head of Department and Senior Consultant of Hand and Reconstructive Microsurgery at Singapore General Hospital (SGH). I also served as the Director of the Micro-reconstruction service and Director of Peripheral nerve and Paralytic upper limb service at SGH. I am currently a Visiting Consultant at SGH.

My surgical expertise is in the reconstruction of brachial plexus (network of nerves) injuries, open and endoscopic peripheral nerve surgeries, and microsurgical reconstruction of the upper limb. I also have special interests in hand and wrist fractures, arthritis of the hand and wrist, wrist arthroscopy, and ligament reconstruction for wrist instability.

I completed my Bachelor’s and Master’s degrees from the National University of Singapore. I was awarded the Health Manpower Development Plan scholarship by the Ministry of Health and went on to complete a 1-year fellowship in Taiwan, specializing in brachial plexus surgery and advanced microsurgery. I am a member of the Royal College of Surgeons, Edinburgh, UK , and a fellow of the Academy of Medicine in Hand Surgery.

I was the Deputy Vice-Chair for the education in the Musculoskeletal Sciences Academic Clinical Program at SingHealth. I was also the Program Director for the SingHealth Hand Surgery program and Core Faculty for the SingHealth Orthopedic surgery program. I am currently a member of the Residency Advisory Committee of the Ministry of Health, which oversees the training of hand surgery residents in Singapore. I held concurrent teaching appointments at Duke-NUS Medical School and NUS Yong Loo Lin School of Medicine.

I am immediate Past President of the Singapore Society for Hand Surgery, Vice-Chairman of the Chapter of Hand Surgeons, the College of Surgeons, Singapore, and Secretary of the Singapore Reconstructive Microsurgery Society. I am a member of the American Society for Surgery of the Hand, the Asia Pacific Wrist Association, and the International Microsurgery Club.

I have been the organizing chairperson of many inaugural courses and organized several workshops. I have published widely in peer-reviewed journals on hand surgery and I speak regularly at local, regional, and international meetings where I focus on topics such as brachial plexus injuries, thumb carpometacarpal arthritis, hand and wrist trauma.

In addition to multiple Singapore Health Quality Service Awards, I am also the recipient of other awards such as the Outstanding Faculty Award & Faculty Appreciation Award for SingHealth Residency, and Orthopaedic Teaching Excellence Award. Learn more about me here:

https://patients.smarterhealth.sg/specialist-doctor/jacqueline-tan-siau-woon/

I am excited to be here to share/discuss Hand and Wrist conditions with everyone. I will be actively answering questions. If you’ve got questions about pain and numbness of the hand, hand and wrist trauma, arthritis of the hand and wrist, wrist arthroscopy and ligament reconstruction for the hand and wrist, feel free to ask me!

Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.

23 Answers
Liana answered 2 years ago

I have been struggling with hand arthritis. For a year, I have been taking oral medication and injections. Is surgery an option for my condition? How common is it and how effective is it? Can it treat the condition permanently? I am 67 years old.

Dr Jacqueline Tan replied 2 years ago

Hi Liana, the most common cause of hand arthritis is degenerative (old age) osteoarthritis. It will be good to have some blood tests and radiological investigations performed to rule out other inflammatory causes, such as rheumatoid arthritis or gout, if you have not had any done yet. Depending on the cause and severity, the treatment varies.

Surgery is reserved in cases which failed conservative treatment with oral medication and injections, as well as for persistent pain, stiffness and deformities. Joint fusions are common for finger distal joint arthritis and joint arthroplasties are common for thumb basal joint arthritis and are occasionally performed for finger proximal joint arthritis. They are effective in relieving the pain and correcting the joint deformity but may result in loss of some finger motion.

Thank you.

Boon Lim answered 2 years ago

I am quite young at 32 years old. But why do my fingers get stiff every morning? I have to stretch them for close to 10 mins to get them to be able to move freely. Is this an early degeneration of my joints? Would this lead to more problems in the future? What should I do?

Dr Jacqueline Tan replied 2 years ago

Hi Boon Lim, there are many causes of finger stiffness other than degenerative joint disease (arthritis), such as trigger finger, inflammatory conditions such as rheumatoid arthritis, repetitive strain injury and chronic overuse.

We need to know if there are any previous injuries to the fingers and associated symptoms such as pain or deformity, and check for the range of motion. It will be good to have some blood tests and radiological investigations performed if both hands/multiple fingers are involved.

Treatment is dependent on the underlying cause of the finger stiffness and it may involve activity modification, heat packs/cold compresses, nonsteroidal anti-inflammatory medications and steroid injections. If the symptoms are not improving, it would be best for you to see a hand specialist.

Thank you.

Rasiyd answered 2 years ago

I spend a lot of time driving. Two days ago, I was driving and my arms and hands were suddenly tingling and felt stiff. I had to stop driving and when I was home, I iced and stretched them but there was no improvement. Yesterday morning, I woke up to a sharp pain in both hands. But the stiffness was gone. Does my condition sound like it’s worrying? What could be the possible cause? And how should I treat it?

Dr Jacqueline Tan replied 2 years ago

Hi Rasiyd, tingling and stiffness in the arms and hands may be due to different causes. Is there any numbness, pins & needles sensation associated with the tingling sensation? You may be suffering from bilateral carpal tunnel syndrome or cervical spondylosis or both. Is the stiffness mainly in the hands? You may be suffering from arthritis, trigger finger or repetitive strain injury.

If the symptoms improve and go away with rest, you don’t have to worry too much about it. It would good to watch your neck posture and do regular finger stretches, especially if you drive for long hours. If the symptoms persist or worsen, it would best for you to see a doctor to investigate the cause.

Thank you.

Zack answered 2 years ago

My father suffers from hand arthritis and I have been purchasing compression gloves online for him. Is there really a positive effect on resolving arthritis pain with such compression gloves? I’m not sure if they really work.

Dr Jacqueline Tan replied 2 years ago

Hi Zack, compression gloves are not routinely prescribed for hand arthritis. The treatment of his hand arthritis depends on his symptoms (pain and stiffness), signs (deformity) & functional limitation. The most common cause of hand arthritis is degenerative (old age) osteoarthritis. Depending on the cause and severity, the treatment varies.

Thank you.

Ian answered 2 years ago

In 2018, my mother underwent aspiration for her ganglion cyst. We noticed that in the past month the cyst regrew. She complains that it’s painful and the pain is spreading to her arm. Is this a worsening of her previous ganglion cyst? Would she need surgery?

Dr Jacqueline Tan replied 2 years ago

Hi Ian, it is the same lump (cyst) that has recurred (regrew). If the lump in 2018 was painless and smaller but the current one is painful and likely bigger, it is worse than before.

Aspiration of cysts are associated with high rates of recurrence. I would recommend surgery now that it has recurred and is painful with the pain radiating to her arm.

Thank you.

Glenn answered 2 years ago

My sister’s left arm has been tingling for 4 days. She is 37 years old. She also mentioned her left shoulder feels heavy and painful. What condition could she be having, Doctor? Should she undergo further examination? Which examination would you recommend?

Dr Jacqueline Tan replied 2 years ago

Hi Glenn, there are two possibilities in her case. She may be suffering from cervical radiculopathy (often called a pinched nerve) or left shoulder issues, such as frozen shoulder, rotator cuff pathology or long head of biceps pathology, which can co-exist with the cervical radiculopathy.

It will be best for her to have her cervical spine and shoulder physically examined by a specialist, if the symptoms are still persistent. She may need a MRI for further assessment.

Thank you.

Ridzuan answered 2 years ago
I broke my right little finger two weeks ago. Now the pain is gone, but I always hear a cracking sound when I move it. Does it mean my finger is not fully healed?
Dr Jacqueline Tan replied 2 years ago

Hi Ridzuan, did you see a doctor and have finger radiographs done? If there is a fracture (crack in the bone), it will usually take 6 weeks to heal, although the pain may resolve earlier. I would recommend that you see a hand specialist for a proper assessment if you haven’t already seen one.

Thank you.

Joanne answered 1 year ago

My husband is an avid carpenter and likes playing around with heavy tools. About a weekend ago, he started complaining to me about feeling pain in his fingers, with the joints being stiff. The slightest pressure on the joints would hurt. Is this a normal scene among people who are into carpentry? Will the pain go away or should we see a hand specialist?

Dr Jacqueline Tan replied 1 year ago

Hi Joanne, it appears he is experiencing tenderness and stiffness in his finger joints and that the pain is likely related to the activity of handling heavy tools. Any activity that requires overuse of the hands can result in inflammation of the joints and this includes carpentry. Was there any direct trauma to the fingers?

I would advise him to stop the carpentry work for a while and see if the pain improves or goes away. If it does not, it would be best to see a hand specialist.

Thank you.

Nicole Chan answered 1 year ago

The skin on my palm on my dominant hand feels thick, stiff and is always red. If i try to make my palm into a fist, it is painful. There are also times when the skin feels like it’s burning and I will have to put my palm under cold water to reduce the burn. I am 50 years old and I don’t do anything intense with my hands, just the usual typing. Can I check what this condition is?

Dr Jacqueline Tan replied 1 year ago

Hi Nicole, it’s hard to make a diagnosis of your condition without actually seeing your hands. If the symptoms of pain, stiffness, redness and burning sensation do not improve, I would recommend that you see your GP/family doctor to make the initial assessment before referring you to see a hand specialist or dermatologist.

Thank you.

Allie answered 1 year ago

I have been experiencing pain in my wrist and my relatives recommended me to go for acupressure. I went for 4-5 sessions so far but don’t find it useful. What do you think about acupressure? Should I continue or see a doctor?

Dr Jacqueline Tan replied 1 year ago

Hi Allie, there are many causes of wrist pain and the cause depends on the location of the pain and whether there are associated symptoms like swelling, redness or stiffness or whether there is a history of repetitive activity, fall or trauma. Before suggesting any treatment, I would recommend that you see a doctor to have your wrist properly examined. You may or may not need further imaging such as X-rays. In most cases, wrist pain can be treated conservatively first with rest, activity modification, wrist brace, medications and/or injections.

Thank you.

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