title: Surgical Treatment of Upper Extremity Pain.
abstract: If the patient with hand pain remains without significant relief and without recovery of function after appropriate pharmaceutical and physical modality treatments, it is appropriate to consider a surgical approach to the pain. Categories of pain amenable to a surgical approach are pain caused by nerve compression, pain caused by a neuroma, and joint pain of neural origin. Compressed nerve should be decompressed and depending on the intraoperative findings a neurolysis also should be performed. Painful neuroma must be resected to stop the pain generator. For a painful joint, the biomechanics of that joint must first be stable before denervation.
authors.affiliation: Department of Plastic Surgery, Johns Hopkins University, 1122 Kenilworth Drive, Suite 18, Towson, MD 21204, USA. Electronic address: ALDellon@Dellon.com.
authors.forename: Arnold Lee
authors.initials: AL
authors.lastname: Dellon
mesh_terms: D059350:Chronic Pain / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D009407:Nerve Block; D009437:Neuralgia / Q000503:physiopathology / Q000601:surgery*; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology / Q000601:surgery*; D010808:Physical Examination; D034941:Upper Extremity / Q000503:physiopathology / Q000601:surgery*
keywords: Complex regional pain syndrome; Joint pain; Nerve compression; Neuroma; Reflex sympathetic dystrophy