Purpose
Neuropathic pain can be life altering and difficult to treat. Nerves can be compressed
along their path in the upper extremities, resulting in chronic neuropathic pain.
This study was performed to evaluate the effectiveness and safety of multiple concomitant
distal nerve decompressions for the treatment of upper extremity nerve pain.
Methods
A retrospective review of patients from a single surgeon’s academic practice was performed
to identify those undergoing nerve decompressions for an indication of “pain” as the
referring diagnosis between April 2020 and June 2021. The primary outcomes included
patient-reported severity of pain using the Visual Analog Scale and quality-of-life
measures, including level of frustration, depression, and impact on quality of life
attributable to pain on a similar 0–10 Likert scale. Complications, if any, were also
determined.
Results
Eleven patients were identified to have undergone multiple concurrent nerve decompressions
for the indication of upper extremity pain. All sites chosen for decompression were
found to be provocative, ie, elicited increased pain on examination with compression.
The median number of decompressions performed was 5 (interquartile range, 4–6), ranging
from 3 to 7. The mean follow-up time was 5 months (SD, 3.43 months). The average pain
over the last month and the average pain over the past week had significant improvement
at the final follow-up, and there was a statistically significant decrease in the
patient-reported mean impact of pain on quality of life following decompressions (preoperative,
5.8; postoperative, 3.6; P = .017; 95% confidence interval, 0.2–4.3). No complications were identified.
Conclusions
Performing multiple concomitant nerve decompressions of the upper extremities is safe
and effective in the treatment of chronic neuropathic pain following upper extremity
trauma.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: November 18, 2022
Accepted:
August 31,
2022
Received:
February 1,
2022
Footnotes
Declaration of interests: No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
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© 2022 THE AUTHORS. Published by Elsevier Inc. on behalf of The American Society for Surgery of the Hand.
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