Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain

Day, Joseph M.; Willoughby, Jason; Pitts, Donald G.; McCallum, Michelle; Foister, Ryan; Uhl, Timothy L.

doi:10.1016/j.jht.2014.02.003

Cited by 11 publications

(5 citation statements)

References 41 publications

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“…24,28–30 Current literature demonstrates increased grip strength, improved intrinsic hand function, and earlier return to work after injury when compared with direct repair alone. 14,20…”

Section: Discussionmentioning

confidence: 99%

“…24,[28][29][30] Current literature demonstrates increased grip strength, improved intrinsic hand function, and earlier return to work after injury when compared with direct repair alone. 14,20 There is no consensus on the use of a perineural window in the AIN RETS procedure. Barbour et al described a perineural window with epineural sutures, 12 but there is a paucity of comparative clinical studies, and animal studies have shown varied results.…”

Section: Discussionmentioning

confidence: 99%

“…A power analysis was performed requiring a final sample size of 28 patients in each arm, allowing for a 20% loss to follow-up from 35 patients, which provided 80% power to detect a minimal clinical important difference of 13 points on the quick Disabilities of the Arm, Shoulder and Hand (qDASH) questionnaire, assuming a standard deviation of 20 points with an alpha value of 0.05. [13][14][15] Patients were included if they had an isolated, acute, and complete ulnar nerve laceration, defined as from proximal to and within 7 cm distal to the level of the medial epicondyle. Patients were excluded with chronic injuries (>6 weeks), multiple nerve injuries, brachial plexus injuries, segmental defects requiring nerve grafting, or those requiring amputation or tenodesis.…”

Section: Methodsmentioning

confidence: 99%

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Primary Repair versus Reverse End-to-Side Coaptation by Anterior Interosseous Nerve Transfer in Proximal Ulnar Nerve Injuries

Gonzalez

Polmear

Carter

et al. 2023

Plastic &Amp; Reconstructive Surgery

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The majority of peripheral nerve injuries (PNIs) affect the upper extremity, 1,2 with the ulnar nerve being the most commonly affected. 1,3,4 Common mechanisms include motor vehicle accidents and penetrating trauma. [1][2][3] These injuries disproportionally affect young men, and can result in functional impairment of the upper extremity. [1][2][3][4][5] Traditionally, PNIs are treated using tensionfree primary repair, 3,6,7 particularly resulting from penetrating trauma. 6,8 Several factors may lead to poor prognosis, including proximal lesions, delayed repair, and patient age. 6 Proximal nerve neurotmesis and axonotmesis injuries are particularly challenging, resulting in sensory and Background: Proximal ulnar nerve lacerations are challenging to treat because of the complex integration of sensory and motor function in the hand. The purpose of this study was to compare primary repair and primary repair plus anterior interosseous nerve (AIN) reverse end-to-side (RETS) coaptation in the setting of proximal ulnar nerve injuries. Methods: A prospective cohort study was performed of all patients at a single, academic, level I trauma center from 2014 to 2018 presenting with isolated complete ulnar nerve lacerations. Patients underwent either primary repair (PR) only or primary repair and AIN RETS (PR + RETS). Data collected included demographic information; quick Disabilities of the Arm, Shoulder and Hand questionnaire score; Medical Research Council score; grip and pinch strength; and visual analogue scale pain scores at 6 and 12 months postoperatively. Results: Sixty patients were included in the study: 28 in the PR group and 32 in the RETS + PR group. There was no difference in demographic variables or location of injury between the two groups. Average quick Disabilities of the Arm, Shoulder and Hand questionnaire scores for the PR and PR + RETS groups were 65 ± 6 and 36 ± 4 at 6 months and 46 ± 4 and 24 ± 3 at 12 months postoperatively, respectively, and were significantly lower in the PR + RETS group at both points. Average grip and pinch strength were significantly greater for the PR + RETS group at 6 and 12 months. Conclusion: This study demonstrated that primary repair of proximal ulnar nerve injuries plus AIN RETS coaptation yielded superior strength and improved upper extremity function when compared with PR alone. (Plast.

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“…24,28–30 Current literature demonstrates increased grip strength, improved intrinsic hand function, and earlier return to work after injury when compared with direct repair alone. 14,20…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Primary Repair versus Reverse End-to-Side Coaptation by Anterior Interosseous Nerve Transfer in Proximal Ulnar Nerve Injuries

Gonzalez

Polmear

Carter

et al. 2023

Plastic &Amp; Reconstructive Surgery

View full text Add to dashboard Cite

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“…Neuropathic pain is common in chronic pain populations and nerve-related pain populations (Blyth 2017). There is limited evidence for the use of physiotherapy to manage neck pain associated with neuropathic pain (Day et al 2014). A multimodal treatment approach incorporating postural education, scapular stabilisation, neural mobilisation exercises, manual therapy and stretching exercises improves pain, disability and grip strength in patients with peripheral neuropathic pain (Level 2B).…”

Section: Managementmentioning

confidence: 99%

Neck pain in South Africa: An overview of the prevalence, assessment and management for the contemporary clinician

Basson

Olivier

Rushton

2019

South African Journal of Physiotherapy

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BackgroundNeck pain is a prevalent condition and is associated with high levels of disability and pain. The long-term prognosis can be poor, and therefore effective management in the acute stage is important.ObjectivesTo provide an overview of the prevalence of neck pain and physiotherapy management and to provide evidence-informed recommendations for clinical practice within a South African context.MethodThe literature was reviewed considering prevalence, risk factors and examination. Management recommendations were derived from the highest levels of evidence of clinical practice guidelines, systematic reviews and randomised clinical trials.ResultsNeck pain is classified into four grades, and three trajectories of recovery have been identified. Although the incidence of neck pain globally is high, in the South African context the majority of the population have limited access to physiotherapy management. Sound clinical reasoning is important in the assessment and decision-making process for management. Exercise, and mobilisation or manipulation are effective treatment options in the management of most types of neck pain. Other physical modalities such as needling, transcutaneous electrical nerve stimulation, laser and intermittent traction may be used as an adjunct to management.ConclusionThe burden of neck pain globally is high; however, there is a lack of information on current practice, prevalence and burden of neck pain in the South African context. Sound evidence-informed clinical reasoning to inform a working diagnosis and to enable patient-centred management is important.Clinical implicationsA thorough assessment is essential to gather information to formulate hypotheses regarding diagnosis and prognosis for neck pain. Exercise, and mobilisation or manipulation are effective management options.

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“…Beleckas et al [7] confirmed that patients with upper extremity conditions were more frequently report anxiety and depression than the general population. For CuTS patients, most articles focus on the patient's disease's progress and few studies pay attention to patients' mental health status [8].…”

Section: Introductionmentioning

confidence: 99%

Relative prevalence of anxiety and depression in cubital tunnel syndrome patients and associated factors

Jia

Shi

Liu

et al. 2020

Preprint

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Purpose: Cubital tunnel syndrome (CuTS) is the second most common peripheral entrapment neuropathy. This study aimed to assess the prevalence of anxiety and depressive symptoms and explore associated factors among CuTS patients.Methods: This is a cross-controlled study. We used the Hospital Anxiety and Depression Scale to assess the prevalence of depression and anxiety. We calculated the proportion of depression and anxiety symptoms and compared characteristics between groups. Univariate analysis and multivariate regression were carried out to identify variables that were independently associated with anxiety and depression.Results: A total of 246 individuals diagnosed with CuTS were included. The results of the HADS demonstrated that 17.8% (n = 44) of the patients presented possible/probable depression, and 14.2% (n = 35) presented possible/probable anxiety. Logistic regression analysis revealed that diabetes Mellitus was independently associated with depression. And modified McGowan grade was independently associated with anxiety.Conclusions: Patients with cubital tunnel syndrome were at an increased risk of anxiety and depression. Abnormal mental states may have a negative impact in the course and outcome of the disease. Early screening for anxiety and depression in CuTS patients should be recommended.

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Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain

Cited by 11 publications

References 41 publications

Primary Repair versus Reverse End-to-Side Coaptation by Anterior Interosseous Nerve Transfer in Proximal Ulnar Nerve Injuries

Primary Repair versus Reverse End-to-Side Coaptation by Anterior Interosseous Nerve Transfer in Proximal Ulnar Nerve Injuries

Neck pain in South Africa: An overview of the prevalence, assessment and management for the contemporary clinician

Relative prevalence of anxiety and depression in cubital tunnel syndrome patients and associated factors

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