What is Operative? Conceptualizing Neuralgia: Neuroma, Compression Neuropathy, Painful Hyperalgesia, and Phantom Nerve Pain

Neuralgia, or nerve pain, is a common presenting complaint for the hand surgeon. When the nerve at play is easily localized, and the cause of the pain is clear (eg, carpal tunnel syndrome), the patient may be easily treated with excellent results. However, in more complex cases, the underlying patho...

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Bibliographic Details
Published inJournal of hand surgery global online Vol. 5; no. 1; pp. 126 - 132
Main Authors Hill, Elspeth J.R., Patterson, J. Megan M., Yee, Andrew, Crock, Lara W., Mackinnon, Susan E.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.01.2023
Elsevier
Subjects
Nerve pain
Nerve surgery
Neuralgia
Neuroma
Neuropathy
Review
Nerve pain
Neuroma
Neuralgia
Neuropathy
Nerve surgery
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Summary:Neuralgia, or nerve pain, is a common presenting complaint for the hand surgeon. When the nerve at play is easily localized, and the cause of the pain is clear (eg, carpal tunnel syndrome), the patient may be easily treated with excellent results. However, in more complex cases, the underlying pathophysiology and cause of neuralgia can be more difficult to interpret; if incorrectly managed, this leads to frustration for both the patient and surgeon. Here we offer a way to conceptualize neuralgia into 4 categories—compression neuropathy, neuroma, painful hyperalgesia, and phantom nerve pain—and offer an illustrative clinical vignette and strategies for optimal management of each. Further, we delineate the reasons why compression neuropathy and neuroma are amenable to surgery, while painful hyperalgesia and phantom nerve pain are not.
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ISSN:2589-5141
2589-5141
DOI:10.1016/j.jhsg.2021.11.004