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Outcomes following the conservative management of patients with non-radicular peripheral neuropathic pain
Affiliation:1. Pat Capps Covey College of Allied Health Professions, Department of Physical Therapy, University of South Alabama, HAHN 2011, 5721 USA Drive N, Mobile, AL 36688-0002, USA;2. Kentucky Hand & Physical Therapy, Lexington, KY, USA;3. Department of Rehabilitation Sciences, University of Kentucky, Lexington, KY, USA;1. Abdus Salam International Centre for Theoretical Physics, Trieste, Italy;2. Department of Physics, University of Antwerp, Antwerp, Belgium;3. University College, Oxford University, Oxford, England;1. Abdus Salam International Centre for Theoretical Physics, Trieste, Italy;2. Donostia International Physics Center (DIPC), Paseo Manuel de Lardizábal, No. 4, 20018 Donostia, San Sebastián, Spain;3. Department of Physics, University of Antwerp, Antwerp, Belgium;4. Oxford University, Oxford, England, United Kingdom;1. Division of Plastic and Reconstructive Surgery, Department of Surgery, McMaster University, HSC 4E12, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada;2. Surgical Outcomes Research Centre (SOURCE), McMaster University, 202-39 Charlton Avenue East, Hamilton, Ontario L8N 1Y3, Canada;3. Department of Clinical Epidemiology and Biostatistics, McMaster University HSC 2C, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada;4. Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Well-Health Building, 293 Wellington Street North, Hamilton, Ontario L8L 8E7, Canada;1. Department of Neurology, Albany Medical Center, Albany, New York;2. Department of Neurology and Neurosurgery, Albany Medical Center, Albany, New York;3. Department of Medicine, Division of Nephrology, Albany Medical Center, Albany, New York
Abstract:Study designProspective cohort.IntroductionThere is limited evidence for conservative management of patients with non-radicular peripheral neuropathic pain (PNP).PurposeTo investigate the effectiveness of a comprehensive treatment approach on pain and disability in patients with non–radicular PNP and to determine if improvements are maintained following the discontinuation of therapy.MethodsPatients received a multi-modal therapeutic intervention. Outcome measures were the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QDASH), Numeric Pain Rating Scale (NPRS), and grip strength. Follow-up data were collected 5 ± 2 months post-discharge.ResultsThere was a significant improvement in the QDASH and mean pain (p < .001). There was no significant change in grip strength (p > .13). Follow-up data suggest that pain and disability scores are maintained (p < .001).ConclusionA comprehensive, conservative treatment program has a positive and lasting effect on pain and disability scores in patients with non-radicular PNP.Level of evidenceIIIa
Keywords:Multiple nerve compression  Carpal tunnel syndrome  Cubital tunnel syndrome  Proximal  Distal
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