Baltimore Peripheral Nerve Surgeon Eric H. Williams MD Provides Surgical Solutions for Patients With Upper Extremity Nerve Pain
If you're experiencing upper extremity nerve pain that interferes with your work, social life, or hobbies, don't assume that drug therapy is your only solution. In many cases, alternative treatments can relieve your pain and improve your overall quality of life. Dr. Eric H. Williams, a skilled peripheral nerve surgeon in Baltimore, has helped many patients find relief from chronic neuropathic pain in the upper extremities—and he may be able to do the same for you.
Why Finding Answers Feels Like Solving a Puzzle
The truth is that the medical community as a whole lacks sufficient training in treating neuropathic pain. It's like a jigsaw puzzle with missing pieces:
- Orthopedic surgeons, even those who have special training in the treatment of the upper extremity and hand, often love to focus on the bones and joints because of their orthopedic background.
- Plastic and reconstructive surgeons are also trained to treat problems in the upper extremities, but they often focus more on restoring soft tissue coverage and function of the hand and tend to be less interested in the pain aspect of therapy.
- Neurosurgeons primarily concentrate on the spine and brain.
While these specialists excel in their respective fields, their expertise or their interest and experience doesn’t necessarily extend to some of the problems regarding the peripheral nerves in the upper extremities.
However, this doesn’t mean you should lose hope in your quest for relief! As a peripheral nerve surgeon, Dr. Williams is dedicated to unraveling the mystery of your pain through targeted procedures:
- Nerve decompression. Nerve decompression surgery relieves pressure on compressed nerves by removing or cutting through structures that impinge upon the nerve.
- Nerve repair. When a nerve is severed, it's like a broken telephone line. By reconnecting the ends of the nerve, continuity, and function can be restored.
- Nerve resection. Sometimes, a nerve is damaged beyond repair and is constantly sending pain signals. In this case, removing the dysfunctional segment of the nerve can help prevent the recurrence of pain—much like pruning a diseased branch to promote the tree's overall health.
Want to learn more? We invite you to explore the patient testimonials section of our website. These stories showcase the profound impact that surgical treatment can have on the lives of individuals who have long struggled with chronic neuropathic pain in the upper extremities.
Signs of Nerve Damage in the Upper Extremities
You can prepare for your first visit with Dr. Williams by creating a detailed description of your pain, including when it started and what activities aggravate your symptoms. Noteworthy symptoms that suggest possible nerve damage in the upper extremities include:
- Numbness and tingling. Numbness and tingling in your arms or hands are often the first red flags of nerve damage. These sensations, known medically as paresthesia, occur when nerves are compressed or irritated.
- Pain. Nerve pain can manifest in various ways, making it a complex symptom to interpret. However, sharp shooting “electrical” pain, burning sensations, and hypersensitivity to normal stimuli like a light touch or clothing brushing against your skin are all common indicators of nerve pain in the upper extremities.
- Muscle weakness. Your nerves are responsible for sending signals from your brain to your muscles, telling them when and how to move. When these nerves are damaged, the communication breaks down, and you end up with noticeable muscle weakness in the form of grip problems, reduced arm strength, and trouble with fine motor skills like buttoning a shirt or typing on your laptop.
- Limited range of motion. Your peripheral nerves play a crucial role in coordinating muscle movements. When these nerves are compromised, your ability to move freely can be affected. However, orthopedic conditions such as arthritis or injury to the soft tissue of the hand can limit motion, and this must be examined and determined.
- Decreased sensation. Your peripheral nerves act as messengers, relaying information about touch, temperature, and pressure to your brain. When these nerves are damaged, the messages become garbled or fail to transmit altogether.
- Changes in skin temperature or color. Nerve damage can manifest in surprising ways, including changes to your skin's temperature or color. Your peripheral nerves don't just control sensation and movement—they also regulate blood flow to your skin.
Diagnosing Nerve Damage in the Upper Extremities
When you experience pain or difficulty in the upper extremities, your first stop should be with your primary care physician. If there is a medical problem causing some symptoms, they may be able to begin some treatment, or they will be able to refer you to a team that can begin to try to provide a diagnosis or a treatment. Dr. Williams may also be able to help if your symptoms have been going on for more than 5-6 months and the symptoms have not improved. You may contact our Baltimore, MD office for a consultation.
Your medical history and a physical examination can help Dr. Williams understand the issue and identify the area of concern that needs to be addressed. EMG (electromyography), imaging studies like ultrasound, X-ray, MRI, MR neurography, or nerve blocks may also be used to help diagnose the issue.
Upper Extremity Conditions Dr. Williams Treats
The upper extremities contain numerous nerves essential for transmitting signals that result in functions like sensation, reflexes, and muscle contraction. These nerves originate in several points in the neck area and make up a complex structure we call the brachial plexus. They tend to be larger in diameter closer to the neck, ultimately dividing up into smaller branches as they extend out into the upper arm and down into the forearm and hand.
Dr. Williams can treat several different types of peripheral nerve conditions affecting the upper extremities.
Carpal Tunnel Syndrome
Carpal tunnel syndrome involves compression of the median nerve as it travels through the carpal tunnel in the wrist, leading to numbness, tingling, and weakness in the hand and fingers. It is often associated with repetitive wrist movements or activities that put pressure on the carpal tunnel.
Chronic Regional Pain Syndrome
Chronic regional pain syndrome (CRPS) is a complex pain condition that can affect the upper extremities, causing severe, debilitating pain, swelling, changes in skin color and temperature, and decreased mobility. The pain affects the area after injury or surgery and is typically disproportionate to the severity of the initial trauma.
Cubital Tunnel Syndrome
Cubital tunnel syndrome is characterized by compression of the ulnar nerve as it passes through the cubital tunnel behind the elbow. Numbness, tingling, and weakness in the ring and little fingers, as well as potential grip and coordination issues, are common symptoms. Leaning on your elbow for prolonged periods or keeping your elbow bent can increase your risk of developing cubital tunnel syndrome.
Post-Surgical Pain
If you have upper extremity pain that is impacting your daily routine six months after an operation, you may have a peripheral nerve entrapment or injury that is not being recognized. Examples of these events include:
- Carpal tunnel release surgery or other types of hand or wrist surgery
- Cyst removal
- Shoulder replacement or shoulder repair surgery
- Elbow replacement or repair surgery
- Fracture repair
- Other upper extremity operations
Of course, it is important to remember that upper extremity pain may have more than one cause. Your symptoms could be both orthopedic and nerve-related. Dr. Williams will work with your orthopedic or hand specialist to determine the best treatment strategies to provide the relief you want.
Pronator Syndrome
Pronator syndrome, also known as pronator teres syndrome (PTS), is a condition that occurs when the proximal median nerve becomes compressed or entrapped by the pronator teres muscle near the elbow in the upper forearm. Symptoms, which include pain, numbness, tingling, and weakness in the forearm and hand, tend to be most noticeable and bothersome when rotating the forearm and hand. Symptoms can be aggravated by resisted pronation (turning the hand downward as if typing on a computer) of the forearm and flexion of the elbow. These symptoms may worsen with repetitive forearm movements or prolonged gripping activities.
This compression can look very much like carpal tunnel syndrome due to the same area of numbness that occurs in the hand when it occurs.
Radial Tunnel Syndrome
Radial tunnel syndrome occurs when the radial nerve becomes compressed or entrapped as it passes through the radial tunnel, a narrow space in the forearm formed by muscles, tendons, and bones. The radial nerve is one of the main nerves in the arm, responsible for controlling muscle movement and sensation in the back of the forearm, back of the wrist and hand.
Radial tunnel syndrome is often caused by repetitive motions or prolonged activities that involve the forearm, such as typing, using tools, or playing musical instruments. It can also be caused by direct trauma to the forearm, anatomical variations, or muscle imbalances that lead to nerve compression. It is often a cause of severe refractory deep-seated lateral upper forearm pain that is present in the meat of the forearm muscles just downstream of the elbow joint.
Traumatic Nerve Injuries
When symptoms develop in the neck, shoulder, arm, or hand after an accident or traumatic injury, the resulting issues may stem from nerve compression or entrapment. These symptoms can be similar to the ones experienced when you lay on an arm for too long. Loss of sensation (numbness) can be quite common. This can be helpful in diagnosing the core issue since the pattern of numbness can help Dr. Williams identify the specific nerve(s) injured.