Team Approach: Upper-Extremity Numbness.

Abstract

* Upper-extremity numbness has a wide differential diagnosis and can arise from pathology in the cervical spine, brachial plexus, shoulder, elbow, and hand.* Physical examination must include evaluation of both nerve root and peripheral nerve function to aid in determining if symptoms are due to central or peripheral pathology.* Double-crush syndrome, with both spinal and peripheral etiology, is not uncommon and, if not recognized, may lead to treatment failure.* A team approach including orthopaedic surgeons, neurologists, physiatrists, radiologists, and occupational therapists can be crucial in making the diagnosis and designing the treatment plan.* Nonoperative treatment can include observation, physical and occupational therapy, functional bracing, and injections of corticosteroids and/or local anesthetics.* Operative treatment is appropriate after an appropriate course of nonoperative management has failed or with specific diagnoses in which a delay in definitive treatment may put a patient at risk for long-term functional deficits.