Evaluation and treatment of pain: aspects for nerve injury and rehabilitation

Pain, or at least discomfort in the form of hypersensitivity, is always a sequela to nerve injury and nerve repair. A carefully planned pain evaluation and treatment program has been shown to result in a decrease in pain and improved function. For a hand therapist, the commitment to evaluation and management of pain is a personal as well as a professional dedication. Patients may greatly vary in their responses to injury, symptomatology, and treatment interventions. Although the hand therapist can successfully intercede with many patients, it is often advantageous to involve a clinical psychologist. Psychosocial and psychophysiologic data can be imperative in evaluating the possibilities of patient outcome with regard to pain, evaluation, and treatment. Psychophysiologic information is likely to increase the hand therapist's evaluation and treatment potency. A psychological assessment and/or intervention is appropriate at several points of treatment--for example, after an appropriate interval of healing time in which an injury should resolve itself, after a major invasive procedure such as surgery, or when a condition is chronic and all other avenues of treatment have been unsuccessful.