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Surgery for unmeasurable neuropathy to alleviate non-specific upper extremity pain : round table discussion

Teunis, Teun ; Coert, J Henk ; Dahlin, Lars B LU orcid ; Henry, Steve ; Lalonde, Donald and Xing, Shuguo G (2026) In Journal of Hand Surgery: European Volume
Abstract

Nerve surgery for unmeasurable upper extremity neuropathophysiology - such as pronator syndrome, supinator syndrome/radial tunnel syndrome, lacertus syndrome, and neurogenic thoracic outlet syndrome - remains a subject of ongoing debate due to the lack of objective reference tests confirming the diagnoses. This round table discussion outlines the perspectives of five expert surgeons navigating the clinical and ethical uncertainties of offering surgery for theoretical neuropathies presenting as non-specific pain. The panel explores the balance between subjective patient reporting and objective diagnostic limitations, the ethical implications of surgical placebo effects, and how to determine treatment effectiveness. The discussion... (More)

Nerve surgery for unmeasurable upper extremity neuropathophysiology - such as pronator syndrome, supinator syndrome/radial tunnel syndrome, lacertus syndrome, and neurogenic thoracic outlet syndrome - remains a subject of ongoing debate due to the lack of objective reference tests confirming the diagnoses. This round table discussion outlines the perspectives of five expert surgeons navigating the clinical and ethical uncertainties of offering surgery for theoretical neuropathies presenting as non-specific pain. The panel explores the balance between subjective patient reporting and objective diagnostic limitations, the ethical implications of surgical placebo effects, and how to determine treatment effectiveness. The discussion highlights the divergent strategies among specialists regarding risk tolerance, overtreatment, and the implementation of shared decision-making in the absence of measurable disease.

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Please use this url to cite or link to this publication:
author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Journal of Hand Surgery: European Volume
publisher
SAGE Publications
external identifiers
  • scopus:105042640928
  • pmid:42338304
ISSN
2043-6289
DOI
10.1177/17531934261454842
language
English
LU publication?
yes
id
24ff6aac-61b1-4084-b46e-def3d6ce106d
date added to LUP
2026-06-24 14:52:47
date last changed
2026-07-02 04:01:10
@article{24ff6aac-61b1-4084-b46e-def3d6ce106d,
  abstract     = {{<p>Nerve surgery for unmeasurable upper extremity neuropathophysiology - such as pronator syndrome, supinator syndrome/radial tunnel syndrome, lacertus syndrome, and neurogenic thoracic outlet syndrome - remains a subject of ongoing debate due to the lack of objective reference tests confirming the diagnoses. This round table discussion outlines the perspectives of five expert surgeons navigating the clinical and ethical uncertainties of offering surgery for theoretical neuropathies presenting as non-specific pain. The panel explores the balance between subjective patient reporting and objective diagnostic limitations, the ethical implications of surgical placebo effects, and how to determine treatment effectiveness. The discussion highlights the divergent strategies among specialists regarding risk tolerance, overtreatment, and the implementation of shared decision-making in the absence of measurable disease.</p>}},
  author       = {{Teunis, Teun and Coert, J Henk and Dahlin, Lars B and Henry, Steve and Lalonde, Donald and Xing, Shuguo G}},
  issn         = {{2043-6289}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{SAGE Publications}},
  series       = {{Journal of Hand Surgery: European Volume}},
  title        = {{Surgery for unmeasurable neuropathy to alleviate non-specific upper extremity pain : round table discussion}},
  url          = {{http://dx.doi.org/10.1177/17531934261454842}},
  doi          = {{10.1177/17531934261454842}},
  year         = {{2026}},
}