Print This Page     Close Window Consult Request Guidelines for Hand Pain     Hand Pain Suggested Pre-Referral Evaluation and Management Guidelines Consider osteoarthritis especially if carpometacarpal joint involved without inflammatory component If pain is neurogenic (numbness, tingling or burning sensation) consider radiculopathy, carpal tunnel syndrome or ulnar mononeuropathy. If pain is neurogenic consider gabapentin 100 mg po TID If pain is radicular, consider NSAIDs, Medrol dose pack; reserve narcotics for severe pain If vasomotor signs and symptoms present, consider reflex sympathetic dystrophy (chronic region pain syndrome) Suggested Additional Test/Management Prior to Specialty Visit If associated with numbness, tingling or burning sensation refer for EMG If associated with weakness, refer for EMG Consider wrist splint (with wrist in neutral) if complaints associated with numbness in digits 1,2 and 3 If unilateral pain, consider x-ray for arthritis; if snuff box of wrist is tender, include lunate views If pain bilateral and associated with red or hot joints, obtain x-ray of bilateral hands and feet. Obtain WESR, ANA, rheumatoid factor. Consider rheumatology consult Patient Education/Information (includes preps)   Appointment Timeframe   How to Get Results to Consultant UMHS Patients: See CareWeb External Patients: hand carry medical records including obstetric records, previous EMGs, x-rays and surgical evaluations and clinic notes to visit Clinic Contact Information Physician: 800-962-3555 Patient: 734-936-7175 Clinic Location Sites Burlington Building - Ann Arbor UM Consulting Physician If adult, request: General Rehabilitation Clinic Faculty If child, request: Pediatric Rehabilitation Clinic Faculty Revised on: 10/07/2009