Neurological evaluation of occupational hand pain

The evaluation of the patient with pain, weakness, or numbness of the hand or upper extremity begins with knowledge of neuroanatomy and of the proper examination techniques. Neurological diseases of the peripheral nerves or central nervous system often present with vague complaints or minimal findings on clinical examination that may be diagnosed only with a combination of radiologic and neurodiagnostic studies. However, tests alone cannot determine the best treatment as each case must be individualized. An understanding of the utility and limitations of the electromyogram and nerve conduction studies is important when treating these patients.