BREAKING THE CHAINS OF PAIN : ADVANCED SYMPATHECTOMY AND NEUROLYSIS FOR RELENTLESS UPPER LIMB NEUROPATHY

Chronic upper limb pain following brachial plexus injuries is a complex condition, often involving neuropathic and sympathetically mediated pain. This case report presents a 36-year-old male with severe upper limb pain post-brachial plexus injury, unresponsive to pharmacological therapy and multiple stellate ganglion blocks. T2-T3 radiofrequency sympathectomy was performed, resulting in signicant pain relief. Residual pain in the ulnar nerve distribution was managed with neurolysis using 6% phenol, achieving sustained relief and improved quality of life at a 6-month follow-up. The case highlights the utility of thoracic sympathectomy and targeted nerve neurolysis in managing refractory upper limb neuropathic pain.