Another good doctor that you may be able to see on short notice would be Dr. Scott Fried in Blue Bell, PA (Southeastern PA, about 19 miles northwest of Philadelphia). I was very pleasantly surprised to be able to see him within the week or so of when when my "carpal tunnel" got unbearable in 2003. He's an orthopedic hand surgeon who specializes in conservative treatment of the entire upper extremity, with surgery as a last resort when nonsurgical treatments don't work. He looks at the patient as a whole and refers out to other specialists as necessary (pain management, neurology, etc. in my case), while overseeing care of upper extremity problems (hand through brachial plexus level).

He does a thorough initial exam using the various arm tests that have already been mentioned, as well as some others that were developed by Dr. Hunter, a co-author of a well-known text on surgery and rehabilitation of the hand and upper extremity (Dr. Fried did post fellowship training at Thomas Jefferson University with both Dr. Hunter and Dr. Whitenack in surgery and treatment of thoracic outlet syndrome and brachial plexus injuries). In my case he found that I had repetitive strain injury with nerve irritation on both sides at the median, ulnar and brachial plexus levels.

He also reviews previous medical records(almost 10 years worth in my case) and has multiple x-rays done of the cervical spine and both wrists to check for cervical ribs and to rule in/out any obvious problems with the bones of the wrists and neck (none in my case). He also refers patients with brachial plexus problems for full upper body EMG and SSEP tests (both positive in my case).

His office has a physical therapy center which will make custom wrist splints and elbow splints when needed (both soft splints and hard splints for my carpal tunnel). The therapists also also teach the basics of how to reduce nerve irritation by modifying daily tasks, nerve glides and other gentle stretches and exercises for the brachial plexus, elbow and wrist areas as needed (in my case, gentle stretches and exercises for the neck and shoulder areas, as well as tendon glides for the hands and brachial plexus level nerve glides). They also use heat, ice, paraffin, and ultrasound as needed.

He also refers patients for massage (a nearby physical therapy center has two massage therapists who are familiar with brachial plexus injuries -- this has helped loosen up my neck and upper back) and biofeedback training (which has helped me with both pain and stress relief).

When applicable, he also recommends an arm support system that provides support for either shoulder without straps going over the neck that cause neck problems. I've found this quite helpful for supporting my right arm that gets tired and heavy easily.

When needed, he does surgeries at the hand through elbow levels, and refers patients that may need brachial plexus surgery to Dr. Julie Freischlag at Johns Hopkins University.

He's also experienced in dealing with workers compensation.

His office phone number is 610-277-1990. He also has a website at www.nervepain.com (note: the "e-mail me for free consultation" link appears to be broken currently) . Information on the arm support is at http://www.docinthehouse.info.

One caveat: it can take a while to get the SSEP results, as he refers patients to a top Philadelphia area specialist (Dr. Ernest Baran) who only performs about two per week (your may be scheduled out three to six months from when you call Dr. Baran's office . Also, it took over a month to get the EMG test done and get the results back.
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You can also check your local library for his two books, Light at the End of the Carpal Tunnel and the Carpal Tunnel Help Book. Both books mention brachial plexus injuries, with the second one going into more detail. The first one contains both basic education about nerve injuries, and his philosophy of diagnosis and treatment, illustrated by case studies of various patients he's treated.

Hope this helps. I am "typing" this with Dragon NaturallySpeaking, as my arms are both practically shot for typing any length of time. Although I'm still not working, my pain level is much more livable than before. I'm currently on several medications managed by a pain management specialist and a neurologist (Dr. Tabby at Drexel University) who Dr. Fried referred me to.

Regards,

ThreeForOne