I am very happy to hear that your wife's pain is being so well managed. It's really up to the individual to decide where to go at this point. There is no cure...but remission is possible. Since she has only had this for a (relatively speaking) short time remission is far more likely for her than for those who have had this a long time. Of course, she needs to really weigh the risks of the various treatments...but it may very well be worth it for her to continue aggressively treating this with either blocks or ketamine in combination with continued physical therapy to keep that hand moving. At the very least I would strongly recommend the continued physical therapy. Her pain levels sound like they are low enough that she should be able to do this and gradually, over time, regain the full use of her hand and perhaps go into remission.

If further aggressive treatment is the way she wants to go, then you need to find a new doctor as quickly as possible who is willing to work with her on this. No sense to keep going back to the same one if he says there is nothing more that he can do for her besides managing the meds if you are looking for more. There's no guarantee, however, that you will find someone who is willing to do more (I don't know the specifics of your wife's case and medical history).

But if nothing else...definitely keep her going with physical therapy for her hand. This doesn't mean that you necessarily have to go to a physical therapist the whole time (you may only be allowed so many visits) but there should be exercises she can do each and every day to improve the function in her and.

Good luck to both of you...I sincerely hope that she is able to get back full function in her hand and that the pain continues to be well managed.