What is Peripheral Nerve Surgery?

Peripheral Nerve Surgery Offers Hope

Historically, the field of peripheral nerve surgery has been primarily focused on improving outcomes in patients who have suffered serious injury to important motor nerves. Motor nerve are the nerves responsible for movement. In other words, the primary focus has been on restoring function, usually to the arm or hand after a serious injury to one or more motor nerves. The irony of this is that the vast majority of patients with a peripheral nerve injury present primarily with pain rather than serious motor dysfunction.

It has only been recently that pioneering surgeons have really started to look at the peripheral nervous system through the prism of chronic pain. This huge blind spot in western medicine came about for two primary reasons. The first is that the treatment of chronic pain has traditionally been considered to be best treated by narcotic or other types of pain medications. The second is due to the fact that doctors have a very poor understanding of peripheral nerve anatomy which makes recognizing the true source of most chronic pain extremely difficult if not impossible.

Peripheral nerve problems are fundamentally mechanical in nature. In other words, the reason the nerve is constantly sending pain messages to the brain is that it has either been compressed or “pinched” in some fashion, or the nerve has been structurally damaged. Structural damage may take the form of a laceration or crush injury to the nerve resulting in the formation of an exquisitely painful structure known as a “neuroma.” A neuroma is a painful ball of nerve fibers mixed with scar tissue on the end of the nerve that is still connected to the spinal cord or brain.

Due to the underlying mechanical nature of most peripheral nerve problems, surgical intervention is the only really effective way to change the environment around the nerve and correct the damage in a way that stops the nerve from sending pain messages to the brain. This may take the form of altering the anatomy around a pinched nerve to relieve the pressure or disconnecting or grafting a damaged nerve using various techniques to prevent the formation of another painful neuroma. This is also why pain medication tends to do a very poor job at controlling chronic pain of nerve origin.

Demetrio Aguila, MD is among an elite handful of peripheral nerve surgeons with a special focus on eliminating chronic pain. Dr. Tollestrup is the only comprehensive peripheral nerve surgeon West of the Mississippi and he devotes 100% of his practice to surgery of the peripheral nerve. He is an expert at diagnosing and treating even the most complex peripheral nerve problems from head to toe, including nerve damage sustained during other surgical procedures.

Dr. Aguila and his team may be able to help. Call us at 1-402-370-9515 or fill out the form on this page to set up a consultation to determine your options.

Peripheral Nerve Surgery for Diabetic Neuropathy

Diabetes and Peripheral Nerve Surgery

Besides a heightened difficulty controlling blood sugar, there are other effects on the body caused by diabetes. One of the more prominent effects is diabetic neuropathy, a condition that affects everything from the tactile sense to muscle control.

The CDC reports that 6.4 percent of diabetics suffered from diabetic neuropathy in 2007, with this figure steadily rising. If you are diabetic and suffering from diabetic neuropathy, peripheral nerve surgery could be right for you.

Development of Peripheral Nerve Surgery

Diabetic neuropathy describes the tendency for nerves in a diabetic’s body to be damaged by the presence of high blood sugar. It was once considered a disease that could only be treated through the careful control of a patient’s diabetes, but there have been advances that have significantly improved the quality of life for people afflicted with this condition.

The largest change came in 1992 when numerous doctors noticed that patients suffering from diabetic neuropathy also suffered from peripheral nerve compression. This allowed them to begin developing new treatments aimed at eliminating the types of constrictions that could cause neuropathy to be present.

Between 30 to 60 percent of patients suffering from diabetic neuropathy are believed to suffer from peripheral nerve compression. By treating this with peripheral nerve surgery, the symptoms of neuropathy may be eliminated.

How Does Peripheral Nerve Surgery Work?

Peripheral nerves run along the spine and down to different parts of the body. They transmit signals to and from different areas of the body. By removing scar tissue and correcting pinching of the nerves with peripheral nerve surgery, the effects of diabetic neuropathy may be reduced or eliminated.

The surgery itself depends entirely upon what type of damage has occurred to the periphery nerves and where it has occurred. There are countless periphery nerve bundles interwoven throughout the body, and some are so tiny that they must be viewed with a microscope.

Surgery will address the presence of scar tissue or structures of the body that may be compressing affected peripheral nerves. As the nerves heal, physical therapy will help the patient slowly recover from any nerve damage that has occurred.

What Type of Peripheral Nerve Treatment is Best?

The type of treatment that works best for diabetic neuropathy will depend entirely upon the unique conditions of the patient. This can include factors like how long a patient has suffered from neuropathy, how old a patient is, how many other surgeries have been attempted to treat neuropathy, and so on.

While recovery may be limited in some circumstances, the general prognosis is that peripheral nerve surgery combined with physical therapy can improve most cases of diabetic neuropathy.

If you currently suffer from diabetes and have been diagnosed with neuropathy, you may be a candidate for peripheral nerve surgery. Doctor Demetrio Aguila is a specialist, and he can help create a treatment plan that is right for you. Contact Dr. Aguila today to schedule your consultation.