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.

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