Treating Nerve Pain With The 3 Rs: Release Repair Or Removal
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Approximately 10% of the general population may experience chronic pain caused by nerve damage. Most of the patients referred to our plastic surgery clinic for nerve pain are seeking relief from peripheral nerve damage, which can affect any nerves outside the central nervous system .
Nearly 90% of patients with peripheral nerve damage can experience the following symptoms in their limbs, hands, or feet:
Peripheral nerve damage can be caused by a range of factors outside a patients controlincluding treatments for other health conditions. Many patients struggle with nerve pain after recovering from:
- Injury:This can include fractures or sprains. Often, we treat brachial plexus injuries, in which an arm is severely stretched or pulled in a vehicle accident, contact collision, or knife or gunshot wound.
- Disease: Infections, nutritional imbalances, diabetes, and medications such as chemotherapy can temporarily or permanently damage nerves.
- Surgery: A nerve may be damaged or irritated during majoryet finesurgeries such as a hand or foot fracture repair, joint replacement, or mastectomy.
Pinched Nerve Pain Is Usually Short
So how long does a pinched nerve cause pain and discomfort? In most cases, symptoms improve and nerve function resumes to normal within 6 to 12 weeks of conservative treatment. Conservative treatment options include physical therapy, and non-steroidal anti-inflammatory drugs like ibuprofen. Lifestyle modifications such as rest, ice and hot therapy, frequent exercise, and sleeping position changes may help as well.
There are a number of factors that will play a role in how long your pinched nerve lasts. The cause of the inflammation, degree of compression, and your immune system response can help determine when your symptoms will subside.
In the event your pinched nerve persists for more than a few months, surgery may be recommended to prevent permanent damage and chronic pain. It may involve getting rid of a portion of a herniated disc or bone spurs. This will alleviate nerve pressure and ensure greater comfort.
Since a surgical procedure may come with risks and a lengthy recovery period, you should always try conservative treatments at first.
Is A Nerve Block Safe
Like general anesthesia, nerve blocks involve some side effects and risks. Most common side effects include unpleasant numbness and weakness of the muscle, when catheters are placed a little bit of leak can occur around the catheter entry and that is totally normal. It is also normal to experience some pain after surgery despite the block. As the block wears off, pain usually increases and it is important to take oral medications early to help control it. Serious complications are very rare and include large bruise or infection at the block area and persistent nerve symptoms and those are usually temporary.
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What You Can Do
Chronic post operative pain may be rare, but it can still happen. And once it happens, it can greatly affect your everyday routine and your quality of life.
But you do not have to live with persistent pain every day of your life. Aside from getting for a second opinion and possibly talk to a doctor who can provide you with the right solution to completely relieve you from the chronic pain you are suffering from, another option is to file a hernia mesh lawsuit.
In some cases, filing a surgical mesh lawsuit may be the only way to seek justice against those who harmed you or a loved one. Furthermore, it may also save other patients from potential complications and injuries in the future.
How Long Does Pain After Dental Work Last
The majority of pain after dental treatment should go away in 1-2 days. For wisdom tooth surgery, pain may last closer to 1-2 weeks. If you have TMJ pain after dental work, it may take months for the pain to go away.
Typically, I recommend asking the dentist who will perform your procedure what kind of pain you should expect afterwards.
In addition, understanding what kind of pain to expect helps you know when your dental problems are cause for a follow-up visit.
Questions to ask your dentist include:
- Will I feel stabbing pain?
- Should I expect a sore mouth?
- Will my teeth be sensitive to hot or cold?
- Should my recovery pain make it hard to perform daily tasks, or is it more likely to simply be annoying or minor?
If you experience pain outside of what your dentist describes as expected, call him or her to find out the next steps. If procedures have been performed poorly or if you have additional issues that must be corrected professionally, you may end up having to get a follow-up procedure.
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Rpni And Dspni For Prevention Of Pain Recurrence
Regenerative Peripheral Nerve Interface and Dermatosensory Peripheral Nerve Interface are options to prevent pain recurrence.
When the ends of the injured nerves are removed surgically, there is the chance for recurrence of the pain. Several strategies are used to prevent this. One of them, which we use in almost all cases, is RPNI or DSPNI treatment of the nerve ends. The process is simple. The ends of the nerves are wrapped with small pieces of muscle or skin grafts taken from nearby tissues. The goal is to give the new ends of the nerves something to grow into, thereby preventing the recurrence of nerve pain. This novel technique was developed at the University of Michigan Section of Plastic Surgery, and is being taught to surgeons around the world. We have successfully used these techniques in treating nerve pain and phantom pain due to amputations, surgery and injury all over the body.
Nerve Injury Contributes To Post
Studies have demonstrated that sensory nerve injury provides a substantial contribution to post-mastectomy pain. This is not surprising, given that multiple small sensory nerves may be injured during breast surgery including mastectomy .
When breast tissue is surgically removed from the chest, sensory nerves traveling through these tissues are transected, stretched, or caught up in scar during the healing process. These nerve injuries can lead to chronic pain due to the development of what are known as end neuromas, neuromas-in-continuity, and scar compression. Altered sensation, including “pins and needles”, shock-like, burning, or stabbing pain can provide evidence of nerve injury as a cause for the pain. Local anesthetic nerve blocks can confirm that the chronic pain is coming form the injured nerve.
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What Can I Do To Help Keep My Pain Under Control
Important! Your doctors and nurses want and need to know about pain that is not well controlled. If you are having pain, please tell someone! Don’t worry about being a “bother.”
You can help the doctors and nurses “measure” your pain. While you are recovering, your doctors and nurses will frequently ask you to rate your pain on a scale of 0 to 10, with 0 being no pain and 10 being the worst pain you can imagine. Reporting your pain as a number helps the doctors and nurses know how well your treatment is working and whether to make any changes. Keep in mind that your comfort level is more important than absolute numbers .
Other Less Invasive Back Pain Operations
Probably the best back operation in terms of outcomes is the one used to treat spinal stenosis. This operations purpose is to relieve pressure on a nerve.
The thing about spinal stenosis is that it doesnt usually cause pain in your back. It causes pain down your legs or arms. The pain it can cause shooting down your legs is called sciatica, and this tends to be worse when youre standing up or leaning backwards.
Spinal stenosis is a narrowing of the central canal in your spine where all the nerves run. This is often a natural process as we age. When you get wear and tear of the vertebrae, you get an overgrowth of bone to stabilize the joints.
Bony overgrowth will reduce the size of the foramen These bony changes can press on the nerve.
Its also possible to have a bulging disc reducing the space for the nerve. Finally, theres a ligament called the ligamentum flavum which runs down the back of the spine and can bulge forward and press on the nerve.
The surgerys purpose is to decompress the nerve by trimming back the disc, or chipping back the bone, and cutting back the ligamentum flavum.
If you can decompress the nerve is this way, the results are often good. The main problem is if you have to remove so much bone that you destabilize the joint and then youre into the same problem, which is now you need to fuse that segment.
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Are There Ways I Can Relieve Pain Without Medication
Yes, there are other ways to relieve pain and it is important to keep an open mind about these techniques. When used along with medication, these techniques can dramatically reduce pain.
Guided imagery is a proven form of focused relaxation that helps create calm, peaceful images in your mind — a “mental escape.”
Relaxation media can be purchased at some bookstores or on-line stores, or can be borrowed from your local library. You can bring your relaxation media and listening device to the hospital to play prior to surgery and during your hospital stay.
For the best results, practice using the relaxation techniques before your surgery, and then use them twice daily during your recovery. Listening to soft music, changing your position in bed, or tuning in to a hospital relaxation channel are additional methods to relieve or lessen pain. Ask your nurse for channel information.
At home, heat or cold therapy may be an option to help reduce swelling and control your pain. Your surgical team will provide specific instructions if these therapies are appropriate for you.
If you have an abdominal or chest incision, you will want to splint the area with a pillow when you are coughing or breathing deeply to decrease motion near your incision. You will be given a pillow in the hospital. Continue to use it at home as well.
Knee Replacement Pain A Year And Beyond
The goal of knee replacement surgery is to help you get back to the activities you love. Your doctor will encourage you to stay fit through activities like swimming, cycling, and even golf. This type of exercise will help you stay limber and pain-free.
On the contrary, there are certain activities that could negatively affect the prosthetic joint materials in place. Even normal use will begin to wear out the implants, but excessive weight or activity can cause your knee replacement to loosen and become painful. You may need to avoid running, jogging, high-impact exercises, and contact sports for the rest of your life following surgery.
The good news is that studies show more than 90% of total knee replacements are still functioning properly 15 years after surgery. Staying healthy and following the advice of your doctor will help you achieve these long-term benefits.
While its possible for pain to persist for a year and beyond, it shouldnt be debilitating. Scar tissue can continue to heal, as well as the muscles in your knee, but if youre suffering from ongoing pain after a year, always talk to your doctor.
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The Problems With Spinal Fusions
Doing a spinal fusion means removing the disc completely. This has been a standard operation for the last 30 years. What everyone would like for a disc problem is the ability to replace the disc with something which behaves just like a healthy disc.
The disc has a very important job, which is to act as a shock absorber and provide movement between each spinal segment. However, technology is not yet at that stage.
When you do a fusion, youre stopping the fused segment from ever moving again. Its an irreversible operation that changes the biomechanics of your spine.
At its most basic, the operation is reducing the ability of your body to work and move properly. More than this though is the problem of the adjacent segments. Because youve fused two segments of the spine, the segments above and below the fusion have to do extra work under more pressure.
Tips For Controlling Back Pain After Surgery
Controlling pain is part of your recovery success. If you are fighting through moderate or severe pain, your body cannot heal quickly. Always talk to your physician if your pain exceeds discomfort and is not manageable.
In pain? Preparing for surgery? PeerWell Health helps you fast forward to better with 1:1 doctor visits, physical therapy, and a custom at-home program for your condition.
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What Happens During Nerve Repair Surgery
Youre normally under general anesthesia for nerve repair surgery, so youll feel no pain during the procedure. Your surgeon examines the injured nerve using a powerful microscope and debrides torn tissue or scar tissue from the ends. The method used to repair your nerve depends on where its located and whats causing the pain.
If you have enough length on the ends of the nerve so that it can be reconnected without stretching it, your surgeon takes that approach. Its the most straightforward nerve repair procedure.
If your doctor has to take a significant amount of tissue from the nerve, leaving a gap so that it cannot be reconnected, he harvests a nerve from your leg or arm to place in the space. This procedure is called nerve grafting.
If you have health issues precluding a nerve graft, your surgeon may choose to use a conduit, a tube that spans the gap and connects the nerve endings. The tube is made of biological or synthetic materials.
When Will My Pinched Nerve Stop Hurting
A pinched nerve is a common condition that may arise when excessive pressure is placed on a nerve by its bones, muscles, or other surrounding tissues. The pressure interferes with the way the nerve functions and leads to a variety of uncomfortable symptoms such as numbness, weakness, and tingling. Symptoms may affect your back, hips, legs, ankles, or feet.
There are a variety of reasons you may experience a pinched nerve. An injury, rheumatoid arthritis, thyroid disease, diabetes, spinal stenosis, repetitive work or hobbies, pregnancy, or obesity may all increase your risk for this condition.
To diagnose a pinched nerve, a doctor will test your reflexes as well as your ability to move your muscles. They may also order an imaging test such as an MRI, CT-scan, or x-ray to look at the structures in your back or neck or an electromyography to check the function of your nerves.
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What To Expect From Nerve Repair Surgery
You have a nerve injury. Perhaps you have numbness, weakness, or chronic pain in a hand or an arm or leg from a traumatic injury, an infection, or a chronic disease like diabetes.
You may have been on temporary disability if your nerve injury affects your ability to do your job. For example, if youre a carpenter, electrician, plumber, or hold another job that involves using your hands, but your fingers or thumb are numb, you may not be able to work. Your nerve injury may require surgical repair so that you can regain normal motor function and sensation.
Our board-certified orthopedic surgeons at Coastal Empire Orthopedics treat many patients who need nerve repair. The surgery is the first step in healing your damaged nerve so that you can regain everyday use of the affected area of your body.
How To Know The Difference
Some patients dont recognize what type of pain theyre feeling. But you can always tell if something else has changed after your surgery. After all, its your body, and if theres anyone who can tell if something is wrong, its you and your doctor.
Nerve damage after a hernia operation is typically unique from the discomfort you felt before the surgery. Another thing that you might notice is the tingling pain on your chest wall after major heart surgery, which is also different from the discomfort youve endured before the surgery.
You can contact your doctor due to the following reasons:
- developing pain in the wound or scar after the operation
- the pain on the surgery site lasts for more than three months
- youre certain that cancer or infection are the causes of your pain
- the pain is different from the one you felt before the surgery
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Can You Fully Recover From A Broken Ankle Or Other Injury Requiring Surgery
Yes! Recovering fully from an ankle fracture or another injury requiring surgery can take several months. During this time, your bones, muscles, ligaments, and tendons must heal. Once your injured tissues are strong, you must also regain strength and mobility in the surrounding tissues.
Of course, every patient, every injury, and every surgical procedure is different. Factors like age and overall health and fitness affect recovery time. Younger patients typically experience quicker recovery times than older patients. Likewise, the severity of the injury and the complexity of the surgery play a role.
At any age and with any surgery, however, recovery is possible. Following your doctor’s advice, getting adequate rest, and adhering to your physical therapy program promote this recovery.
What Are Some Of The Risks And Benefits Associated With Pain Medication
Opioids after surgery: medications such as morphine, fentanyl, hydromorphone
- Benefits: Strong pain relievers. Many options are available if one is causing significant side effects.
- Risks: May cause nausea, vomiting, itching, drowsiness, and/or constipation. Although these drugs carry a risk of abuse and addiction, the risk is manageable if the medications are used properly, for the right reasons, and for a short period of time.
Opioids at home
- Benefits: Effective for moderate to severe pain. Many options available.
- Risks: Nausea, vomiting, itching, drowsiness, and/or constipation. Stomach upset can be lessened if the drug is taken with food. You should not drive or operate machinery while taking these medications. Note: These medications often contain acetaminophen . Make sure that other medications that you are taking do not contain acetaminophen. Too much acetaminophen can damage your liver.
- Benefits: Effective for mild to moderate pain. They have very few side effects and are safe for most patients. They often decrease the amount of stronger medications you need, which may reduce the risk of side effects.
- Risks: Liver damage may result if more than the recommended daily dose is used. Patients with pre-existing liver disease or those who drink significant quantities of alcohol may be at increased risk.
Nonsteroidal anti-inflammatory drugs ibuprofen , naproxen sodium , celecoxib and others
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