Get Answers to Your Questions in Our Nerve Damage and Surgery FAQ
Why does my foot look different after my knee replacement surgery? Should it hurt to have sex after a C-section? How can I relieve the pressure on a trapped nerve? Our FAQ page has the answers you need to kick chronic pain for good.
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Is occipital neuralgia serious?
Even though occipital neuralgia is not a life-threatening condition, it can have a serious impact on your overall quality of life. It can cause pain that interferes with daily activities and may prevent you from enjoying time with family or friends.
You can often find relief from the pain caused by occipital neuralgia through various treatments. When conservative treatments fail to bring the necessary relief, occipital nerve decompression surgery performed by a peripheral nerve surgeon can help.
Treating Occipital Neuralgia
Occipital neuralgia can occur if there is a pinched or damaged occipital nerve that runs from the neck to the base of the skull. It can result in a chronic, intense headache that makes it difficult to do daily activities. While the pain from occipital neuralgia is similar to that of a migraine, the condition itself is more serious since it is nerve related.
In order to effectively treat occipital neuralgia, the source of the pain needs to be determined. To diagnose the condition and determine if a compressed occipital nerve is the cause of the pain, a nerve block may be done. If the nerve block temporarily provides relief from the pain, it can confirm the diagnosis of occipital neuralgia.
When conservative treatments such as medication do not provide relief, nerve decompression surgery can be done to release the occipital nerves from muscles or surrounding tissue that are compressing the nerves. This surgery is done as an outpatient procedure and you will be able to go home the same day.
After the occipital release procedure, you may have restrictions to follow for several weeks. These include no heavy lifting or driving a vehicle. You may also feel tired and may need to take pain medication. Headaches from occipital neuralgia should be reduced after the first two weeks but numbness and tingling may be present until the nerves recover from the prior compressed condition.
Find Relief From Occipital Neuralgia
If you have occipital neuralgia and are looking for pain relief options, contact Dr. Williams to discuss if surgery may be the right choice for you. To schedule an appointment in the Baltimore office, call us at (410)709-3868 or fill out our contact form online.
Why does my surgical scar still hurt?
It is not uncommon for a surgical scar to hurt after an incision is healed. Scar tissue forms after surgery to heal a wound and can form internally or externally. This scar tissue can often cause pain due to a variety of reasons including an injury to the nerve. Dr. Williams can determine the cause of your surgical scar pain and recommend options that will best suit your needs.
Common Causes for Surgical Scar Pain
The most common cause of surgical scar pain after surgery is a nerve that is injured or stuck in scar tissue. You may not only experience pain from scar tissue, but may also have swelling, itching, and increased sensitivity.
Some common causes for surgical scar pain are:
- Tightness. Tightness in the surgical site can make moving difficult and painful.
- Nerve damage. Damage to the nerve can cause pain or numbness in the surgical site area.
- Adhesions. Adhesions are caused by fibrosis and can cause inflammation and pain. They can also cause a loss of joint or tissue function.
In order to reduce surgical scar formation and pain, you can do the following at home:
- Moisturize to keep the scar tissue hydrated.
- Break up the scar tissue by doing a self-massage using circular motions along the scar.
- Move around to prevent the area from becoming tight.
- Use sunscreen to prevent sunburns and discoloration.
Keep in mind that after surgery, it is normal to experience pain as you heal. If this post-surgical pain becomes chronic and lasts after several months to a year, it is time to consult Dr. Williams for an evaluation.
Dr. Williams will determine the cause of your pain and recommend options to provide relief. Depending on the cause of your pain, the following options may be considered:
- Nerve reconstruction
- Nerve decompression
- Nerve resection
- Revision to the existing procedure
If a nerve is not causing the issue, surgery may not be an option to reduce the pain. In those cases, physical therapy, massage, laser treatments, and other conservative methods may be recommended to help provide relief.
Contact a Nerve Pain Specialist
If your surgical scar still hurts and you need to find relief from the pain, contact Dr. Williams for a consultation. To schedule an appointment in our Baltimore office, call us at (410)709-3868 or fill out our contact form online.
Is it normal to experience chronic pain after hernia surgery?
Experiencing pain after hernia surgery is part of the normal healing process. If you had inguinal hernia surgery in the groin area and your pain after surgery is lasting longer than six months, however, it is considered to be chronic pain.
Chronic pain is not normal and should never be ignored. It can indicate that there is a nerve injury, nerve damage, or inflammation happening in the surgical area. Chronic pain should be evaluated by a pain specialist to determine the cause and best options for relief.
Types of Post-Surgical Pain
Most hernia surgeries are minimally invasive procedures that involve pushing the hernia back inside the body and placing a mesh patch and stitches on the abdominal wall to strengthen and support the area using a laparoscopy technique. Some hernia surgeries are done as open surgeries and use the same mesh technique.
After surgery, it is normal to feel pain for several weeks. Pain is part of the healing process and can be relieved by medication.
For pain that does not go away, there can be other reasons. Post-surgical pain can result from:
- Inflammation from the placement of the mesh
- Sensory nerve entrapment in the scar tissue
- Nerve damage or injury
Chronic pain after hernia surgery can be felt as a burning or stabbing pain in the groin area and cause complications with sleep. Some other symptoms of chronic pain after hernia surgery are:
- Pain when walking
- Pain when sitting
- Pain in the groin area or testicles
- Pain that radiates
- Feeling that something foreign is in the body
- Pain with physical intimacy
- Pain with wearing clothing such as underwear or a belt
- Psychological distress
Chronic Pain Treatment Options
Treatment for chronic pain after hernia surgery depends on the cause and level of pain you are experiencing. If you are experiencing persistent pain for six months or more, nerve damage is likely to be the reason.
The most common cause of chronic pain after hernia surgery is damage or injury to a nerve. During hernia surgery, a nerve may have been injured, compressed, or stuck in scar tissue after the mesh insert was placed. To determine if the pain is the result of nerve damage or injury, a nerve block may be used. A nerve block uses a local anesthetic to reduce the pain. If the nerve block temporarily reduces the pain, it indicates that nerves are the cause of the problem.
Dr. Williams can do the following to help with a nerve-related pain issue:
- Nerve reconstruction
- Nerve decompression
- Nerve resection
- Additional surgery to correct the previous hernia repair procedure
Contact a Post-Surgical Pain Specialist
If you are suffering from chronic pain after hernia surgery or have questions about what options are available to relieve chronic pain after surgery, contact post-surgical pain specialist Dr. Eric H. Williams. To schedule a consultation in our Baltimore office, contact us online or call us at 410-709-3868.
When should I be concerned about chronic pain after a knee replacement?
Knee replacement surgery can be life-changing. It often allows a person to reclaim an active lifestyle they may have thought was lost forever due to the poor functioning of their knees.
But not every knee replacement is entirely successful. In some cases, patients report experiencing ongoing problematic pain that hinders them as much—or more—than the problem the surgery was supposed to fix. While it is only natural that there will be some pain during the recovery and rehabilitation periods after surgery, chronic pain means there is a serious problem that needs to be addressed.
Causes of Post-Surgery Pain
There are a range of reasons you might experience chronic pain after a knee replacement procedure. For example, something could go wrong with the artificial knee itself and lead to significant pain. Or an infection could be the issue. Or you might experience what is called “overstuffing”—a condition in which your knee joint is larger following the surgery and feels as though it is filled up more than it should be.
Another possibility is nerve damage. It is possible that during the procedure, the surgeon inadvertently damaged nerves around the joint. It might also be the case that nerves have become entrapped in scar tissue or compressed. When any of these things happen, you may well experience ongoing pain that turns out to be difficult to diagnose.
In these circumstances, a peripheral nerve surgeon—like Dr. Eric H. Williams—is your best option for finding the relief you need.
Don’t Ignore Ongoing Pain After a Knee Replacement
If it has been six months since your surgery and you are still in pain, something is definitely amiss. Don’t ignore the pain or try to grit your teeth and just keep going. Instead, talk to a doctor right away. If the problem is nerve damage, entrapment, or compression, peripheral nerve surgery can be the solution.
We Can Help You Get Relief From Post-Surgery Chronic Pain
Dr. Williams has the experience and expertise necessary to diagnose and correct problems related to damaged nerves following knee replacement surgery. If you have been in pain for months following surgery, it is time to get some relief. Contact us today so that we can help sooner rather than later.
What conditions could meralgia paresthetica be mistaken for?
While the numbness, tingling, or burning of meralgia paresthetica is not the kind of thing you can miss (especially if these feelings in your thigh keep you tossing and turning at night), the actual diagnosis of the problem is frequently missed.
A number of conditions resemble meralgia paresthetica closely enough that misdiagnosis is possible. These conditions include:
- Lumbar radiculopathy. Pain caused by compression or inflammation of a nerve in the spine
- Trochanteric bursitis. Inflammation of the fluid-filled sac near the hip joint
- Primary hip disease. Also known as primary osteoarthritis
- L2-L3 nerve root lesion or other neuropathies. Can lead to difficulty climbing stairs
- Chronic appendicitis. Symptoms may come and go but can be quite serious
- Uterine fibroids. Noncancerous growths of the uterus
With so many conditions with similar symptoms, it is only natural that misdiagnoses can occur. But while it may be to be expected, that is not much comfort when you are the person who is experiencing the symptoms. Fortunately, there are some diagnostic tools that can help.
Identifying the Problem Correctly
Your doctor may order radiographs of your hip in order to determine whether your issue is meralgia paresthetica or another condition. It is also possible that your doctor may use electromyography (EMG) to help make the diagnosis. EMG records electrical activity when a nerve stimulates a muscle and can be used to identify and diagnosis neuromuscular abnormalities. The test requires inserting one or more small needles into a muscle and EMG can distinguish meralgia paresthetica from radiculopathy or pain emanating from the hip.
Once the issue has been properly diagnosed, corrective measures can be taken. If the issue is indeed meralgia paresthetica, nerve release surgery may be the most effective solution if more conservative treatment options have not provided relief.
Dr. Eric H. Williams Can Identify and Treat Meralgia Paresthetica
As we have suggested, a correct diagnosis is the first step toward finding relief from meralgia paresthetica. Dr. Williams can provide that diagnosis—and once the problem is properly identified, he can suggest the best path forward. If you have discomfort toward the top of your leg, don’t wait to start the journey toward relief. Contact us today to schedule an appointment.
What is traumatic carpal tunnel syndrome?
When we think about carpal tunnel syndrome, we generally think of a repetitive stress injury. We might, for example, associate the numbness, tingling, and pain of carpal tunnel syndrome with jobs that involve a significant amount of typing or other repetitive motions.
Carpal tunnel syndrome can also be caused by a traumatic injury such as a car accident. Any injury that entraps or impinges on the median nerve as it passes through the carpal tunnel in the wrist can lead to the development of symptoms.
How an Accident Can Lead to Traumatic Carpal Tunnel Syndrome
In an event like a car accident, the ligaments and tendons surrounding the median nerve may be damaged. As they heal, scar tissue may form. This scar tissue can impinge on the median nerve leading to the classic symptoms of carpal tunnel syndrome. Because the problem arises as ligaments and tendons heal rather than in the accident itself, the onset of traumatic carpal tunnel syndrome is often delayed—sometimes for quite some time.
Once traumatic carpal tunnel syndrome is diagnosed, however, the treatment plan resembles that of any case of carpal tunnel syndrome.
Treating Traumatic Carpal Tunnel Syndrome
In most cases, your doctor will suggest a series of common, conservative treatment options to try to get you relief from your carpal tunnel symptoms. However, these are not always effective—especially since the cause of the problem is trauma rather than repetitive motion or genetic predisposition.
It may well be the case that the best solution for addressing the symptoms of traumatic carpal tunnel syndrome is the minimally invasive surgical technique known as ultrasound-guided carpal tunnel release. This surgery releases the median nerve, alleviating the symptoms of carpal tunnel syndrome.
Dr. Williams Can Treat Trauma-Induced Injuries
Dr. Eric H. Williams has the experience and expertise required to help you get the relief you need from traumatic carpal tunnel syndrome. Schedule an appointment today so that we can get you on the road to recovery sooner rather than later.
Can meralgia paresthetica make it hard to sleep at night?
As names of medical conditions go, meralgia paresthetica is a mouthful. And the condition itself is no picnic.
Meralgia paresthetica is caused by the compression of the lateral femoral cutaneous nerve. That’s the nerve responsible for providing sensation to the front and side portions of your thigh. When that nerve is compressed, the sensations you feel are not the normal ones you might expect. Instead, you may experience burning, aching, numbness, or even stabbing pains in and around your thigh.
Having any of those feelings in your thigh is likely to make it quite difficult to drift off to sleep, so it is important to find a way to address the problem.
A Few Self-Care Options to Try
There are some self-care things you can try to lessen the burning sensation that often makes it difficult to sleep. For example, you might try kinesiology tape as a way to take pressure off of the compressed nerve. Or you could head to your kitchen, grab a rolling pin, and roll it over the affected area in an effort to at least temporarily restore regular nerve function.
You can also choose a sleeping position that is likely to ease the problem. The best option is to sleep on the side opposite the discomfort with a pillow between your legs. (If the burning is in your left thigh, sleep on your right side.) This can help ease the compression of the nerve enough to allow you to get to sleep.
Sometimes Surgery Is the Way to Go
These self-care options can sometimes provide relief and allow you to get the sleep you need. However, if conservative treatments are ineffective, surgically releasing the nerve so that it is no longer compressed might be the best option. Freeing the trapped nerve can offer lasting relief from meralgia paresthetica.
Dr. Williams Can Help Your Meralgia Paresthetica
If you are losing sleep due to meralgia paresthetica, it is time to see a doctor. Dr. Eric H. Williams is an experienced and compassionate surgeon committed to helping patients move past persistent pain related to nerve issues. If you are experiencing ongoing discomfort in the area of your thigh, contact us today for an appointment.
How do I know if I need carpal tunnel surgery?
You have been experiencing the symptoms of carpal tunnel syndrome for quite some time. During that time, you have tried a range of different conservative approaches to treatment.
You’ve worn braces. You’ve consistently done some stretching exercises. You’ve tried over-the-counter pain relievers. But so far, nothing has really provided significant, consistent relief. And at this point, the pain, numbness, and tingling are starting to make it difficult for you to continue with your daily activities—a situation that can be particularly problematic if the pain is preventing you from performing your job duties.
It’s time to consider surgery.
Don’t Wait Too Long to Take Care of Your Carpal Tunnel Pain
You may be reluctant to have surgery. That’s completely understandable. However, it is important to remember that surgery will stop the progression of the nerve damage you are experiencing. Stopping ongoing damage sooner rather than later is the best move you can make to ensure positive results from the surgical procedure.
In addition to simple reluctance to have surgery, you may also be worried that having the procedure done will result in a long recovery period that might keep you from working or enjoying your regular activities.
Fortunately, we have good news on that front: The recovery time is minimal for ultrasound-guided carpal tunnel release surgery. That means you can get back to your daily life quickly—and in significantly less pain.
Let’s Take Care of Your Carpal Tunnel Syndrome Pain. Contact Our Nerve Pain Specialist Today.
Dr. Eric H. Williams is ready to help you find relief from the ongoing symptoms of carpal tunnel syndrome. Ultrasound-guided carpal tunnel release surgery can correct the problem and get you back to your activities quickly.
If conservative approaches to dealing with the symptoms of carpal tunnel syndrome simply are not getting the job done, it is time to talk with Dr. Williams. You do not have to just live with the pain of carpal tunnel syndrome. Instead, contact us today to get started on the path toward putting carpal tunnel syndrome symptoms in your past.
How do I know if my ankle pain is neuropathic?
When you sprain your ankle, the pain you feel generally falls into the category of orthopedic pain—which simply means it is related to the muscles, bones, and connective tissues in and around your ankle.
Neuropathic pain is different. Pain is said to be neuropathic if it is caused by injured, stretched, or compressed nerves. You may experience neuropathic pain as a result of an ankle injury or after ankle surgery. This sort of pain is generally chronic—meaning it lasts for more than six months after an injury or surgery.
Symptoms of Neuropathic Pain
When asked to describe their pain, our patients have used some striking comparisons:
- It feels as though you are walking on sharp rock or shards of glass.
- It feels as though bees are stinging or fire ants are biting your foot constantly.
- It feels as though your entire foot is wrapped in barbed wire.
- It feels like a serious sunburn on the top of your foot.
- It feels like an electric current is shooting down your leg.
In addition, you may experience discomfort or pain (often severe) simply because you are wearing shoes or socks—or even when your foot is touched by something light like a bedsheet.
Sometimes the Solution Is Surgery for Your Neuropathic Pain
If it is clear that the pain you are experiencing is not orthopedic in nature, it is time to be evaluated for neuropathic pain and to discuss potential solutions.
In some cases, there are non-surgical approaches that might help. In other instances, surgery to release the compressed nerve or otherwise repair nerve damage may be the best solution.
One thing that is not an option is to simply try to ignore neuropathic pain. It will upend your day-to-day life, keeping you from enjoying your active lifestyle. Finding the best solution for relieving neuropathic pain is essential.
Dr. Williams Can Help You Find Relief. Contact Our Nerve Pain Specialist Today.
Dr. Eric H. Williams is committed to listening to you and to finding the best solutions to address ongoing pain. Known for both his skill as a surgeon and his compassion for his patients, Dr. Williams will make sure you understand all of your options and are comfortable with the proposed solutions. To learn more about neuropathic pain, request our free whitepaper. When you are ready to get relief from your chronic pain, contact us to make an appointment.
Could my pain have been misdiagnosed as sciatica?
Superior cluneal nerve entrapment is hard to diagnose and is often misdiagnosed as sciatica.
If you are experiencing pain in low back and buttock, it may be related to a problem with a nerve. The nerve may be the sciatic nerve, which is located fairly low on the body beneath the sacrum and pelvic bone. Or it may be the cluneal nerve, which is located outside the spot where the sacrum and pelvic bone come together.
Okay, so two different nerves in two different spots. So far, so good.
But brace yourself for another unusual word: the cluneal nerve travels through a fibro-osseus tunnel (we warned you!) tunnel. That tunnel is not unlike the carpal tunnel in the wrist and the cluneal nerve is not unlike the median nerve. That is to say: just like the median nerve can get squeezed in the carpal tunnel, the cluneal nerve can get squeezed in its fibro-osseus tunnel.
The result is easy to understand: pain.
Diagnosis of Superior Cluneal Dearve Entrapment Is All About Location
We’ve noted the different locations of the sciatic nerve and the cluneal nerve. Those different locations mean they can cause pain in different parts of the body. Sciatica generally involves pain in the lower part of the buttock radiating down the back of the leg. Superior cluneal nerve entrapment generally involves pain in the lower back through the buttock—but not into the leg.
It is often misdiagnosed as sciatica, but also SI joint dysfunction, arthritis, and lumbar spine degenerative disease. It is very important and even needed for the patients to have a differential diagnosis explored by their physician. They can try to compare the results of different blocks that they have and their effect on their pain. It is important not to let the doctor tell the patient if the block was successful. It is important that the patient tell the doctor if it worked or not. Because spinal joint disease is so common, we frequently only see what we know. So, if someone has "an okay" response with one injection, but a superior cluneal nerve block is not tried to compare the result to the facet block or the epidural injection, or nerve root injection, or SI joint injection, then the patient may miss the opportunity to compare the results. They may actually find out before they have a failed spinal fusion or laminectomy, or SI joint fusion, that the superior cluneal nerve may actually be the culprit. It is also very possible that the patient may have both! This does happen more than we think, and it is one reason why patients may not see the results they wanted with one diagnosis is completely treated. If they are still having pain after spinal fusion or SI joint fusion, the patient can either "accept" the outcome or keep looking. One of the things to look for is compression or injury to the superior cluneal nerves.
The nerve is located lateral to midline, at the low back, and crosses only into the upper buttock, though it can radiate down as far as the posterior hip. Patients may be able to find it themselves by pressing at the low back at the location of their posterior pelvic bones.
Let’s Talk About AblationIf physical therapy, stretching, heat, ice, anti-inflammatories, and conservative measures do not help, and nerve blocks of the superior cluneal nerves have provided good evidence that this is the cause of pain, then ablation of the nerves is an option. There are several ways to ablate these nerves. Some pain management teams will "burn" the nerves with radiofrequency ablation; some may freeze them with cryoablation. This is great when they work. The only problem I have seen with these modalities is trying to cover all of the anatomic variations of where these nerves are located. So, we prefer as surgeons to take a more direct approach: surgical resection. We prefer surgically exploring the region, finding the nerves, no matter where they are located, and surgically removing them. We have seen many variations in the anatomy which can easily explain why the RFA and Cryo approaches may not be as successful in some patients as others. While the surgical approach is more invasive, it tends to provide a much better view of these nerves than the current imaging modalities such as ultrasound. Because this is essentially an operation on the skin, recovery tends to be rapid.Other options for treatment may include "electrical stimulation." Some may try to "stimulate" the nerve to try to stop hurting with peripheral or spinal cord stimulators. Again, due to the same anatomic variations that can make the ablation procedures challenging, this makes the result of stimulators challenging as well. Also, these techniques require the permanent implant of a foreign body in the lumbar region which many patients would like to avoid.
Get the Right Diagnosis and Clarity About Treatment
We understand that just reading this FAQ may have given you a headache—so here’s the long and short: if you are having pain in your posterior, you need to get the right diagnosis so that you can get the correct treatment. Dr. Eric H. Williams can diagnose the specific cause of your pain and explain the best course of action to correct the problem. Contact us today so that we can get started putting a stop to your pain.