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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  • Why does the tarsal tunnel syndrome cause so much pain?

    Why does the tarsal tunnel syndrome cause so much pain?FAQ Tarsal Tunnel Surgery

    Tarsal tunnel syndrome occurs when the tibial nerve and its branches of the medial plantar, lateral plantar, and calcaneal nerves get compressed or pinched.    Essentially the compression of nerve can occur from structural changes, trauma, extra muscles that you are born with, an enlarged nerve, and a variety of other cause.   Essentially there is just not enough room in a very tight space for the nerve to continue to function properly.   This leads to decreased blood flow or decreased ability for the nerve to get the appropriate nutrients and supplies it needs to function properly, and then it does the same thing that all nerves do when they stop working well…..  It talks to you!   Numbness, burning pain, tingling, buzzing, “creepy crawlies” can occur, or weakness, and muscle atrophy, loss of balance can also eventually set in.   Why some patients experience some of these symptoms while others do not is a bit of a mystery.

    What is a typical recovery like after release of the tarsal tunnel and the medial plantar, lateral plantar, and calcaneal nerves?   

    Most patients report that they actually do quite well after tarsal tunnel surgery, but some will struggle more than others. Because there is an incision on the inside of the ankle, and because the ankle does move, this is usually the source of most of the discomfort. Some physicians prefer to splint the foot after surgery to all the skin to rest and in an effort to improve the pain.   This is in general a good idea for orthopedic type procedures where the surgeon wants the foot to remain still so that bones heal, and that ligaments and tendons that were operated on or sutured together heal in with scar tissue like glue.  But when we consider nerve surgery we DON’T WANT SCAR TISSUE TO FORM AROUND NERVES, so it is very important to get the foot moving quickly.  Think of this as steel reinforced concrete.   The nerve is the rebar and the scar is the concrete.   We DON’T want steel reinforced concrete, we don’t want the nerve getting stuck in the scar tissue, so it won’t move or glide back and forth. We want to start making a tract for that nerve to move almost from the first day that we are done operating.  But we don’t want the skin to break down either.   So we have to play a delicate balancing act.   Ask the patient to move the ankle, but not use the ankle too much.  Ask the patient to move the foot, which may be uncomfortable, but allow the patient enough support, so they are not miserable.    We wrap the foot after tarsal tunnel release with a large cotton dressing that looks kind of like a giant cotton ball.   This bulky dressing is soft and moves with the patient but is sturdy enough not to fall apart.  It allows the patient to weight bear with some force, but it is annoying enough to keep them from running around the house.   It is soft enough that it won’t bother the person next to you in bed, but it is firm enough to be supportive and protect the incision.    

    Will I need crutches after surgery? 

    Yes. As we age, however, crutches can get a bit unwieldy, and so frequently, we will recommend a walker for those who have a bit more difficulty getting around.  Nearly all folks will need crutches at least until the dressing comes off after one week. Remember, we don’t want the patient to break the incision open because they are walking too much. About half the patients will no longer be using crutches at three weeks after the surgery when they come to have their incision evaluated and the sutures removed. A few stragglers will need crutches for about a month. If you need them longer than this, you are really struggling, and we will need to re-evaluate and make sure that everything is okay and determine if physical therapy would be beneficial for you.   

    May I shower after surgery? 

    I do expect patients to shower after surgery.  Patients will typically have to use a protective “cast bag” or large plastic bag around their leg to protect the giant water-absorptive cotton ball that is wrapped around their leg.  It is not fun when this gets wet – so don’t get it wet.  Have a plastic dressing placed over the incision that will allow them to shower.  But we do not allow patients to take a bath for about two weeks.

    Can I wash my tarsal tunnel incision after my dressing comes off?  

    Yes. You may wash the suture line with hibaclens soap (antibacterial soap) daily.  We then ask the patient to paint the incision with Betadine or Iodine to keep it clean and cover it with a large bandaid to protect it.  Putting an ace bandage on the foot at this time can also help keep the post-op swelling down. 

    Do I need physical therapy after surgery after Tarsal tunnel release?  

    This is a very personalized answer.  Some patients have had a wonderful experience with physical therapy while others have not.  Some patients will prefer to “do it on my own.”  While other patients will really like to have someone “helping them along.”  We are happy to recommend physical therapy when patients feel that this will be a major benefit for them.  I do think there is an advantage to this.  However, we also acknowledge that some patients will be able to control their own recovery well with a graded gentle return to activities.  We discourage any strenuous activities for about six weeks, but walking on even ground, walking on a treadmill, or elliptical trainer can be very helpful in increasing one’s activity AFTER the sutures have come out three weeks after surgery.   We generally will not start physical therapy until this time.    We strongly encourage walking on land and in a pool starting 3.5 weeks after surgery to help you recover well.  REMEMBER:  we don’t want patients busting open their incisions, so we ask patients to “walk for the needs, and not their wants” for the first three weeks.  

    Can I drive after my tarsal tunnel release? 

    Eventually you can return to driving.  But let’s use some common sense. 

    1.  If we operate on the right foot and you have sutures in the ankle, then you are going to be moving that ankle a lot.   That is great for getting the nerve to move back and forth, but that is NOT great for the incision, which has sutures that can cut through the skin.  So if you have surgery on the RIGHT foot, it will be a bit longer before you can drive.  

    2.  Common sense helps here as well.  If you are stoned on drugs – NO, you cannot drive.  3.  If your pain is more than you can tolerate and you are distracted by it – NO, you can not drive.  Most people who have their LEFT FOOT operated on can start to drive somewhere between 10-14 days after surgery. RIGHT FOOT is a bit longer.   BUT Everyone is different.  

    The MOST IMPORTANT thing to remember is SAFETY!   Do not put yourself or others around you in danger.  Please use common sense.  If your spouse or family member won’t get in the car with you when you want to drive — then you should not be driving!   However, if they won’t ride with you PRIOR to surgery –  I can’t help you there…  You are on your own.      

    When will I know if I am better after tarsal tunnel release?  

    This is a complicated question. As one can imagine, there is NOT one correct answer here, and believe it or not – you will be telling your doctor when you are better!  However, in our experience, some patients will see relief from the minute they wake up. Others will get relief slowly over time.  Still, others may not get the relief that they were hoping for at all.   However, our experience is that most patients (85%) will eventually get improvements within weeks to months.   It is also common to continue to see improvements over time. We encourage patience, as those who have had symptoms for many years may take longer to improve.  We encourage patients to wait 6-12 months before trying to find and search out “other” causes for their pain because it can take time to see improvements, especially in particularly challenging situations.  

    When can I return to work after tarsal tunnel release surgery? 

    Again, this is a very individualized question.   If you are a sedentary worker and do mostly desk work, and you can work from home, then most patients may feel up to returning to work after about a week.   If the home option is not available, then it may take anywhere from 1-3 weeks.  If you have a heavy manual labor type position and are in significantly dangerous situations, then it may take up to 2-3 months.  If you have a position where you are expected to walk around for an extended period every day but are not in a particularly dangerous environment, you will probably be looking at about 3-4 weeks, but again everyone is different. The main point here is to make sure that you are SAFE to return to your work, and to be kind to yourself, while not taking advantage of your employer.    Your safety and your recovery are our priority, but we also want to be socially responsible as well.  

    Will I be able to return to sports or activities like hiking, yoga, running, etc.?    

    Well, it helps if you were active in these areas BEFORE the operation! But in general we do expect patients to get back to many if not all of the activities that they enjoyed prior to surgery. We strongly encourage walking on land and in a pool for several weeks after surgery to help you recover well.  It may take up to three months before you can be expected to have unrestricted activities.   

    What kind of pain can I expect after a Tarsal Tunnel release surgery?

    The pain after tarsal tunnel release seems to be very reasonable for nearly all patients. There are always the two ends of the spectrum. There are the patients that do have a very high pain threshold, as well as those with a very low pain threshold. But most patients do very well with a mixture of several medications. We encourage a cocktail of medications, both over the counter as well as prescription medications. We typically start with extra strength Tylenol and motrin alternating these throughout the day.  Then we add to this Gabapentin or lyrica for their treatment of nerve pain. We encourage ice on the surgical site intermittently, and then finally patients are given a prescription for a stronger narcotic medication that they may take if they are still experiencing pain that is not well controlled.  Some of our patients never take a pill of the narcotic, but most will take a few tablets. 

    What will I need after my Tarsal Tunnel surgery?  

    You will need crutches or a cane or walker for a few days to steady your gait. Some people who want to return to work early or who have long distances to walk may want to use a rolling scooter for some of the time they are up and about. You will need to pick up your medications for postop discomfort.  You will need a nice ice bag or two – (nothing wrong with a ziplock freezer bag.) You will need a protective cover to place over your dressing while you shower.  You will want to try to set up a place to recover that is on one floor if you can, but this is not required, but it is much easier. You will need someone to help drive and do many of your normal daily chores while you are recovering.  

    When can I travel after my tarsal tunnel release?  

    We do see many patients from out of town. If patients live less than two hours away from Baltimore, then they may go home after the procedure. They will need a ride as they will not be able to drive themselves. If they are driving distance, but further than two hours away, we typically ask them to spend the night in one of our local hotels. The reason we do this is in case of a complication such as bleeding, the patient can contact us and be seen quickly. Otherwise, they might be hours away and have a hard time trying to get into an emergency room with physicians that they do not know. If you are flying from out of town, we typically encourage patients not to make plans for a minimum of 24-36 hours. Again safety is our primary concern here. We want to make sure that there are no acute complications, that your pain is well controlled, and that you have plenty of time not to rush through the airport.   

  • Why does my colostomy site have burning pain?

    If you recently had colostomy surgery and have symptoms such as burning or stabbing pain around your colostomy site, you might wonder why this pain is happening and what can be done to make it stop. Consulting an experienced nerve specialist can help you understand the various causes of colostomy site pain and if nerve reconstruction surgery is an option to treat it. Colostomy site pain treated by Baltimore nerve specialist

    Causes of Colostomy Site Pain

    A colostomy is an opening made on the abdominal wall that connects the colon to an external collection bag. The purpose of a colostomy is to allow waste products to pass out of the body without having to go through the large intestine. This procedure is life-saving for many patients and, in some cases, can be reversed over time. 

    Some patients report severe debilitating pain around the site of their colostomy. This pain is often due to intercostal nerves caught in scar tissue or even stitched when the surgeon closes the site. This can lead to irritation and inflammation that produces a burning or stabbing sensation in the area of the colostomy site. Most people experience radiating pain from the abdominal wall to the side.

    Another possible cause of burning pain is post-operative inflammation due to stitches or sutures used during the procedure. As these begin to heal, they put pressure on nearby nerves, inflaming them and creating great discomfort.  

    Consulting an Experienced Peripheral Nerve Surgeon

    Without question, burning pain near the site of the stoma is uncomfortable, inconvenient, and disruptive to daily life. Fortunately, there are treatments for debilitating nerve pain. A peripheral nerve surgeon who specializes in pain treatment can determine the root cause of your symptoms and develop a treatment plan tailored specifically for you. 

    For example, a nerve block may be administered to rule out other potential conditions, such as a hernia. If the nerve block provides relief from the pain, then entrapment of the intercostal nerves may be to blame.

    Nerve reconstruction surgery is one type of procedure Dr. Williams performs to relieve pain at the colostomy site. It involves removing the sensory nerves stuck in scar tissue and relocating them to a surgical site far from the previous one so it doesn’t occur again or form a painful neuroma. One of Dr. Williams’ patients reported up to 95 percent relief of his pain—so much so, he was able to get off all narcotic and neuropathic medications, and now only uses an over-the-counter pain reliever occasionally.

    If Dr. Williams determines you’re a candidate for nerve reconstruction surgery to relieve colostomy site pain, he’ll outline the risks associated with the procedure and the results you can expect. He’ll also provide thorough answers to your questions so you can make an informed decision about your next steps.

    Don't Live With Burning Colostomy Site Pain 

    Life after colostomy surgery shouldn’t involve burning or stabbing pain. To learn about effective treatments that can make a difference for you, reach out to Dr. Williams for an evaluation—call our Baltimore office at 410-709-3868 or contact us online.


  • Does nerve decompression surgery work for everyone who has diabetes?

    man with red irritated feet peripheral neuropathyNerve decompression is a surgical procedure used to relieve pain caused by a compressed nerve in the body. It can be an effective treatment for some people with Type 1 and Type 2 diabetes, but it is important to understand that not everyone will benefit from the surgery. In order to make an informed decision about whether or not nerve decompression is right for you, it is important to discuss your options with your doctor.

    Success of Nerve Decompression for Those With Diabetes

    Even though nerve decompression can work effectively for some people with Type 1 or Type 2 diabetes, it is not an option for everyone. Those who are ideal candidates for the procedure have symptoms of numbness and tingling, either with or without the presence of pain due to peripheral neuropathy. If there is only pain without numbness or tingling, they may not be a candidate for nerve decompression.

    Determining if nerve decompression surgery will be a successful option for you depends on individual factors such as:

    • The severity of your nerve damage
    • Whether your diabetes is well-controlled and your HgbA1c is less than 8.5
    • Weighing under 350 pounds
    • Not having uncontrolled swelling or restricted blood flow in your feet or any current open wounds

    What to Discuss With Your Doctor Before Surgery

    Before deciding if nerve decompression surgery is right for you, there are certain things you should discuss with your doctor. These include:

    • Your medical history, including any past surgeries
    • Any medications you are currently taking, including over-the-counter drugs and prescription medications
    • Your current level of physical activity and lifestyle habits
    • Risk factors associated with nerve compression surgery, such as anesthesia risks
    • Recovery time frame and post-surgical care instructions 
    • Potential complications or side effects 

    If you are considering nerve decompression surgery, schedule an appointment with Dr. Williams. He can determine if you will benefit from surgery and create a treatment plan to fit your needs. Find out more by contacting our Baltimore office at (410) 709-3868 or by filling out our contact form online.

  • Are there any alternatives to medication for diabetic nerve pain?

    two pill bottles on white background pain medicationDiabetic nerve pain can be a debilitating condition, causing severe discomfort and making everyday activities like walking or even standing difficult. While medication is often the first course of treatment for diabetic peripheral neuropathy pain, the drugs can have undesirable side effects, such as weight gain and fatigue. If you are suffering from diabetic nerve pain, Dr. Williams can evaluate your condition to determine what treatments other than medication, such as nerve decompression surgery, may be an option for you to consider.

    Nerve Decompression for Diabetic Nerve Pain

    Nerve decompression is a surgical procedure to free compressed sections of nerves in the body to increase blood flow, allow the nerves to move more freely, and reduce pain caused by compression. This procedure has been shown to be effective for many people suffering from peripheral neuropathy by helping to relieve symptoms of nerve pain and restore mobility and function. If you are looking for an alternative to medication for diabetic nerve pain, speak with Dr. Williams about the possibility of undergoing a nerve decompression procedure.

    With the proper treatment, you can regain control over your condition and live a more comfortable, pain-free life. In addition to having Dr. Williams perform nerve decompression surgery, you can do the following to manage symptoms of diabetic peripheral neuropathy:

    • Monitoring your blood sugar levels to keep them under control
    • Increasing exercise and eating a healthy diet
    • Quitting smoking
    • Taking good care of your feet

    Are You Looking for a Diabetic Nerve Pain Specialist?

    If you suffer from diabetic nerve pain and are looking for treatment options other than medication, contact our office for an evaluation. Dr. Williams can determine if nerve decompression surgery is an option for you and will create a treatment plan to help ease your pain and get you back to living pain-free as soon as possible. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.

  • What should I do if I have knee pain after knee replacement surgery?

    man with knee replacement surgery scars in painIf you have pain or discomfort after knee replacement surgery, it could be part of the normal healing process. However, it should not be ignored when the pain is ongoing or becomes severe since it could indicate a more serious problem. Dr. Williams can evaluate the post-surgical pain you are experiencing to determine what treatment options may work best for your specific condition.

    Why You May Have Knee Pain After Joint Replacement Surgery

    Experiencing some discomfort or pain while you heal after knee replacement surgery is normal. You will likely have some pain when kneeling, bending the knee, or doing daily activities. Pain may also occur at night, but the pain should begin to subside after a few weeks. Your surgeon should have told you what to expect and might have prescribed a pain reliever to take in the days following surgery.

    Chronic pain after knee replacement surgery is not normal, however. It could indicate a more serious problem, such as:

    • Infection
    • Blood clot
    • Failed or misaligned knee implant
    • Nerve damage

    You Shouldn't Continue to Suffer Post-Surgical Knee Pain

    Ongoing pain after knee replacement surgery should not be ignored. It is important to have any pain evaluated by the surgeon who did your knee replacement procedure to ensure that there are no problems with the alignment of the new joint or that infection is not present. If everything looks normal and there is no explanation for the pain, the issue could be nerve related, and you will want to seek the advice of Dr. Williams.

    You should not have to live in pain caused by nerve damage when Dr. Williams can determine what treatment options could ease your chronic pain and have you back to enjoying your life. Dr. Williams has successfully treated and resolved nerve injuries resulting from knee replacement surgery through procedures such as knee denervation.

    How to Know If Our Maryland Peripheral Nerve Specialist Can Help You

    If you are suffering from ongoing knee pain after replacement surgery, contact our office for an evaluation. Dr. Williams can create a treatment plan to help ease your pain and get you back to living pain-free as soon as possible. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.

  • What is fasciotomy?

    Fasciotomy is a surgical procedure to relieve pressure in a muscle compartment caused by a condition such as chronic exertional compartment syndrome. This procedure also increases blood flow to the nerves and muscles. Our doctor explains more about fasciotomy as a treatment option for exertional compartment syndrome. Fasciotomy for exertional compartment syndrome

    Treating Exertional Compartment Syndrome

    Exertional compartment syndrome causes pain or cramps in the front muscle compartment of the lower leg. It can occur during exercise where there are repetitive movements such as swimming, biking, or running and lessen once the activity is stopped.

    There are both nonsurgical and surgical options for treating exertional compartment syndrome. Nonsurgical options are only effective if you stop or reduce the specific activity triggering the condition. Surgery may be an option if conservative methods are ineffective in resolving pain. A fasciotomy is a surgical procedure often recommended for exertional compartment syndrome. It involves cutting the tight fascia, the bands of tissue surrounding the muscles, to relieve pressure in the muscle compartment.

    What to Expect From Fasciotomy

    Dr. Eric H. Williams will determine if your condition is exertional compartment syndrome or another condition causing the pain. Once a diagnosis is made, Dr. Williams will recommend treatment options such as a fasciotomy. At your consultation, he will thoroughly answer your questions and prepare you for what to expect before and after surgery.

    Possible Risks and Complications

    • Infection
    • Permanent nerve damage
    • Damage to muscle or blood vessels
    • Weakness or numbness
    • Shedding of skin
    • Scar tissue formation

    Fasciotomy may not completely resolve chronic exertional compartment syndrome in some cases.

    Are You Looking for a Baltimore Peripheral Nerve Specialist?

    If you have chronic exertional compartment syndrome and need help, contact Dr. Williams for an evaluation. Our goal is to help ease your symptoms and get you back to enjoying your favorite activities as soon as possible. To schedule an appointment in the Baltimore office, contact us at 410-709-3868, or fill out our contact form.


  • What could happen if piriformis syndrome is left untreated?

    woman with low back-gluteal painPiriformis syndrome is a condition that causes gluteal pain and numbness. The condition can worsen with activity and is often caused by overuse or trauma. If it is left untreated, it may turn into a painful chronic condition that leaves you with restrictions or other issues such as sciatica. Dr. Williams explains how he can treat piriformis syndrome with nerve compression services so you can return to living pain-free.

    Diagnosing and Treating Piriformis Syndrome

    There are other conditions that can present symptoms that are similar to piriformis syndrome, such as a herniated disc, cluneal nerve entrapment, or sciatica. There is not a single test to diagnose piriformis syndrome, so diagnosis is made by ruling out other conditions and diagnosing based on symptoms and pain.

    To treat piriformis syndrome, avoiding activities that cause pain is first recommended, along with rest. Other treatment options include:

    • Physical therapy that includes stretching exercises
    • Medication such as anti-inflammatories or muscle relaxants
    • Nerve release surgery to release the sciatic nerve from the piriformis muscle

    Untreated Piriformis Syndrome Complications

    Piriformis syndrome can lead to serious complications if left untreated or undiagnosed. For some patients, the pain may be misdiagnosed as a lower back issue, so treatment is based on that type of condition rather than piriformis syndrome.

    If the symptoms are thought to be from another condition other than piriformis syndrome, the patient may have unnecessary surgery or injections that increase their risk for complications and lead to chronic pain. Not treating piriformis syndrome can also make the person unable to train or continue an exercise routine.

    Contact a Baltimore Peripheral Nerve Specialist

    If you have piriformis syndrome and need treatment, contact our office for an evaluation. Dr. Williams can accurately diagnose the condition, answer any questions you may have, create a treatment plan to prevent possible complications, and get you back to living pain-free as soon as possible. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.

  • How do I know if I have a problem with my lateral femoral cutaneous nerve or if it's something else?

    man holding upper thigh in painThe lateral femoral cutaneous nerve, located in the outer thigh, can become compressed and cause symptoms such as burning, tingling, or numbness in the leg. However, other conditions can also cause similar symptoms. Consulting with our Baltimore peripheral nerve specialist can determine if you have lateral femoral cutaneous entrapment, also known as meralgia paresthetica, or another condition. Learn more here.

    Symptoms of Lateral Femoral Cutaneous Nerve Entrapment

    Lateral nerve entrapment can cause a range of symptoms in the outer part of the thigh. Symptoms typically affect one side of the body and may worsen after standing or walking. Some common symptoms of lateral femoral cutaneous nerve entrapment may include the following:

    • Burning
    • Numbness
    • Tingling
    • Sensitivity

    Meralgia paresthetica is not the only condition that causes these symptoms. If you are experiencing pain and numbness in your thigh, you could also have a muscle tear, overuse injury, or a sprain. A herniated disc in the back, chronic appendicitis, uterine fibroids, or a problem with the hip joint can also produce similar symptoms. It’s important to see a doctor to find out what is causing your symptoms.

    Meralgia paresthetica can be caused by trauma or from a condition such as diabetes. Some other causes include:

    • Wearing tight clothing or something heavy such as a tool belt
    • Being obese
    • Gaining weight
    • Wearing something heavy such as a tool belt
    • Pregnancy
    • Past surgery or injury near the inguinal ligament
    • Increase in abdominal pressure due to fluid accumulating

    Meralgia Paresthetica Diagnosis and Treatment Options

    If you are experiencing discomfort in your outer thigh and have symptoms of meralgia paresthetica, it is essential to see a doctor who can diagnose your condition. The diagnosis and severity of symptoms can determine the proper type of treatment and provide relief from meralgia paresthetica or another condition.

    Meralgia paresthetica can be diagnosed through a physical exam and medical history. For some patients, imaging tests or nerve studies may be required to exclude other conditions. Once a diagnosis is made, conservative treatments are first recommended. Conservative measures that can help ease discomfort from lateral femoral cutaneous nerve entrapment include:

    • Losing weight or maintaining a healthy weight
    • Wearing clothes that are loose
    • Medication such as over-the-counter pain relievers

    In more severe cases that do not respond to conservative measures, nerve decompression surgery may be needed.

    Contact Our Maryland Peripheral Nerve Specialist Today

    Dr. Williams can help ease your lateral femoral cutaneous nerve symptoms and get you back to living pain-free as soon as possible. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.

  • What is the difference between cluneal nerve entrapment and piriformis syndrome?

    woman with pain in her hip and buttockPiriformis syndrome and superior cluneal nerve entrapment can have similar symptoms, such as deep pain in the hip or buttock, but the two conditions also have major differences as well, including the type of treatment used to provide relief. Dr. Williams explains the similarities and differences between the two conditions and how he can treat either so you can get back to enjoying your regular activities without pain.

    Similarities and Differences Between Superior Cluneal Nerve Entrapment and Piriformis Syndrome

    Piriformis syndrome can mirror the symptoms of entrapment of the superior cluneal nerve since both conditions cause pain in the buttock or hip. The main difference between the two conditions is that with piriformis syndrome, sitting causes severe pain and discomfort, whereas with superior cluneal nerve entrapment, the pain subsides during periods of rest.

    In addition to deep pain in the buttock, piriformis syndrome can cause spasms or cramps in the buttock and other symptoms such as:

    • Numbness in the foot, leg, or buttock
    • A sensation of pins and needles in the leg
    • Increase in pain when doing activities such as running, squatting, or climbing stairs

    Superior cluneal nerve entrapment can cause pain in the buttocks and lower back and symptoms such as:

    • Burning sensation in the buttock
    • Pain that is to one side rather than concentrated in the middle
    • Pain that worsens with activity but reduces with rest

    Diagnosis and Treatment Options

    Since treatment options are different for piriformis syndrome and superior cluneal nerve entrapment, it is important to get an accurate diagnosis in order to find relief. Both conditions can be difficult to diagnose and are often misdiagnosed. To determine if the cause of your pain is due to superior cluneal nerve entrapment, a nerve block may be injected into the area. If the pain disappears, the diagnosis would likely be confirmed.

    Diagnosing piriformis syndrome can be a challenge since there is not a single test to determine a diagnosis. Because other conditions such as superior cluneal nerve entrapment can cause similar symptoms, the two conditions can get misdiagnosed. To diagnose piriformis syndrome, a specialist will evaluate the pain and symptoms.

    To treat piriformis syndrome, a doctor will recommend rest and physical therapy. In addition, steroids or muscle relaxants may be used to relieve pain. When conservative treatments do not provide relief, a nerve specialist can perform nerve release surgery to release the sciatic nerve from the piriformis muscle. To treat superior cluneal nerve entrapment, a specialist will likely recommend decompression surgery of the cluneal nerve. 

    Since the treatment for piriformis syndrome and superior cluneal nerve entrapment are different, it is important to get the correct diagnosis and to see a peripheral nerve specialist such as Dr. Williams.

    Contact Our Office

    Dr. Williams has the expertise to treat both piriformis syndrome and superior cluneal nerve entrapment and can give the best advice to get you back to living pain-free. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.

  • Will exertional compartment syndrome go away on its own?

    tennis player on ground with leg pain

    Exertional compartment syndrome causes severe muscle pain and cramping in the legs, making it difficult for athletes and those interested in high-intensity activities to participate due to pressure in the muscle compartment. Symptoms may stop with rest but can intensify when doing an activity.

    While modifying or avoiding certain physical activities may help with exertional compartment syndrome for some patients, others may require surgery to correct the underlying issue so they can get back to the activities they enjoy. Find out more about the different approaches—such as a nerve decompression or nerve release surgery—that Dr. Williams may recommend to treat this condition.

    Treating Exertional Compartment Syndrome

    There are both non-surgical and surgical approaches used to treat exertional compartment syndrome. Conservative treatments may include resting or changing from a high-intensity activity to one that is low-impact to provide relief. In addition, using pain medication or wearing custom orthotics can also help to minimize symptoms.

    For those who are athletes, non-surgical options may not be the solution since modifying or avoiding an activity will make it difficult to compete in the sport they enjoy. The symptoms may ease up when resting but flare up again when the person returns to the activity.

    Dr. Williams can evaluate the condition to confirm that it is exertional compartment syndrome and not another condition such as shin splints that is causing the pain. Once a diagnosis is made, Dr. Williams will recommend treatment based on the patient’s specific needs. Some options used to treat exertional compartment syndrome include:

    • Fasciotomy. This surgical procedure is the most effective treatment of chronic exertional compartment syndrome. It involves cutting open the inflexible tissue encasing each of the affected muscle compartments to relieve pressure.
    • Nerve release surgery. This type of surgery is done to free nerves that are compressed by the affected muscles. It may be done in addition to a fasciotomy or on its own.

    Contact Dr. Eric H. Williams for Help

    Don’t suffer from the symptoms of exertional compartment syndrome any longer. Our goal is to help ease your symptoms and get you back to enjoying your favorite activities as soon as possible. To schedule an appointment in the Baltimore office, contact us at (410) 709-3868 or fill out our contact form online.