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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What is tarsal tunnel syndrome?
Tarsal tunnel syndrome is a nerve compression disorder in which the main nerve to your foot gets pinched in a tight location. The tibial nerve branches into three nerves in the ankle -- the medial plantar, lateral plantar, and calcaneal nerves. Patients may present with slightly different symptoms, but most have some component of numbness, tingling, burning pain, or sharp stabbing electrical type pains that radiate into the sole of the foot and the toes. It is often worse with activities and better with rest.
How do I know if surgery is right for me?
There are several important factors that come into play when deciding whether surgery is the right option for you. One of the most important factors is your health. Being in good health greatly reduces the risk of complications occurring during surgery and leads to a speedy recovery. Next, you need to ask yourself what is your level of pain, discomfort, disability, or functional loss. Then, you need to understand the common and not so common risks of surgery and the healing process. Finally, you should be able to express your expectations to your physician. You should not proceed until you understand to potential risks for a procedure, and have a clear understanding of a reasonable expectation for what can hopefully be achieved.
Is peripheral nerve surgery safe?
All surgical procedures are accompanied by a certain degree of risk. Our expert team is dedicated to making your operation go smoothly. We careful review your medical history and current health condition before deciding if it is safe for you to proceed with surgery. It is important that you fully disclose all pertinent information so that we are able to make an accurate assessment of the risks involved. We will take every precaution necessary to reduce the possibility of any complications.
When do I consider an operation for a nerve problem?
First, this question assumes that there is an operation that can fix the problem the patient has. There are certainly some things we just simply can not improve, and referral to other specialists may be necessary. However, if we have a potential to make a difference with on operation, there is not a single good answer for this. Every patient has a slightly different story; every patient has a different personality; every patient comes to the office with different experiences and biases; every patient has a slightly different health back ground and medical risk factors. But I do try to present one common sense rule: if the symptoms that the patient has (numbness, weakness, pain, ect) extend beyond the mild annoyance and start to become intrusive to one's valuable life activities, then assuming reasonable risks for surgery, a patient may wish to begin to consider a surgical treatment option. Otherwise medications, stopping the activities that exacerbate the problem, and other life style changes are likely safer and may be as effective.
What happens during my initial consultation?
During your consultation we will carefully discuss your history and complaints. We will review your medical history and current health, define the problem, define what you would like to have made better. Then we will try to make a diagnosis or a list of possible diagnoses that could explain the current problems. Very commonly a patient will require further tests. These may be done in the office or in other locations. Frequently we will perform Neurosensory Testing in our office to evaluate the function of a particular nerve or set of nerves. Frequently we will perform nerve blocks to help target problem nerves to see if we can localize the source of a particular problem. Often patients may be referred for further imaging studies such as MRI or electrophysiologic testing to study the function of the nerves thought to be involved. If a diagnosis and a plan is generated and a surgical treatment plan is considered, then this is a good time to ask specific questions about the procedure so that you are fully prepared, mentally and emotionally, for surgery. We will discuss the results that can be achieved, with the aid of anatomic drawings. When a final decision is made you may choose to schedule a procedure with the staff during the appointment or call back at a later time to do so.
Will my insurance cover the surgery?
Most insurance carriers generally cover costs for reconstructive surgery. Our office staff will be happy to help you work through any insurance issues that you may have.
Are you a pain management doctor?
No. Dr. Williams is a Board Certified Plastic and Reconstructive Surgeon with Fellowship Training in Peripheral Nerve Surgery (one year additional training with A. Lee Dellon MD PhD at the Dellon Institute for Peripheral Nerve Surgery). Due to the significant inherent risks of long term narcotic use the medical community has created an entire specialty devoted to the science of medical pain management. These specialists are board certified in the medical treatment of pain. Due to a sharp crackdown by government agencies, surgeons and physicians of all types are discouraged, and in some circumstances mandated to refer patients suffering from chronic pain to those physicians who are certified in Pain Management. These physicians often play a critical role in diagnosing the cause of the chronic pain, as well as, managing the effects of chronic pain with many different classes of medications and other modalities. Often referral to a Board Certified Pain Management Physician is a very important part of a well coordinated treatment plan for a patient, and is part of the team approach that provides better care for patients suffering with these difficult problems.
If you are a Plastic Surgeon, why do you take care of patients with nerve problems and pain?
Great question? Plastic Surgeons have long been know as problem solvers. We like to solve difficult problems -- cleft lips, cleft palates, chronic wounds, facial fractures, missing hands, breast reconstruction...... Hand Surgery was a natural off shoot from Plastic Surgery. The reconstruction of the upper extremity often required reconstruction of the peripheral nervous system. For many years plastic surgeons have played a pivotal roll in the reconstruction of the soft tissue in the upper extremity. Therefore, almost all plastic surgeons are at least familiar with the management of peripheral nerve injuries in the upper extremities. Dr. Lee Dellon, a Plastic Surgeon who had additional Fellowship training as a Hand Surgeon, is a true pioneer in the field of peripheral nerve surgery. In the 1990's Dr. Dellon began to use the same practices and principles of upper extremity peripheral nerve reconstruction and management in the lower extremity in other locations throughout the body. At this time there are several Plastic Surgery societies a dedicated major amount of time to the teaching of peripheral nerve treatment strategies. These societies include the American Society for Peripheral Nerve, the American Society of Reconstructive Microsurgery, and American Association for Hand Surgery.
Nerve injuries and neuropathic pain is still a major problem. We are still looking for good answers to hard problems. Some Plastic Surgeons choose to focus on cosmetic surgery and some on reconstruction. Dr. Williams has chosen to focus his efforts on the peripheral nerve injured patient, and trying to improve the quality of life of those suffering from these problems.