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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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
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 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 make 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.