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.