We want to celebrate with this patient who had Christmas a week or two early! This delightful patient has had pain and numbness in both feet from the knees to the top of the feet for 10 years now. She had been diagnosed with an untreatable “peripheral neuropathy.” Like so many of our patients, because she had symptoms in both legs, the only diagnosis that her treating physicians were willing to entertain was a medical ”peripheral neuropathy.”
What does that mean? Well, it means that surgery is not helpful to treat the problem because the disease is not caused by something that surgery would help. Surgery on your nerves will not cure someone’s diabetes. This is very true. I say that again. It is true, surgery on the feet will not cure a poorly controlled diabetic patient’s blood sugar, cure Lyme disease, or cure an autoimmune disease that may be attacking one's peripheral nervous system.
But, and a BIG BUT, is that some diseases that cause patients to have symptoms of neuropathy in their feet, which include pins and needles, intense burning pain, numbness, buzzing sensations, or sharp shooting pain do lead to swelling in the nerves themselves that then increase the likelihood that these nerves will get pinched in the tight tunnels that they travel through when they travel from the spine to the tips of the fingers and toes.
And here is the key, our goal as peripheral nerve surgeons is to open those tunnels up, so that the nerves can get more oxygen from better blood flow within the nerves, so that the nerves may function better, which has a very high likelihood of improving one's pain and sensation.
A good analogy would be to put your hands around your neck and squeeze tightly for about 30 seconds so that you have a hard time breathing. Would you feel better with the hands still around your neck or if you released your hands? If you need help figuring that out – this is NOT the webpage for you.
It is also very important to understand that NOT EVERY patient that has a diagnosis of peripheral neuropathy will benefit from surgical decompression. First, a patient must be medically stable, any known treatable cause of neuropathy must be dealt with and stabilized first by a neurologist or endocrinologist, or rheumatologist. IF the patient’s symptoms are still present after “maximal medical care,” then it is advised that the patient seek out an experienced peripheral nerve surgeon for a hands-on physical examination to determine if they might be a good candidate for peripheral nerve decompression.
This patient in the video has had a wonderful response to multiple nerve decompressions to her leg, and we are very excited for her improvements. This is the entire reason we perform these operations.
Why do we make more than one incision? Because there is often more than one nerve compressed. She had symptoms on top of the foot and on the bottom of the foot, therefore when we examine a patient, we look for evidence of entrapment of the nerves to the top of the foot and nerve to the bottom of the foot. They are in different places, so we have to make different incisions. We don’t always have to make so many incisions, and there are times when we may need more than this patient has.
Cheers to an early Christmas! Better sleep, less burning, less pins and needles, less electrical shocks, and more useful feeling in the feet!
EW