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nerve decompression surgery

Low Back Pain Involving Superior Cluneal Nerve Compression

By | back pain, Dr. Tollestrup Blog, nerve decompression surgery, Nerve Surgery, news and events, persistent pain after spine surgery, success stories | No Comments

Low Back Pain Not Coming from the Spine

Low back pain stemming from superior cluneal nerve entrapment is an underdiagnosed condition. Dr. Tollestrup has developed a surgical approach to help alleviate low back that does not emanate from the spine. He has many patients who have had success with this procedure. Marty is one of them. He is sharing his story in hopes of reaching others still struggling with chronic low back pain.

Marty’s First Nerve Surgery

Marty first came to see Dr. Tollestrup for groin pain after an inguinal hernia repair. Dr. Tollestrup eliminated the nerve pain by removing several damaged nerves in the right lower abdominal and groin area.

After nerve surgery, Marty continued to have some deep right groin pain due to severe arthritis in the right hip joint. After undergoing a right hip replacement, Marty’s right groin pain was finally completely gone.

New Low Back Pain

Unfortunately, during the time it took to resolve the orthopedic hip problem, Marty developed severe right-sided low back pain with radiation of the pain into the hip area. This pain became constant and debilitating. Lying on his back intensified the pain, making it impossible to sleep.

CT imaging of the spine did not show any reason for the low back pain and hip pain. With imaging clear, Marty tried pain management but was not able to get any relief.

Back to Dr. Tollestrup

Marty returned to see Dr. Tollestrup in hopes that he might be able to do something for his low back pain. After listening to Marty describe the location of the pain, Dr. Tollestrup suspected that Marty might be suffering from compression of the superior cluneal nerves.

The superior cluneal nerves are a cluster of nerves that branch off the main L1, L2, and L3 nerve roots and travel along the lumbar spine. These nerves pass through tight tunnels made up of fascia and bone and can become entrapped.

Entrapment of the superior cluneal nerves can cause severe low back pain which is usually off to the side slightly rather than in the middle, directly over the spine. There can also be a radiation of pain into the buttocks or hip. It is a common problem that is rarely diagnosed correctly. Many patients with this problem will undergo unnecessary spine surgery. Undergoing spine surgery when the low back pain is actually due to superior cluneal nerve entrapment will have no effect on the original pain at best, and at worst, can make the original low back pain become much worse.

Superior Cluneal Nerve Entrapment

Dr. Tollestrup sent Marty for a diagnostic block of the right superior cluneal nerves. Once the nerves were anesthetized Marty’s low back pain was instantly relieved. This let Dr. Tollestrup know that the real source of the low back pain was entrapment of the superior cluneal nerves and not some type of problem with the spine itself.

In this photo the green circle is around the superior cluneal nerves.

With this knowledge, Dr. Tollestrup was able to take Marty to the operating room and remove these small, unimportant sensory nerves to permanently relieve his low back pain.

Low Back Pain Gone

A week after surgery Marty is once again pain-free thanks to Dr. Tollestrup.

Superior cluneal nerve entrapment usually goes undiagnosed by orthopedic surgeons simply because they do not have comprehensive knowledge of the peripheral nervous system.

If you have unresolved low back pain, Dr. Tollestrup can help. Please fill out the form on the right or call the office at 702-666-0463.

 

Sharon is back to long walks and sleeping through the night thanks to surgery from Dr. Tollestrup to remove her Piriformis Muscle.

Severe Nerve Compression Goes Undiagnosed for Ten Years

By | Dr. Tollestrup Blog, nerve decompression surgery, Nerve Surgery, success stories | No Comments

Nerve Compression at Multiple Sites Causes Ten Years of Chronic Pain

Carrie is a patient of mine who needlessly suffered for ten years because no one could properly diagnose nerve compression as the source of her pain. I am sharing her story in hopes of reaching others who may be dealing with the same problem.

Spine Surgery

Carrie started her chronic pain journey more than a decade ago with severe sciatica pain in both legs. She underwent decompression of the spinal cord with a fusion of the L4-L5 vertebrae.

This surgery resolved her right leg pain but left her with numbness in both feet and shooting pain in her left leg radiating into the top of the left foot.

Through the years, Carrie tried dozens of therapeutic interventions. Sadly, one treatment she tried involved a charlatan chiropractor who charged her $5000 for powdered drink supplements and two small, ultimately useless machines. Neither of these offered her any relief.

Spinal Injections

Last year Carrie underwent multiple spinal injections by her pain management doctor. These spinal injections resolved most of the sciatica pain from the low back/buttock area down the posterior thigh to about the level of the knee.

However, again she was only able to achieve partial relief. The injections did not help any of the symptoms from the knee down. The more active she would be, the more pain she would experience in the lower leg and foot. She also started to have weakness in the left leg.

Correct Diagnosis

Carrie’s podiatrist referred her to me. Upon examination, I diagnosed her with serious nerve compression syndrome which involved entrapment of multiple nerves at various locations throughout the left leg. The problem started with a compression of the left sciatic nerve deep in the left buttock called piriformis syndrome. She also had a simultaneous compression of other nerves in the lower leg and top of the foot at three additional locations.

I performed surgery on Carrie, releasing the pressure on four different nerves at four different sites in the left pelvis and leg.

Nerve Decompression Surgery with Dr. Tollestrup can help eliminate migraine headaches.

Dr. Tollestrup performs nerve decompression surgery

 

 

 

 

 

 

Two months later Carrie has complete relief from the pain in her left leg! She continues to have some numbness and weakness on the top of her foot. With these types of nerve injuries, especially ones that have been present for many years, recovery can take a year.

For most patients, the thing that really affects their quality of life is the pain. They usually do very well dealing with numbness or weakness as these problems do not occupy the mind every waking moment and rob the patient of sleep at night.

If you have been unable to achieve relief from chronic pain, I might be able to help. Please fill out a form on the right or call my office at 702-666-0643.

Tim Tollestrup MD

Denervation surgery helps patient with chronic knee pain

Knee Replacement Surgery Fails to Heal Pain

By | arthoplasty, Dr. Tollestrup Blog, nerve decompression surgery, success stories | No Comments

Pain Increases After Knee Replacement Surgery

Wanda had a left total knee replacement done by her orthopedic surgeon.

Unfortunately, after surgery, she still suffered from terrible pain. In fact, physical therapy made her pain worse. During physical therapy, she was using a Continuous Passive Motion machine. The more Wanda used the CPM machine, the more she started experiencing numbness and tingling involving the skin over the inside of her lower leg and pain on the inside of her ankle.

In addition, she started having severe, radiating pain starting near the inside of her knee and traveling up her inner thigh into the groin area.

Orthopedic Surgeon Denies Pain

Baffled by the cause of her persistent knee pain, Wanda’s orthopedic doctor just continued to send her to physical therapy. In total, Wanda participated in three rounds of physical therapy. Despite extensive therapy, Wanda’s symptoms never improved.

Wanda’s orthopedic surgeon told her many times that he didn’t understand how she could still be having pain and that everything was perfect with her knee replacement. Eventually, her surgeon started to intimate that the problem was all in Wanda’s head. Unfortunately for patients suffering from peripheral nerve damage, this is not an uncommon experience.

Finding Relief

Luckily for Wanda, her husband researched constantly on the internet and found Dr. Tollestrup. Wanda then came to see Dr. Tollestrup for an evaluation.

After learning about her arthroplasty, Dr. Tollestrup knew that Wanda had most likely undergone an unnecessary surgery because her knee pain before surgery was exactly the same as after the knee replacement. He also suspected that the source of her ongoing pain stems from the small sensory nerves that give sensation to the soft tissue around the knee joint itself.

Based on the description of the location of the new pain and numbness from the groin down to the inside of the ankle that Wanda started to experience after the knee surgery, Dr. Tollestrup also knew that there was a problem with Wanda’s saphenous nerve. A brief physical exam confirmed that the saphenous nerve was being compressed or pinched deep in the inner thigh in a tight space called the adductor canal. Using local anesthetic, Dr. Tollestrup put to sleep the small sensory nerves causing the pain in the area of the left knee. This gave Wanda immediate, temporary relief from her left knee pain, thus confirming Dr. Tollestrup’s diagnosis.

Disconnecting Damaged Nerves

With the accurate diagnosis made, Dr. Tollestrup took Wanda to the operating room.

Through a single incision just above the knee on the inside of the thigh, he was able to find and disconnect all of the damaged nerves to the knee. He also relieved the pressure on the main saphenous nerve in the adductor canal.

Click here to watch this video from the operating room showing exactly what Dr. Tollestrup did in surgery.

By the time Wanda came back to see Dr. Tollestrup for her one-week post-op visit, all of the original pain in the left knee was gone. The sensation on the inside part of the lower leg had returned to normal. She was no longer experiencing the shooting pain up the inside of her left thigh into the groin or the pain on the inside of her ankle.

“I don’t have any pain at all,” Wanda said. “I am so happy I found Dr. Tollestrup.”

If you or someone you know has persistent knee pain before or after a knee arthroplasty, Dr. Tollestrup may be able to help. Please fill out the form on the right or call the office at 702.666.0463.

Schwannoma Removed During Complex Peripheral Nerve Surgery

By | Dr. Tollestrup Blog, failed morton's neuroma surgery, nerve decompression surgery, Nerve Surgery, news and events, success stories | No Comments

Complex Peripheral Nerve Surgery Solves Chronic Pain Problem

Marilyn came to see Dr. Tollestrup for a complicated peripheral nerve pain problem. Dr. Tollestrup performed a tedious peripheral nerve surgery which fixed her issue permanently. This is her story,

For many years, Marilyn’s ankle was swollen. When she bumped her ankle, she would feel a painful electric shock sensation radiating down into her foot. A CT scan showed a tumor involving the right posterior tibial nerve.

The preliminary diagnosis was a schwannoma, a tumor found in peripheral nerves. Schwannomas are usually benign. But because they are located in peripheral nerves, schwannomas can cause significant nerve pain and weakness.

When a schwannoma grows inside a nerve, the rest of the nerve fibers end up plastered to the outside of the tumor kind of like spaghetti stuck to the outside of a balloon. This can make surgery to remove the tumor difficult.

With this diagnosis in mind, Dr. Tollestrup brought Marilyn to the operating room.

First, he decompressed nerves in the medial ankle area. Using an overhead operating microscope, he then carefully dissected the tumor out of Marilyn’s tibial nerve without injuring any of the other important nerve fibers.

The surgery was a complete success! Marilyn no longer has to endure the sharp, shooting pains in her ankle. Additionally, Dr. Tollestrup was also able to preserve normal sensation to the bottom of Marylin’s right foot.

Here is what Marilyn had to say about her experience. Take a listen here.

If you or someone you know has a peripheral nerve injury or pain of an undiagnosed peripheral nerve origin, Dr. Tollestrup may be able to help. Please fill out a form on the right or call the office at 702-666-0463.

Nerve Surgery Success After Six Failed Back Surgeries

By | back pain, chronic pain after surgery, Dr. Tollestrup Blog, nerve decompression surgery, Nerve Surgery, piriformis syndrome, success stories | No Comments

Failed Back Surgery Leads to Nerve Surgery Success

Thomas came to see Dr. Tollestrup after he endured failed back surgery six times. His chief complaint is pain and paresthesia involving the left lower extremity.

Pain and Numbness

Thomas’s pain starts in the left knee and radiates down into the lateral leg and over the dorsum of the foot. He also has pain in the calf muscle and the plantar surface of the foot. He states that he gets a lot of cramping in the toes and the arch of the foot.

Sitting makes the pain worse. When he sits, he also has pain in the left buttock and thigh.

He has a strange sensation that is kind of like a tingling from the knee down into the foot. He describes his pain as a “hard ache” most of the time with occasional intermittent painful electric shocks.

Thomas takes a sleeping aid otherwise he doesn’t sleep very well due to the pain. His wife says that he tries to sleep most of the day just to try to get away from the pain.

He has had a thorough workup with imaging of the spine from both his spine surgeon and his pain management physician. Neither of them can find any ongoing pathology at the spine level.

Sciatic Nerve Compression

On physical examination, Thomas shows evidence of compression of the large sciatic nerve at the level of the piriformis muscle in the deep buttock. This is called piriformis syndrome.

He also has compression of the common peroneal nerve just below the outside of the knee.

To confirm this, Thomas had a diagnostic injection of the left piriformis muscle which totally relieved his usual sciatica pain for about 48 hours.

With the diagnosis confirmed, Dr. Tollestrup took Thomas to the operating room and performed a surgery he developed where the piriformis muscle is removed and the pressure on the sciatic nerve completely relieved.

Surgical Success Times Two

After this surgery, Thomas has complete relief of the sciatic pain from the buttock to the knee level but persisted in having radiating pain down the outside of the lower leg and over the top of the left foot.

He went back to the operating room a second time for surgical decompression of the common peroneal nerve, a nerve that can become pinched just below the outside of the knee. After this procedure, Thomas is now completely pain-free of the original pain in his left leg.

Thomas is not being evaluated by Dr. Tollestrup for his chronic low back pain. Back surgery was supposed to relieve this pain but only made it worse.

Stay tuned for an update on Thomas’s low back pain.

“He has provided me with a quality of life that I thought I lost forever. I now have absolutely no pain in my legs. I am able to walk without pain again.”

Nerve Compression Causes Severe Sciatica Pain

By | back pain, Dr. Tollestrup Blog, nerve decompression surgery, Nerve Surgery, Patient Stories, piriformis syndrome | No Comments

Nerve Compression Compromises Quality of Life

Christine suffers from multiple chronic pain issues stemming from nerve compression. These cover the range from severe low back pain and sciatica pain to bladder pain to pain in multiple joints. We will tell her story in segments. Readers can follow her journey back to health with the help of Dr. Tollestrup and his innovative surgeries.

Severe Sciatica Pain

Christine has an aggressive form of osteoarthritis. Eventually, the arthritis pain in the right hip progresses to the point where Christine elects to have the right hip replacement surgery.

After surgery, Christine begins experiencing severe, right-sided sciatica pain. With a history of low back surgery, her doctors assume the problem stems from her back. This despite the fact that MRI imaging of the lumbar spine does not show a problem.

With medication failing to control her pain, she elects to have a newer type of spinal cord stimulator implanted. This is effective for three years. Then the pain in the right leg  comes back with a vengeance.

Pinpointing the Pain

It was at this point that Christine is referred to Dr. Tollestrup by her primary care physician. After completing a comprehensive peripheral nerve evaluation, Dr. Tollestrup concludes that her pain comes from two different pinched nerves in the right leg.

The first location is compression of the sciatic nerve in the deep buttock, a very common cause of sciatica pain called piriformis syndrome. The sciatica pain caused by piriformis syndrome is often missed or attributed to be due to some type of problem at the spine level.

In addition, Christine also has compression of a different nerve near the outside of the knee called the common peroneal nerve.

Rare Find

In the operating room, Dr. Tim Tollestrup finds a very interesting and rare set of circumstances. In Christine’s case, she has an anatomic variation in her piriformis muscle where she effectively has two separate muscle bellies medially joined together into one common tendon.

Understanding this particular anatomic variation of the piriformis muscle is key to understanding why Christine’s previously mild sciatica pain in the right leg became so severe right after the hip replacement. Often when the hip is replaced, the top part of the femur bone, where the piriformis tendon is attached, is removed to accommodate the prosthetic hip joint. Because the piriformis muscle is relatively unimportant in moving the leg, there is often no effort made by the orthopedic surgeon to reconstruct it.

In Christine’s case, however, this had serious consequences because as soon as the piriformis tendon was released, it retracted away from the hip and towards the spine, effectively strangling the part of the sciatic nerve passing through it in the crotch of the two tendons where they joined together.

Sciatica Pain Gone

By the one-week post-op, Christine tells Dr. Tollestrup that 95% of her original sciatica pain was already gone. At the 6-week post-op visit, she notes that her original sciatica pain was 100% gone.

Christine’s sciatica pain is 100% gone after nerve compression surgery*.

Christine has other chronic pain issues, including fairly severe left-sided sciatica pain, which she is continuing to work with Dr. Tollestrup to solve.

If you or someone you love has chronic pain, Dr. Tollestrup can help. Fill out the form on the right side of this page or call the office at 702-666-0463.

*Disclaimer

We do not guarantee any specific results or outcomes for surgery, should our practice work on your behalf. Information on this website may be used as a reference for successes we’ve achieved for our patients, and not as an assurance or guarantee for similar results in all instances.

Nerve Compression Causes Severe Sciatica Pain

Chronic Pain Eliminated by Nerve Decompression Surgery

By | Dr. Tollestrup Blog, nerve decompression surgery, news and events, success stories | No Comments

Surgery Helps Patient Get Relief and Get Off Narcotics

Series of Nerve Decompressions by Dr. Tim Tollestrup Heals Raymond

Five years ago, Raymond was in a terrible car accident. He was at a stop when his compact Toyota pest-control truck was rear-ended by a suburban traveling approximately 65 mph. Fortunately, the only injury was a laceration to his forehead.

Almost immediately, however, Raymond became aware of significant pain involving the left thigh and calf. In addition, the left first, second, and third toes were painfully numb.

As time passed, Raymond’s symptoms worsened. He started experiencing pain radiating down the leg and a painful numbness on the left foot. He also has significant pain and numbness in the ball and toes of the left foot as well. Raymond also had pain in the deep left buttock as well as the posterior thigh. When the left buttock pain becomes severe, it radiates over into the right buttock as well.

In the months and years after his accident, which was on the job, Raymond has had to fight the Draconian work comp healthcare system. This is difficult enough for patients with commonly understood and readily identifiable injuries. It is even more difficult for patients with peripheral nerve injuries. After several years of seeing doctor after doctor without any relief from his pain, Raymond’s work comp case was finally closed out.

Dr. Tim Tollestrup devises a surgical solution

Almost five years after the original injury, Raymond was referred to Dr. Tollestrup by his primary care physician. Dr. Tollestrup identified the source of Raymond’s chronic pain as being due to a series of nerve compression injuries affecting the left leg, starting at the level of the pelvis and extending all the way down to the foot.

Raymond underwent surgery to repair the nerve injuries.

One week post op Raymond went back to see Dr. Tollestrup. All of his original pain in the left buttock and leg was gone.

He is now six weeks out from his original surgery and remains free from the severe pain that plagued him without relief for the last five years*.

Look at that smile!

raymond-c

*Disclaimer

We do not guarantee any specific results or outcomes for surgery, should our practice work on your behalf. Information on this website may be used as a reference for successes we’ve achieved for our patients, and not as an assurance or guarantee for similar results in all instances.