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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.

 

Removing Piriformis Muscle Heals Sciatica Pain

By | Dr. Tollestrup Blog, Nerve Surgery, news and events, piriformis syndrome, success stories | No Comments

Dr. Tollestrup Doubles Up on Successful Surgeries To Heal Sciatica Pain

We recently shared this video story about Spencer Hawkins, a patient of Dr. Tollestrup’s who battled severe sciatica pain for years. Dr. Tollestrup was able to eliminate Spencer’s pain by surgically removing his piriformis muscle. Now Spencer is back playing the sports he loves.

Click Here to Watch Spencer Get Back in the Game

Ironically, Spencer’s softball buddy David Sherman was suffering from a very similar pain problem. The two researched online together and discovered they both had piriformis syndrome. David came to see Dr. Tollestrup first but opted to wait until Spencer had surgery. After seeing Spencer’s results, David decided to go for it too. This is his story.

Decade of Chronic Pain

David’s original problem was severe low back pain and bilateral sciatica pain. The sciatica pain in the left leg was much worse than the right leg. David suffered for more than ten years. He endured 11 epidural injections with varying degrees of relief.

Eventually, David decided to undergo spine surgery. His spine surgeon confidently told him that surgery would fix both his low back pain and his sciatica pain. He had a fusion of the lumbar spine from L4 to S1.

The results of the spine surgery were mixed. While the fusion fixed his low back pain, it did nothing for the severe sciatica pain in the left leg. The pain eventually got so bad that it limited David to walking no more than a couple of blocks at a time. This resulted in David having to give up tennis and softball, two sports that he loved to play.

David came to see Dr. Tollestrup after researching online. After an evaluation, Dr. Tollestrup diagnosed David with piriformis syndrome. A follow-up diagnostic injection of the left piriformis muscle resulted in two weeks of almost complete relief from his usual pain.

Bye Bye Piriformis Muscle

Based on his excellent response to the piriformis injection, David opted to undergo surgery with Dr. Tollestrup to remove the piriformis muscle pinching his sciatic nerve. A piriformis muscle is a spare part – like an appendix – that most people don’t need.

By the time David came back to see Dr. Tollestrup for his one-week postop appointment, his original sciatica pain was essentially completely gone.

Cautiously optimistic, David is back playing softball in two different leagues 3 to 4 times a week with his friend and fellow success story Spencer.

Here is what David had to say after his successful surgery.

“After suffering from sciatica pain for more than 10 years, one week after surgery to remove my piriformis muscle my pain is gone. I am now back to enjoying my life again.”

If you or someone you know has sciatica pain, the problem could be piriformis syndrome. Dr. Tollestrup can help. Fill out a form on the right or call 702-666-0463.

 

A Tragic Tale of Unnecessary Knee Replacement and Amputation

By | arthoplasty, knee replacement, news and events, Patient Stories, success stories | No Comments

A Tragic Tale of Unnecessary Knee Replacement and Amputation

Kathy’s story is a tragic tale of a misdiagnosis leading to unnecessary knee replacement and amputation. We are sharing her experience in hopes of reaching other patients like her who may be able to avoid the mistakes made by her doctors.

An injury at work left Kathy with chronic knee pain. An orthopedic surgeon suggested a total knee arthroplasty. Kathy agreed.

But after surgery, she continued to have severe pain. Unfortunately, the only solution her surgeon could think of was to replace the prosthetic knee.

This vicious cycle continued and Kathy endured two additional knee arthroplasties. Complications following the third knee arthroplasty left Kathy with no alternative but an above-knee amputation (AKA).

Following the amputation, Kathy developed horrible phantom pain as well as severe residual limb pain in the end of her stump. While the phantom pain was bad, the residual limb pain was more debilitating because it prevented Kathy from being able to wear a prosthetic leg, thus confining her to a wheelchair.

True Source of Pain: Damage to Peripheral Nerves

The real tragedy of Kathy’s story is that it could have almost certainly been prevented had she found Dr. Tollestrup earlier.

In Dr. Tollestrup’s opinion, the most likely cause of Kathy’s original knee pain was damaged peripheral nerves. Sadly, with a knee denervation surgery by Dr. Tollestrup, the knee replacement surgeries and subsequent amputation could have been avoided.

Kathy finally found Dr. Tollestrup. He diagnosed the source of her pain as coming from the multiple neuromas which had formed on the ends of all the nerves that were cut through when the leg was amputated.

Dr. Tollestrup performed two cutting-edge surgical procedures involving a combination of disconnecting the smaller damaged nerves and sewing cadaveric nerve grafts to the larger damaged nerves to prevent re-formation of the painful neuromas. This is a highly complex surgery that Dr. Tollestrup is uniquely qualified to do.

Second Chance: Out of the Wheelchair and Back to Active Life

It has now been about a year and a half since Kathy’s first surgery. Her phantom pain is almost completely gone. The residual limb pain is also drastically improved. It is not completely gone but is down to such a mild level that she is no longer taking pain medication. She is now able to wear her prosthetic leg as much as she wants to without experiencing the horrible pain that she used to. This has freed her from the confines of her wheelchair which has been life-changing for her.

Kathy is looking forward to getting back to a much more active lifestyle again.

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.

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.

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.

Piriformis Syndrome Cured by Removing Piriformis Muscle

By | Dr. Tollestrup Blog, news and events, piriformis syndrome, success stories | No Comments

Piriformis Syndrome Cured by Removing Piriformis Muscle

Susan F. was suffering from severe burning pain in the left leg which started in the buttock area and radiated all the way down the leg to the level of the ankle. This pain was compromising her active lifestyle, making her feel frustrated and depressed.

She sought treatment initially from a spine surgeon who told her that the pain in the left leg was coming from her back and that she needed back surgery.

Unfortunately, after recovering from the spine surgery, Susan quickly realized that although the pain wasn’t quite as severe as before the back surgery, most of the burning pain in the left leg was still present.

Susan then went to Dr. Tim Tollestrup who diagnosed the cause of the burning pain in the left leg as piriformis syndrome, which is entrapment or compression of the big sciatic nerve by a small muscle called the piriformis muscle deep in the buttock.

Piriformis syndrome is a severely under-diagnosed problem occurring when the nerve roots of L4, L5, S1, S2, and S3, which make up part of the lumbosacral plexus, become compressed between the bony inferior rim of the greater sciatic notch of the pelvis and the overlying piriformis muscle as they converge to form the proximal sciatic nerve. The greater sciatic notch is effectively a window from the inside of the pelvis to the outside of the pelvis. The structures traveling through this relatively tight space include both the piriformis muscle and the 5 nerve roots that make up the sciatic nerve.

Susan underwent surgery by Dr. Tollestrup who removed the piriformis muscle and decompressed the sciatic nerve.

It has now been two months since her surgery and Susan is back doing yoga, golf, and taking long walks – all the things she was unable to do before due to the burning pain in the left leg.

“I am so thankful that Dr. Tollestrup got rid of all of my pain. I would recommend him to anyone who is still suffering from chronic pain.”

Low Back Pain Gone Thanks to Innovative Surgeries

By | Dr. Tollestrup Blog, news and events, persistent pain after spine surgery, piriformis syndrome, success stories | No Comments

Low Back Pain Finally Gone Thanks to Innovative Surgeries by Dr. Tollestrup

Barry is a patient with a  history of low back pain. Like many patients with chronic pain, Barry experienced a number of failed treatments until he finally found Dr. Tim Tollestrup.

Several years ago Barry went on a long vacation to Australia. Prior to going on that trip he had an epidural which gave him total relief of his low back pain for almost three months. About 3 days before coming home from Australia he started to experience numbness in the left leg. The plane ride home really exacerbated the symptoms in the left leg producing severe radiating pain down the leg as well as increased numbness.

Upon returning to the United States he underwent a lumbar spine fusion which relieved most of the radiating pain in the left leg. He continued to have tingling and numbness in the left leg and foot, however, along with significant pain in the left calf muscle. The cramping pain in the left calf muscle would get especially bad with any kind of exercise. The left calf would also tend to ache all night long, making sleep difficult. Sitting for extended periods of time would produce pain in both buttocks with radiation of the pain into the posterior thighs.

Unfortunately for Barry, the lumbar spine fusion did not relieve his original back pain.

Dr. Tollestrup’s Approach

Barry was referred to Dr. Tollestrup by his primary care physician. Dr. Tollestrup evaluated Barry and identified a compression of the left sciatic nerve in the deep buttock, a condition known as piriformis syndrome as the primary cause of the residual numbness in the left leg and the pain in the left calf muscle.

Barry underwent surgery to remove the piriformis muscle and decompress the sciatic nerve. By 8 weeks post-op, the numbness and pain in the left leg was gone!

Next, Dr. Tollestrup investigated the cause of Barry’s chronic low back pain which had not been relieved by his low back surgery. Physical examination showed that the likely source of the low back pain was compression of several small nerves on either side of the spine called the superior cluneal nerves. In order to confirm this diagnosis, Dr. Tollestrup referred Barry for a block of these nerves where the nerves were put to sleep using a long-acting local anesthetic. This gave Barry complete relief from his usual, constant low back pain for about 48 hours.

Based on the positive result from the block, Barry went back to the OR where Dr. Tollestrup performed an operation he developed to remove these superior cluneal nerves.

Barry just checked in for his three month post-op visit after having the superior cluneal nerves removed and he has had complete relief from his original lower back pain. Barry joked with Dr. Tollestrup that now that his low back pain is gone, he has been much more active, working in his garden, etc. Now he is experiencing soreness in muscles that he has not used for a very long time due to the fact that he was so limited by his original back pain.

Two successful, innovative surgeries by Dr. Tollestrup have given Barry complete relief*.

Low Back Pain Gone

*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.

Denervation Surgery Heals Patient Suffering from a Failed Morton’s Neuroma Excision

By | Dr. Tollestrup Blog, failed morton's neuroma surgery, news and events | No Comments

Denervation Surgery Heals Patient After a Failed Morton’s Neuroma Excision

Ronald is a 72-year-old gentleman who underwent an excision of a Morton’s neuroma through an incision on the top of his foot. The doctor who did the original surgery cut out the “neuroma” of the nerve on the bottom of the foot that goes to the second webspace. The procedure was complicated by a postoperative wound infection with MRSA which took months to heal.

Ronald went on to develop chronic severe pain in the ball of the left foot. He subsequently had a second attempt at re-excision of the true neuroma via an approach through the ball of the foot. Unfortunately, this did not improve his pain. In fact, the pain became wore worse and spread rapidly, eventually involving most of the ball of the foot and the first three toes.

At this point, Ronald came to see Dr. Tim Tollestrup who formulated a surgical plan to excise the neuroma once and for all.

Dr. Tollestrup operated on him via an approach through the non weight bearing arch of the foot. Once he cut into the foot, he found the damaged nerves, disconnected them and then sewed on nerve grafts to the end of the native nerves to prevent painful neuromas from forming again.

Five months post op, Ronald came to see Dr. Tollestrup. His quote to Dr. Tollestrup was that his foot is “1000% better.” He is able to walk again without the severe constant pain that he had before surgery.

For patient’s who have failed Morton’s neuroma surgery, there is now a very good surgical option to treat the pain. This novel approach involves making an incision in the non weight bearing arch of the foot. The surgeon then identifies the injured nerves and disconnects them far enough back that they are no longer located in the weight bearing area of the foot. Nerve allografts are then sewn onto the ends of the native nerves which prevents the formation of another painful neuroma resulting in the elimination of the debilitating chronic pain associated with this problem.

For patients who have failed Morton’s neuroma surgery, this surgical option can literally change their lives, just like it did Ronald’s!

Morton's Neuroma Patient

Denervation surgery helped Ronald get back on his foot after failed Morton’s Neuroma surgery.*

*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.

Carpal Tunnel Release and Denervation Surgery Help Patient Regain Use of Her Dominant Hand

By | Dr. Tollestrup Blog, Nerve Surgery, news and events, Patient Stories, success stories | No Comments

Carpal Tunnel Release Helps Patient Regain Use of Her Hand

Carpal Tunnel Syndrome and nerve injuries stemming from a dog attack made it impossible for Maria to use her left hand. Then she met Dr. Tollestrup. Maria agreed to share her story below in hopes of reaching others.

Maria was attacked by a dog in August, 2015, and sustained bite injuries to the left forearm just above the wrist. She suffered lacerations to both the front and back of the forearm from the dog’s teeth. Although the lacerations healed quickly, Maria started to experience severe pain and numbness involving the skin over the front side of the forearm. Next, the pain and numbness started to spread into the thumb and index finger as well as the middle finger. It got so bad that Maria began having a hard time using the left hand, her dominant hand, as it became increasingly difficult to voluntarily move the thumb and index finger. Her grip strength started to deteriorate and she began having trouble holding onto things with the left hand, often inadvertently dropping item from her grasp.

Maria was referred to Dr. Tim Tollestrup by her neurologist after seeing an orthopedic surgeon who didn’t have any solutions. Based on the location of the pain and numbness in the forearm, Dr. Tollestrup realized that the dog bite had injured a nerve in the forearm called the lateral antebrachial cutaneous nerve. This was then compounded with the development of carpal tunnel syndrome which was the source of pain, numbness, and weakness in the hand.

Maria underwent surgery by Dr. Tollestrup who did a carpal tunnel release to relieve the pressure on the median nerve to the hand. He also disconnected the damaged nerve up near the elbow and sewed on a nerve graft which acts as a cap on the nerve, preventing the nerve from forming another painful neuroma on the end.

Now at two months post-op, Maria is completely pain free and able to once again use the left hand normally. All of the numbness and tingling in the left forearm and hand has completely resolved. Maria is ecstatic because she can now hold her coffee mug once again in the left hand.

“I am so thankful for the excellent outcome from my surgery with Dr. Tollestrup.”*maria

*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 Pain Resolved Thanks to Surgery with Dr. Tollestrup

By | Dr. Tollestrup Blog, Nerve Surgery, news and events, success stories | No Comments

Nerve Pain Resolved Thanks to Surgery with Dr. Tim Tollestrup

Jodee is a young patient of Dr. Tim Tollestrup. She is sharing her story to reach others who are suffering from nerve pain.

Jodee suffered an accident back in 2012 when a 300 pound food cart crushed her left foot.  She sustained multiple peripheral nerve injuries at that time and underwent successful surgical treatment with very good resolution of her symptoms.

Over two years later, Jodee started to experience aching and burning pain over the top of the left foot. This type of pain usually indicates nerve pain. The pain was exacerbated by wearing any type of snug fitting shoe which would rub the top of the left foot. This was a problem for her because the type of shoes that she had to wear at work were quite snug. Jodee’s pain would worsen throughout the day.

Upon examining Jodee, Dr. Tollestrup realized that her nerve pain involved one of the nerves which had not been disconnected originally, the saphenous nerve. He then ordered nerve block for this nerve and the pain went away for several hours confirming the saphenous nerve as the source of her foot pain.

Dr. Tollestrup took Jodee into the operating room and performed a surgical procedure disconnecting the saphenous nerve. This was very successful and Jodee is not back to work, full duty without any pain in her left foot.

Here is what Jodee had to say about Dr. Tollestrup and her experience with him.

“Dr. Tollestrup saved me from so many problems and helped me keep my job. I am now pain free and grateful to have found him.”

Jodee is grateful to have found Dr. Tollestrup who disconnected nerves in her foot to get rid of the pain.

Jodee is grateful to have found Dr. Tollestrup who disconnected nerves in her foot to get rid of the pain.*

*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.