There’s no need to suffer from chronic joint pain when nerve surgery can help you feel, move and live life like yourself again. Dr. Tim Tollestrup and his team in Las Vegas help countless patients regain their quality of life with denervation surgery for chronic joint pain.
Denervation surgery can provide permanent relief to your chronic joint pain by disconnecting the nerves that are causing the life-altering discomfort. Disconnecting the affected nerves stops the pain signals from traveling along the pathway back to the brain, where your body actually “feels” the pain. Denervation surgery removes a segment of the damaged nerve to disrupt the chronic pain signal and either eliminate or drastically reduce your pain.
Without the chronic pain that has been holding you back and affecting your range of motion, you may also find that other aches and pains associated with your limited range of motion also resolve. For example, if chronic pain is affecting the way you walk, your adjusted gait could be causing back pain, knee pain, or foot pain. Once the chronic pain is resolved and your gait can return to normal, you may find that those associated pains disappear, too!
Causes of Chronic Joint Pain
The major joints of the body such as the knees, hips, shoulders, ankles and elbows have so many important jobs to do to help us enjoy our daily lives, including helping us move, walk, jump, lift, dance and more! With all that activity, it makes sense that chronic joint pain is such a common ailment, because our joints get a lot of use and take a lot of stress over the course of a lifetime. For people who are especially active, like athletes, dancers, construction workers, and people who work on their feet, that wear and tear can happen faster and accumulate damage that results in chronic joint pain.
There are a wide variety of causes for chronic joint pain, including:
- Osteoarthritis – A painful condition characterized by the pain, inflammation and degeneration of a joint. Though most cases of osteoarthritis occur in older adults, it can occur in younger people as well.
- Tendonitis – Inflammation of the tendons that can be caused by repetitive overuse. Tendonitis tends to be worse during activities such as climbing stairs or playing tennis.
- Bursitis – Inflammation of the knee caused by overuse or injury.
- Chondromalacia patella – Damage to the cartilage that is located under the kneecap
- Gout – A painful condition caused by a buildup of uric acid in the joints. Gout can be managed with medication and diet.
- Baker’s Cyst – A buildup of fluid behind the knee
- Rheumatoid arthritis – Rheumatoid arthritis is a chronic autoimmune disorder that can cause inflammation and painful swelling and can eventually lead to deformation of the joints and deterioration of bones.
- Dislocation – When a part of a joint is knocked out of its ideal position, usually as the result of an accident or injury, chronic pain can result.
- Meniscus Tear – A tear in the cartilage of a joint, usually caused by trauma.
- Torn Ligament – A tear in a ligaments of a joint. This injury is very common for people who participate in high-impact sports such as football, rugby, volleyball, ice skating, basketball and tennis.
- Surgery – Some patients who undergo surgery on a joint are left with chronic pain due to a complication. If delicate tissues or nerves are damaged during the course of surgery such as a total knee replacement, the patient may experience more pain after surgery than they had before the surgery.
Chronic knee pain after knee surgery
No matter how your knee became injured initially, the surgery you have to repair it can sometimes lead to chronic knee pain. Knee replacement is one of the most common orthopedic surgeries, with a total of approximately 700,000 knee replacements performed every year in the United States. Some estimates project that there will be almost 3.5 million knee replacement surgeries in the United States by the year 2030!
Persistent pain after a total knee replacement represents a growing problem. Approximately 40% of patients who undergo knee replacement surgery report at least some type of chronic discomfort after their recovery period. A full 15% of these patients will rate their pain as “severe to extreme.” Using current numbers, this means that just over 100,000 people a year are left with “severe to extreme” pain in the knee that has just undergone total joint replacement. What a disappointment to people who were expecting relief!
Knee pain after surgery is a confusing, frustrating situation for both patients and their orthopedic surgeons, who typically have no explanation or solution for the persistent pain. Not infrequently, the patient may even experience worse pain after the knee replacement surgery than they had before.
Causes of pain after knee surgery
While the majority of chronic joint pain is usually due to some type of underlying orthopedic problem such as advanced arthritis, this is not always the case. There is often a complex series of nerves associated with the major joints in the body, such as the knee joints. Some of these nerves may be large nerves transiting through the area on their way to another part of the body. Some nerves may be sensory to the joint structures, and still other nerves may be sensory to the skin and deeper soft tissue surrounding the joint itself. These nerves are all susceptible to damage or compression from a variety of different injury mechanisms.
Surgery on the knee joint, whether it is an arthroscopic meniscus repair or a total knee arthroplasty, carries with it a small but significant risk of damage to one or more of these nerves. The trauma to the soft tissue envelope surrounding the knee joint causes swelling, inflammation and scarring that can entrap nerves, causing severe pain with motion of the joint.
In addition, the smaller sensory nerves in the area of the knee joint are often inadvertently cut or crushed during the process of replacing the knee joint or inserting the trocar into the joint space in the case of an arthroscopic procedure. This can lead to the formation of a neuroma (a painful ball of sensitive nerve ends mixed with scar tissue) that will then simply serve to send constant pain signals to the person’s brain.
Many patients who end up in this situation undergo multiple additional orthopedic knee surgeries – revision after revision before finally being consigned to the pain management realm. Once the pain generator is a damaged sensory nerve, it doesn’t matter how many additional orthopedic surgeries the patient has, the pain will not get better and frequently can be made worse.
Nerve surgery to treat chronic nerve pain in the knee
A detailed understanding of the nerve anatomy around joints provides the option of a “joint denervation procedure,” where the damaged nerves can be located and disconnected upstream from the area of injury. These nerves can then be handled in specific ways to prevent additional inappropriate stimulation and the formation of painful neuromas. Nerve surgery serves to shut off the pain signal to the patient’s brain and eliminate the sensation of pain in the knee area. This simple approach can be applied to many other situations involving chronic joint pain including shoulders, elbows, wrists, and ankles.
Mark came to see Dr. Tim Tollestrup after suffering through years of debilitating knee pain. Unfortunately, he is a classic example of a patient enduring unnecessary, ineffective surgical procedures because his doctors did not properly diagnose the source of his pain.
Mark’s pain started in 2012 when he was injured at work. His first line of treatment was multiple steroid injections into the knee. During this period, he had an MRI which was “normal.”
When the pain did not abate, he underwent a diagnostic right knee arthroscopy. The orthopedic surgeon told him he “cleaned up” some stuff in the right knee but that there was nothing specific that was identified as the source of Mark’s pain.
Unfortunately, after the right knee arthroscopy, Mark experienced excruciating pain that required him to stay in the hospital for several days on morphine. He was eventually able to transition to oral pain medications and be discharged, however, the pain in the right knee never improved.
Ten months after the knee arthroscopy, Mark had a total knee replacement or knee arthroplasty. After this surgery, his pain actually became worse, with pain spikes as high as 9/10 in severity depending on his activity level. Mark was unable to squat or kneel on the right knee at all.
Unfortunately for Mark, both surgeries including a total knee replacement were completely unnecessary and made his pain worse. This is because his knee pain was due to a peripheral nerve injury. The proof is that his pain was no better, even after the entire knee joint was replaced.
Dr. Tollestrup performed knee denervation surgery on Mark to disconnect the injured nerves, and now Mark is finally pain free.
The Tollestrup Team Can Help
Dr. Tim Tollestrup and his team can help you regain your quality of life by reducing or eliminating your chronic joint pain. Call us at 702-666-0463 or fill out the form on this page to set up a consultation to determine your options.