Questions and Answers
- Can Dr. Tollestrup Help Me? Tollestrup specializes in treating patients with chronic pain due to various types of injuries to peripheral nerves. If your pain is due to injury or entrapment of one or more peripheral nerves, then there is a very high chance that Dr. Tim Tollestrup can help.
How do I know if my pain is due to peripheral nerve damage? – Nerve pain can take many forms. There are a handful of common characteristics, however, that identify your pain as most likely coming from peripheral nerve damage:
- Sensory changes – symptoms like numbness, tingling, pins and needles, or decreased sensation/dullness.
- Character of pain – nerve pain often presents as a burning sensation but may also feel electrical in nature (i.e. a shocking or buzzing sensation). Nerve pain can “shoot” or radiate from one place to another and can mimic just about any sensation. The sensations that nerve damage produces are often so strange that patients frequently say that they have a hard time describing what they are feeling in words.
- Severity of pain – one of the hallmarks of nerve pain how excruciating it is. Patients with nerve damage usually appear to be in much more pain than the situation seems to justify. In addition, pain medication is often very ineffective at treating pain of nerve origin. Patients often remark that they would gladly cut off the offending arm or leg, etc., if they could just get rid of the pain.
- When is the right time to have peripheral nerve surgery? When the impact on a person’s quality of life outweighs the risks associated with the surgery itself. Generally speaking, if a patient is otherwise healthy enough to tolerate a general anesthetic, the risks of peripheral nerve surgery are very low. If your problem is still very manageable with acceptable lifestyle modifications and reasonable levels of pain medication, then continuing along that course is probably a better option than surgery. On the other hand, for patients whose quality of life is significantly compromised, or in many cases, nonexistent, the already low risks of surgery fade to insignificance. Only you as a patient knows when the level of pain, numbness, etc., tips the scales in the favor of undergoing surgery to relieve pain and restore function. For most patients with a serious peripheral nerve problem, this is not a difficult issue to decide.
- What percentage of Dr. Tollestrup’s patients get relief? – That often depends on the type of nerve problem the patient has. For example, patients with peripheral neuropathy who qualify for nerve decompression surgery will experience very good or complete relief from their symptoms about 80% of the time. When the pain is coming from a single damaged nerve where disconnecting the nerve is the best course of action, relief is usually achieved greater than 99% of the time. For most peripheral nerve problems, a good rule of thumb is that the success rate is 80% or better.
- I hate taking pain pills. Can Dr. Tollestrup’s surgery help me get off my pain medication? – The short answer is yes! Dr. Tollestrup’s goal is always to relieve the patient’s pain completely and most of the time he is able to do that. Once the nerve pain is gone, and if that’s the only reason you were taking pain medication, then you’re pain management doctor will be able to wean you off your pain medication.
- What exactly does Dr. Tollestrup do during surgery to take the pain away? – That depends on how the nerve has been injured. If the nerve is compressed or “pinched,” the solution typically involves cutting or removing tissue (not the nerve itself) to open the space up around the nerve so the nerve is no longer under pressure. If the nerve has been physically cut, it may be sewn back together directly or repaired via the use of a nerve graft. If a nerve is stuck in scar tissue, it may need to be freed up so it can glide through the tissue again. If the nerve has been damaged beyond repair or if it’s not an important nerve, sometimes the best course of action is to disconnect the nerve so that it can no longer send a pain signal to the brain.
- I did a nerve study and it came back negative. So why do I need nerve surgery? – EMG (Electromyelogram) and Nerve Conduction Velocity (NCV) studies are rarely useful in diagnosing or pinpointing the source of a peripheral nerve problem. Particularly in complex cases, the EMG/NCV studies will usually be either completely normal or identify only a small portion of the problem. By far, the best way to diagnose a peripheral nerve problem is by taking a careful history combined with a comprehensive peripheral nerve examination.
- My doctor says my injury is healed. I get the feeling he/she thinks I am imagining the pain. Could I be? – The pain from peripheral nerve damage will often persist long after the trauma from the original injury or surgery has long since healed. The difficulty for patients with peripheral nerve pain is that they often appear “normal” to the rest of the medical world. Most doctors do not know how to recognize or evaluate peripheral nerve injuries. This problem is compounded by the fact that peripheral nerve injuries typically don’t show up on imaging studies (X-ray, CT scans, MRIs) or Electromyogram/Nerve Conduction Velocity (EMG/NCV) studies. As a result, treating physicians are usually left baffled by the source of the pain and frequently start to question the patient’s true motives (i.e. drug seeking) or even their sanity.
- Why don’t other physicians have knowledge about and readily recommend this type of surgery? – The first part of the problem is that the vast majority of physicians do not learn anything beyond the basics about the peripheral nervous system. Without this knowledge base, most doctors can’t recognize a peripheral nerve injury even when they are looking right at it. The second part of the problem is that even they do suspect peripheral nerve damage, most doctors don’t know what to do for the patient other than prescribe pain medication themselves or send them to a pain management doctor. The field of surgery that Dr. Tollestrup practices is relatively new and most doctors are not even aware that it exists.
- Why is no one else doing peripheral nerve surgery? Sounds too good to be true? – Actually, peripheral nerve surgery has been around for a long time. The traditional approach to peripheral nerve surgery has historically focused on serious nerve injuries that affect the ability to move muscles. Until very recently, no one had ever taken a comprehensive approach to the peripheral nervous system with the primary goal of solving chronic pain problems. As a result, there are very few doctors who have the training and expertise necessary to tackle complex peripheral nerve problems where the primary symptom is chronic pain.
- Do all patients get relief from Dr. Tollestrup’s surgery? – No. There are very few things that are absolute in medicine. Peripheral nerve surgery is not the answer to all types of chronic pain. As a general rule, the more complex the problem the higher the chance the patient may not obtain complete relief from their pain. While Dr. Tollestrup can usually relieve the pain completely, some patients only experience partial relief. Even partial relief with pain levels reduced to a manageable level, however, can improve the patient’s quality of life.
- I would love to see stories about other patients like me. Can you refer me to any patient stories and testimonials? – Tollestrup’s patients are more than happy to share their stories. In fact, they are somewhat evangelistic in that they want to spread the word about his practice to reach other people suffering from chronic pain. You can read their stories and watch video testimonials.
- How soon can I anticipate relief? – The rate of relief from original symptoms following peripheral nerve surgery depends on a number of factors. If a nerve has been cut and sewn back together, the rate of growth of the nerve is about a millimeter a day or an inch a month. IF the symptoms are due to nerve compression which compromises the blood flow to the nerve but the nerve is otherwise essentially healthy, then relief can be almost immediate. The longer and more severely the nerve has been compressed, the longer recovery may take. Pain symptoms tend go away much quicker than return of normal sensation in severely injured nerves. It can take months or even more than a year in some cases for numbness or sensory loss to resolve. In general, nerve recovery rates are faster in younger patients although nerve regeneration and functional improvement are also commonly seen in elderly patients as well.
- How can I pay for the surgery? – For patients paying cash, cash rates for Dr. Tollestrup’s surgeries can be provided once he determines the scope of the problem and maps out what he will need to do surgically. For patients who have insurance that Dr. Tollestrup does not accept, a cash payment will be required upfront and then our office will work with the patient to help them get reimbursed.
See If The Tollestrup Team Can Help
Dr. Tim Tollestrup and his team may be able to help. Call us at 702-666-0463 or fill out the form on this page to set up a consultation to determine your options.
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.