Historically, the field of peripheral nerve surgery has been primarily focused on improving outcomes in patients who have suffered serious injury to important motor nerves. Motor nerve are the nerves responsible for movement. In other words, the primary focus has been on restoring function, usually to the arm or hand after a serious injury to one or more motor nerves. The irony of this is that the vast majority of patients with a peripheral nerve injury present primarily with pain rather than serious motor dysfunction.

It has only been recently that pioneering surgeons have really started to look at the peripheral nervous system through the prism of chronic pain. This huge blind spot in western medicine came about for two primary reasons. The first is that the treatment of chronic pain has traditionally been considered to be best treated by narcotic or other types of pain medications. The second is due to the fact that doctors have a very poor understanding of peripheral nerve anatomy which makes recognizing the true source of most chronic pain extremely difficult if not impossible.

Peripheral nerve problems are fundamentally mechanical in nature. In other words, the reason the nerve is constantly sending pain messages to the brain is that it has either been compressed or “pinched” in some fashion, or the nerve has been structurally damaged. Structural damage may take the form of a laceration or crush injury to the nerve resulting in the formation of an exquisitely painful structure known as a “neuroma.” A neuroma is a painful ball of nerve fibers mixed with scar tissue on the end of the nerve that is still connected to the spinal cord or brain.

Due to the underlying mechanical nature of most peripheral nerve problems, surgical intervention is the only really effective way to change the environment around the nerve and correct the damage in a way that stops the nerve from sending pain messages to the brain. This may take the form of altering the anatomy around a pinched nerve to relieve the pressure or disconnecting or grafting a damaged nerve using various techniques to prevent the formation of another painful neuroma. This is also why pain medication tends to do a very poor job at controlling chronic pain of nerve origin.

Tim Tollestrup, MD is among an elite handful of peripheral nerve surgeons with a special focus on eliminating chronic pain. Dr. Tollestrup is the only comprehensive peripheral nerve surgeon West of the Mississippi and he devotes 100% of his practice to surgery of the peripheral nerve. He is an expert at diagnosing and treating even the most complex peripheral nerve problems from head to toe, including nerve damage sustained during other surgical procedures.

Dr. Tim Tollestrup is a pioneer, with his efforts to push the envelope in developing a new form of surgery and a radically new treatment option for people suffering from chronic pain that’s made him one of only four surgeons in the world who exclusively focus on chronic pain-related peripheral nerve injuries.

Nerve surgery procedures performed by the Tollestrup team may provide permanent relief and long-term solutions to a myriad of chronic pain problems, previously considered to be untreatable.

This specialized field of peripheral nerve surgery is the missing piece of the chronic pain puzzle and remains unknown to 99.9% of medical professionals. The primary reason for this is that doctors are not trained to have a detailed understanding of complex peripheral nerve anatomy, nor do they receive any specialized, comprehensive training in recognizing, diagnosing, or treating these kinds of complex peripheral nerve problems.

A detailed, comprehensive understanding of peripheral nerve anatomy is the Rosetta Stone for understanding chronic pain, and can help patients who fall into these four broad categories:

  • Patients who develop chronic pain (pain lasting more than 6 months) after any type of surgical procedure or traumatic injury once the original problem has been addressed.
  • Patients who develop symptoms including numbness, tingling, pins/needles, electrical shock sensations, severe burning pain, focal muscle weakness (i.e. foot drop) and many other strange painful or “weird” sensations that may be difficult to describe.
  • Patients who continue to experience chronic pain, sensory loss, or weakness in an arm or leg after undergoing spine surgery (peripheral nerve problems often coexist with spine problems).
  • Patients who develop severe, chronic pain without a history of prior surgery or traumatic injury that no other doctors have been able to diagnose or treat successfully, including neuropathy pain.

Understanding Peripheral Nerve Issues

Anatomically speaking, the human nervous system is divided into two categories. The central nervous system is made up of the brain and spinal cord. The peripheral nervous system is made up of all the other nerves in your body. This means that once nerves exit the skull or spine, they become part of the peripheral nervous system.

Not all pain is due to a peripheral nerve problem. It is therefore very important to try and determine if the chronic pain you may be experiencing stems from some type of peripheral nerve injury or not. Patients with peripheral nerve injuries typically experience one or more of the following clinical symptoms or signs:

  • Pain (usually quite severe)
  • Muscle weakness (mild to severe)
  • Painful sensitivity to a particular area of skin
  • Numbness or decreased sensation
  • Tingling or pins and needles
  • Electrical or burning sensations
  • Unusual color changes of hands or feet (one or both)

If you experience any of these symptoms, you are probably suffering from some type of peripheral nerve problem. If that’s the case, surgery may be an option to provide long-term relief. Peripheral nerve surgery aims to correct the underlying problem, thereby providing permanent pain relief rather than trying to manage the pain.

The Latest Surgical Techniques to Relieve Pain

Dr. Tim Tollestrup and the team offer peripheral nerve surgery treatment options for the following conditions:

Carpal Tunnel
Cubital Tunnel
Tarsal Tunnel
Radial Tunnel
Common Peroneal Nerve
Lateral Femoral Nerve
Winged Scapula
Proximal Media Nerve Compression

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.