Dr. Tollestrup explains how he developed a simple, surgical solution to help patients overcome pain from Peripheral Neuropathy.
The common current understanding about peripheral neuropathy is it’s a progressive and incurable disease process. So all of the treatments designed around peripheral neuropathy is sort of to try and manage medicines like Lyrica, or Gabapentin, or narcotic pain medication and then there’s a whole slew of other treatments that really cross over into the snake oil department, none of that even claims to cure neuropathy. It’s sort of all just to try and manage the symptom.
One of the most important advances in the treatment of peripheral neuropathy is the concept of what is actually causing the pain. In many patients with peripheral neuropathy, the actual clinical symptoms, the numbness, the burning, the tingling, the weakness, et cetera, is secondary to mechanical compression that is developed. So these nerves are being squeezed or pinched. There’s a metabolic process in diabetics, for example, or somebody with hypothyroidism, although very often you can’t really identify whatever the underlying process is, but that’s not as important as what it does to the nerves, which is it causes these nerves to swell.
So these nerves become pinched, they run in tight spaces, especially around joints and places like that. So if you have a defined space and all of a sudden the nerves start to swell and become larger, pretty soon, the tissue around the nerve starts acting as a mechanical compression point on the nerve. And this is what is actually causing much of the clinical symptoms in patients with peripheral neuropathy. If you can identify which nerves and exactly at what locations the pressure on the nerves is being applied, you can go in surgically and decompress the nerves. The concept is the same as you would do for somebody who has carpal tunnel syndrome.
It’s well-accepted to decompress nerves in the upper extremity for somebody with diabetes who has the same symptoms in their hands and arms as they do in their lower legs and feet. But nobody ever thinks about doing surgery for the nerves down in the lower legs, and it’s the same process that’s going on. So that’s really an important point to understand in regards to the treatment of peripheral neuropathy nowadays.