Julie suffered from Peripheral Neuropathy pain for more than a decade. She tried many different treatments ranging from the standard to the bizarre. At the end of her rope, she discovered Dr. Tim Tollestrup on YouTube.
In a simple, outpatient procedure, Dr. Tollestrup was able to relieve her pain. Julie is too shy to appear on camera but she did offer to write up her thoughts. This is her story, shared with permission.
One of the important nerves that innervates the lower buttock and the back of the thigh extending in some, even down into the upper posterior calf area is a nerve or really sort of a web of nerves called the posterior femoral cutaneous nerve. This is a nerve that really is sort of, could be subdivided into four other individual nerves. You have the main nerve that goes down the back of the thigh. You have a perineal branch that comes between the legs, and then you have media and lateral inferior cluneal nerve that innervates the lower buttock area.
Anybody who has trauma to the buttock or posterior thigh area or a surgical procedure for example, if they’ve had a hamstring rupture or tear that has been surgically repaired, this nerve is at high risk of becoming entrapped in scar tissue or being injured. Can be a tricky nerve to identify as the source of the problem, because it doesn’t always manifest as numbness of the skin, even though it does innervate the skin. And so for somebody who sort of has run of the mill sciatica, buttock pain that runs down the back of the leg, that could come from a spine problem. It could come from piriformis syndrome, which is compression of the sciatic nerve. And it can also come from damage or injury to the posterior femoral cutaneous nerve, which is something that most doctors will completely overlook if they even know that that nerve exist.
With the posterior femoral cutaneous nerve, it’s kind of analogous to the lateral femoral cutaneous nerve, but for the back of the thigh in the lower buttock area. But unlike the lateral femoral cutaneous nerve, which compression of that nerve produces meralgia paresthetica, which is pain in the front and side of the thigh, the posterior femoral cutaneous nerve doesn’t really have a natural point of anatomic narrowing that it passes to, where it can become compressed.
Typically people with problems of the posterior femoral cutaneous nerve have had trauma to the buttock area, whether it’s blunt trauma, or penetrating trauma, or an operation that has damaged the nerve. If it’s necessary to fix pain due to injury to the posterior femoral cutaneous nerve, you’re typically talking about going in and finding all these branches and then disconnecting them. That’s really the way to solve that pain problem, because it’s not an issue of compression. It’s an issue of the nerve being structurally damaged. And at that point, there’s no good way to treat it other than to just disconnect the nerve. And so the patient trades off some skin numbness in the back of the thigh and maybe the lower buttock for resolution of the pain.