Nerve Compression Compromises Quality of Life
Christine suffers from multiple chronic pain issues stemming from nerve compression. These cover the range from severe low back pain and sciatica pain to bladder pain to pain in multiple joints. We will tell her story in segments. Readers can follow her journey back to health with the help of Dr. Tollestrup and his innovative surgeries.
Severe Sciatica Pain
Christine has an aggressive form of osteoarthritis. Eventually, the arthritis pain in the right hip progresses to the point where Christine elects to have the right hip replacement surgery.
After surgery, Christine begins experiencing severe, right-sided sciatica pain. With a history of low back surgery, her doctors assume the problem stems from her back. This despite the fact that MRI imaging of the lumbar spine does not show a problem.
With medication failing to control her pain, she elects to have a newer type of spinal cord stimulator implanted. This is effective for three years. Then the pain in the right leg comes back with a vengeance.
Pinpointing the Pain
It was at this point that Christine is referred to Dr. Tollestrup by her primary care physician. After completing a comprehensive peripheral nerve evaluation, Dr. Tollestrup concludes that her pain comes from two different pinched nerves in the right leg.
The first location is compression of the sciatic nerve in the deep buttock, a very common cause of sciatica pain called piriformis syndrome. The sciatica pain caused by piriformis syndrome is often missed or attributed to be due to some type of problem at the spine level.
In addition, Christine also has compression of a different nerve near the outside of the knee called the common peroneal nerve.
In the operating room, Dr. Tim Tollestrup finds a very interesting and rare set of circumstances. In Christine’s case, she has an anatomic variation in her piriformis muscle where she effectively has two separate muscle bellies medially joined together into one common tendon.
Understanding this particular anatomic variation of the piriformis muscle is key to understanding why Christine’s previously mild sciatica pain in the right leg became so severe right after the hip replacement. Often when the hip is replaced, the top part of the femur bone, where the piriformis tendon is attached, is removed to accommodate the prosthetic hip joint. Because the piriformis muscle is relatively unimportant in moving the leg, there is often no effort made by the orthopedic surgeon to reconstruct it.
In Christine’s case, however, this had serious consequences because as soon as the piriformis tendon was released, it retracted away from the hip and towards the spine, effectively strangling the part of the sciatic nerve passing through it in the crotch of the two tendons where they joined together.
Sciatica Pain Gone
By the one-week post-op, Christine tells Dr. Tollestrup that 95% of her original sciatica pain was already gone. At the 6-week post-op visit, she notes that her original sciatica pain was 100% gone.
Christine has other chronic pain issues, including fairly severe left-sided sciatica pain, which she is continuing to work with Dr. Tollestrup to solve.
If you or someone you love has chronic pain, Dr. Tollestrup can help. Fill out the form on the right side of this page or call the office at 702-666-0463.
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.