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Peripheral Nerves & Chronic Pain

The peripheral nerves are a critical part of what makes your body work—this nervous system is composed of 43 pairs of nerves that connect your brain and your spine with the rest of your body, carrying messages about movement and sense to and from your extremities. When one or more of these nerves is damaged, it can have a serious effect on your quality of life. Listed below are some of the conditions that Dr. Banister treats regularly. One of the cornerstones of Dr. Banister’s treatment philosophy is his commitment to remaining on the cutting edge of new techniques and treatment methods, so patients who entrust their care to Dr. Banister know that they are receiving world-class care from a doctor who genuinely cares about their health and safety.

Conditions

Carpal Tunnel

Carpal tunnel is a syndrome that results from compression of the median nerve in the wrist. It can cause numbness, tingling, and pain in the thumb, index finger, and middle finger. These symptoms may be mild initially, but can worsen with time. As with some other disorders of the peripheral nervous system, management should be conservative at first. If your carpal tunnel is severe, interfering with your ability to perform everyday activities, and has not responded to medical management, a procedure called carpal tunnel release may be an option.

Chronic Pain

Chronic pain in the back or extremities is a known contributor to decreased quality of life, and this nonstop pain can make even everyday activities seem impossible. Initial efforts to treat chronic pain should include conservative measures, such as medication, rest, bracing, or physical therapy. However, some cases are so extreme or are unresponsive to treatment that spinal cord stimulation is warranted. Placement of a dorsal column stimulator is a surgical procedure that is designed to decrease pain and allow return to normal activities.

Migraine

A migraine is a severe recurring headache that usually affects one side of the head. It is often accompanied by a throbbing sensation, nausea, sensitivity to light, and disturbed vision. Some migraines are caused by compression of the peripheral sensory nerves that surround the face, causing migraines so severe that they interfere with everyday activities. When these nerves are compressed, they may increase the frequency and severity of a migraine, so relieving pressure on the nerves may reduce the incidence and duration of future migraines. In such cases, Dr. Banister may recommend surgical decompression of the peripheral sensory nerves.

Ulnar Nerve Entrapment

The peripheral nerve that passes through your elbow at your “funny bone” is called the ulnar nerve. Through trauma or tumor, this nerve can become damaged or compressed, which can cause permanent numbness or tingling in that area. In serious cases, it can cause loss of function to some muscles in the hand. Some patients undergo a procedure called ulnar nerve decompression to remove pressure on the ulnar nerve.

Surgical Procedures

Carpal Tunnel Release

Carpal tunnel release is a surgery that is performed to relieve the symptoms of carpal tunnel syndrome when conservative management has proven ineffective. Carpal tunnel syndrome results from compression of the median nerve, often by the carpal ligament. In carpal tunnel release surgery, the surgeon makes a cut in the carpal ligament to allow more space for the nerve that it was pinching. This is an outpatient procedure with a relatively brief recovery period.

Dorsal Column Stimulation

Placement of a dorsal column stimulator is a procedure aimed at decreasing chronic pain in the back or legs. In this minimally invasive procedure, small programmable generators are placed just under the skin and emit electric signals that block the sensation of pain from the spinal cord. Some studies show up to 70% of people who undergo dorsal column stimulation report reduction in overall pain.

Surgical decompression of the peripheral sensory nerves

In an effort to decrease the frequency, intensity and duration of severe migraines, surgical decompression of the peripheral sensory nerves may be recommended. This outpatient procedure usually only takes several hours, and the skull itself is not interrupted. Instead, this is a minimally invasive procedure that is only performed if the compressed nerve can be identified with a high degree of certainty. This procedure is associated with a relatively brief recovery period.

Ulnar nerve decompression

Ulnar nerve decompression is the treatment of choice to alleviate ulnar nerve entrapment. In this procedure, the patient is lightly sedated and the surgeon can explore the area surrounding the ulnar nerve, removing any force that is compressing the nerve—often the offending structure is simply muscle or connective tissue. Ulnar nerve decompression is most often an outpatient procedure that provides immediate relief of the uncomfortable sensations associated with ulnar nerve entrapment.