Updated: 1:26 p.m. Monday, Dec. 29, 2008 | Posted: 11:29 a.m. Monday, Dec. 29, 2008

Easing Nerve Pain After Surgery

BACKGROUND: After surgery, disrupted nerves can leave a patient with excruciating pain, numbness and burning sensations caused by nerve compression or mechanical interruption. Patients often go through extensive examinations including X-rays and CT or MRI scans, which can be costly and may not specifically identify the nerve or nerves responsible for the pain. Amputees can experience this pain at the site where their amputation took place. This happens because the very bottom part of the nerves closest to the stump can get in to the scar tissue as it forms. This is common in lower extremity amputee patients and can make it difficult to utilize a prosthetic leg. Now, patients who are experiencing post-operative pain more than six months after undergoing surgery have a new option that may eliminate their pain for good.

ENDING THE PAIN: Before nerve surgery can take place, it's important for doctors to rule out any other possible causes of the pain. Infection, bone abnormality, systemic neuropathy, local scarring and underlying diseases are all ruled out before a patient is eligible for surgery.

Ivica Ducic, M.D., Ph.D., a plastic surgeon at Georgetown University Hospital in Washington, D.C., has developed a procedure that helps patients who suffer from chronic nerve pain after a surgery. "For patients who are still in pain at least six months after surgery or trauma, there are new advances in peripheral nerve surgery that can help, even when other methods and treatments have failed," Dr. Ducic was quoted as saying. Using microsurgical instruments and techniques, the damaged nerve is resected and then implanted into the adjacent muscle. Doing this protects the end of the nerve, alleviates the pain and also prevents the nerve from growing back. This procedure can ease the pain of an amputee or a patient who has undergone surgery and suffers from post-operative groin, testicular and vulvar pain.

ANOTHER APPLICATION: Dr. Ducic also developed a surgical procedure to treat migraine headaches that result from compressed nerves, also known as compression neuropathy. When nerves are contained in an abnormally tight space, they can cause a burning sensation, tingling and pain, which can result in migraine headaches. Much like carpal tunnel surgery relieves compressed nerves in the wrist, this procedure eliminates pain by reducing the tight space around the nerves, thus decompressing them. Migraines related to the forehead, temporal or occipital regions can be treated using the same-day procedure with limited and hidden incisions. To be eligible for this surgery, a patient with a history of migraines must have a work-up and at least six months of unsuccessful therapeutic treatment from a headache-specialized neurologist.

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