What Relief Feels Like


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Surgical procedures are performed with the goal of making us feel better and fixing the cause of a specific problem. Unfortunately, sometimes chronic pain is an unintended consequence of the operation and this pain can occur even if the procedure in question was done correctly. Why would this occur and how could it be remedied? In order to answer this question, we must first recognize the saying that, ‘All pain comes from nerves’. The corollary to this adage is that if one can identify the specific nerve(s) causing the pain and what is wrong with them, perhaps something can be done to improve the pain.

There are many, common surgical procedures which can result in chronic pain. Examples include inguinal (groin) hernia repair, appendectomy, hysterectomy, Caesarian section, vasectomy, and certain types of breast reconstruction.chronic painAs a cosmetic as well as reconstructive plastic surgeon, I was trained to work from head to toe and hence acquired an intimate understanding of the anatomy of the entire body. As a peripheral nerve surgeon, my specific knowledge of peripheral nerves and how such nerves may be injured, surgically manipulated and repaired has given me an appreciation for defining when nerves have been injured and whether or not they are amenable to surgical treatment.

The nerves that are often injured during the surgical procedures mentioned above are extremely small and can vary in their exact anatomic location. For these reasons, sometimes these nerves are accidentally cut, stretched or burned without the initial operative surgeon realizing that an injury has occurred. In addition, sometimes during the normal wound healing process scar tissue beneath the skin can envelop small nerves and cause compression which, in turn, can lead to chronic pain. Only when this pain does not subside many weeks or months following the initial operative procedure, do clinicians recognize that something has gone awry. Fortunately, certain general principles and compression points exist that allow a peripheral nerve surgeon to determine whether or not a particular nerve may have been injured.

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