phoneSAN FRANCISCO: 415-751-0583 WALNUT CREEK: 925-933-5700

healthgrades vitals

Article Index


Neuropathy in its simplest definition is a word which refers to some type of pathology within the nerve(s). There are numerous reasons why people experience the pain and/or numbness associated with neuropathy. Some of the more common causes include diabetes, alcoholism, thyroid disorders, exposure to certain chemotherapeutic drugs, exposure to heavy metals (e.g. lead, mercury), and impaired blood flow. The exact mechanism by which neuropathy occurs is also different in each of these specific situations. In addition, the neuropathy may be termed ‘idiopathic’, which simply means that the exact cause is unclear. While many patients with various forms of neuropathy can be treated successfully with medication and other conservative methods, there are plenty of situations in which these modalities are ineffective. Moreover, many patients are told that their neuropathy is likely to be progressive and irreversible which can be very difficult to hear and except. However, if some element of the neuropathic symptoms are due to nerve compression (i.e. a pinched nerve), there is certainly cause for optimism and hope.neuropathy


How Do I Know If a Pinched or Injured Nerve Is Involved in My Case?


During your consultation with Dr. Peled, he will take a thorough history focusing specifically on your neuropathy symptoms. We will discuss all the prior treatments which you have tried in the past, which ones were successful and which ones were unsuccessful and go over any imaging studies or diagnostic tests that you may have had. Dr. Peled will then perform a comprehensive physical examination to elucidate if there are any physical findings that suggest that a pinched nerve could be causing your pain. Sometimes, a nerve block will be used to confirm whether or a suspected nerve is actually the culprit in your particular case. Other times a different type of test will be recommended. If the information gathered from these various sources suggests that there is a peripheral nerve which is compressed (i.e. "pinched") and is contributing to your neuropathy symptoms, you may become a candidate for surgery to decompress (i.e. “un-pinch”) the injured nerve.



How Are These Types of Operations Performed?


Almost universally, surgery to decompress injured nerves in neuropathy patients can be performed on an outpatient basis. On rare occasions, a 23-hour overnight stay at a hospital may be necessary. During the procedure, Dr. Peled carefully exposes the injured nerves and removes any excessive scar tissue and connective tissue which may be compressing them. It is important to remember that the nerves themselves are not cut so as to minimize the chance of neuroma formation following surgery and to preserve as much function and sensation as possible. If the injured nerves in your particular case happen to be in your upper or lower extremities, only one extremity can be operated upon at one time because you will then favor that extremity and use the other side more. We want to make sure that the first side is fully healed before we operate on the other side because the reverse will be true following that second procedure. There is usually very little in the way of post-operative, confining dressings and/or restrictions and patients are able to eat and drink whatever they like immediately following their procedure. Pain medicine is prescribed for post-operative discomfort which is usually very well tolerated.

neuropathy pg3a


How Likely Am I to See a Benefit from These Types of Procedures?


The ultimate outcome from an operation to decompress one or more nerves is dependent on numerous factors such as the nerves in question, the patient's age and co-morbidities, the duration and severity of symptoms as well as other factors. With respect to diabetic neuropathy (the most common form in the United States as well as worldwide) the published results suggest that in appropriately selected patients, success rates in terms of good relief of pain and restoration of sensation can be above 70%. Depending on your specific history, the particular type of procedure you have had performed and which nerve or nerves have been addressed in your particular case, recovery times can also vary. Generally speaking, a procedure is not considered unsuccessful until at least a year has gone by as nerves can often take many months to recover and patients can often see steady improvement for many months following their operations. A much more specific and accurate answer to this question can be provided once we know the particulars of your situation which is why it is so important to have a formal consultation and examination with Dr. Peled.


csps1  ww22011-Vertical-small 2 healthgrades vitals