Florida Nerve Injury Pain Center

Serving Patients in Jacksonville, Florida

What causes pain associated with nerve injury?

A nerve injury can result in weakness or paralysis of a muscle or in numbness of an area of skin. In some people, it also causes chronic pain as the damaged portion of the nerve (a neuroma) tries to repair itself and in the process sends shooting, stabbing and/or throbbing dull pain signals from incorrectly aligned nerve fibers.

Are there non-surgical options for my nerve injury pain?

Any patient with chronic pain following injury should be evaluated by their primary medical doctor or a pain management specialist to determine if their pain is nerve related. If the pain is related to nerve injury, they may prescribe traditional narcotic pain medication, or non-narcotic neuropathic pain medication to help manage your pain. Typically medical treatment alone will not recover an injured nerve and they may order electrodiagnostic studies (EMG/NCS) to monitor for signs of recovery. In the meantime, you must protect any part of your body that is numb or lacks sensation so that it is not further injured. In addition a physical therapist may help to splint or provide motion to preserve joint motion for areas of your body that lack muscle function due to nerve injury.

Are there surgical options for nerve injury and the associated pain?

Surgery is an option when spontaneous nerve regeneration does not restore the desired function, or if the pain is due to an injured nerve. Surgical options to restore function may include nerve repair, reconstruction with a nerve graft or conduit, nerve transfer or even a tendon or muscle transfer. If your main complaint is pain is due to a damaged nerve, we will perform a diagnostic local anesthetic blockade of the injured nerve similar to a dental nerve block to determine which nerve is causing your pain. Patients who have a marked decrease in their pain following the temporary nerve block are good candidates for surgery any may decrease their pain permanently.

 

The process

I have been diagnosed with a nerve injury and have chronic pain, what is the next step?

I) Prior to the initial consultation:

1. Schedule a consultation with our surgeons
2. Complete our nerve injury/pain questionnaire
3. Obtain your records from prior treating physicians outlining previous treatment or diagnostic studies pertinent to your injury

What is done at the initial consultation?

II) The initial consultation steps:

1. Our surgeons will review your history with you, perform a physical examination, and answer all your questions and concerns
2. Our surgeons will perform a diagnostic nerve block to identify if your chronic pain is neural in origin and can be surgically treated.

Now that I am a candidate for surgery, what does surgery entail?

III) Surgery is performed under general anesthesia under supervision of a board certified anesthesiologist.

IV) For most patients, surgery is performed on an outpatient basis (you go home the same day). Depending on the number of nerves treated, surgery takes 1 to 2 hours to perform.

What should I expect during my recovery?

V) Following surgery until the first visit (usually 7 days) we encourage patients to relax, and not perform any strenuous activity. A dressing is placed over the incision(s) and may be removed in 48 hours when you are able to shower. Activity and work status depend on the procedures performed and will be discussed during your initial consultation. If you had nerve reconstruction you will be seen and evaluated by a physical or occupational therapist. You are not able to drive or operate heavy machinery while taking any post-operative narcotic pain medication.

Some patients experience immediate pain relief if their pain was due to nerve injury, others it can take several months. All sutures are typically dissolvable and do not require removal.

What are the risks of surgery?

In addition to common surgical risks, the unique risks of nerve reconstruction and nerve surgery to alleviate chronic pain include: incomplete recovery of motor function that may require waiting up to three years to determine the amount of recovery or may require a second operation to restore function; patients may still be left with areas of pain or there may not be a change in the amount of pain; residual burning or tingling pain during nerve regeneration that can last up to a year; unpredictable scar formation. A small proportion of surgical candidates require a second surgery to address an additional nerve causing persistent pain.