Nerve Injury Pain

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. During this repair process, the neuroma sends shooting, stabbing and/or throbbing dull pain signals from incorrectly aligned nerve fibers.

Options for Nerve Pain

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, the doctor 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 the doctor 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/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 in cases where 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/muscle transfer. If your main concern is pain is due to a damaged nerve, our nerve specialists at Florida Plastic Surgery Group 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 pain following the temporary nerve block are good candidates for surgery and may be able to permanently decrease their pain.

The Process

I have been diagnosed with a nerve injury and have chronic pain, what is the next step?
Before arriving at your initial consultation with our surgeons:

• Complete our nerve injury/pain questionnaire
• Obtain your records from prior treating physicians outlining previous treatment or diagnostic studies pertinent to your injury

What happens during the initial consultation?
The initial consultation steps:

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

Surgery Expectations

Now that I am a candidate for surgery, what does surgery entail?
Surgery is performed under general anesthesia under supervision of a board certified anesthesiologist.

For most patients, surgery is performed on an outpatient basis. Depending on the number of nerves treated, surgery takes 1-2 hours to perform.

What should I expect during my recovery?

During the first 7 days following surgery, we encourage patients to relax and avoid performing any strenuous activity. A dressing is placed over the incision(s) and may be removed in 48 hours. 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. Please note that you are not able to drive or operate heavy machinery while taking any postoperative narcotic pain medication.
Some patients experience immediate pain relief if their pain was due to nerve injury. For others, the results of the procedure can take several months to take effect.

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:

• Delayed recovery of motor function
• Incomplete recovery of motor function
• A required second operation to restore function
• Remaining degrees of pain or no change in pain
• Residual burning or tingling during nerve regeneration that can last up to a year
• Scar formation

In addition, a small proportion of surgical candidates require a second surgery to address persistent nerve pain.

If you have further questions about nerve injury pain or surgical treatment for damaged nerves, please contact our plastic surgeons today to schedule a consultation.