Saturday
May 18, 2024 
Chronic, unrelenting pain can take people to dark places. I see this often in my practice as a surgeon, and I’ve experienced it myself. After just 10 days of being in excruciating pain and unable to sleep, my mind was in a state of turmoil. I felt hopeless.
Unfortunately, millions of people suffer a lot longer than I did — sometimes permanently. More than 50 million Americans live in chronic pain. For many, trying to find relief involves constant medical appointments and trial and error of medications, opioids, and pain management techniques. Some treatments might temporarily mask the pain, but often don’t address or fix the root cause — and the pain comes rushing back. Other pain sufferers never find relief and, in extreme cases, die by suicide. One in 10 suicides is related to chronic pain.
We can’t accept a reality where there are seemingly only three choices for pain sufferers searching for answers — living a life ruled by pain, being dependent on pain medication, or no longer living.
I am especially passionate about this topic because as a trained micro and nerve surgeon, I’ve helped hundreds of patients determine that an injured nerve is the source of their pain and have performed nerve surgery to repair the damage and help resolve their painful symptoms — more permanently.
Nerve injuries are common and often are the result of some type of injury, such as a previous trauma, surgical procedure, sports injury, or amputation. However, nerves often go undiagnosed as the source of pain because nerve damage may not be visible on an X-ray, CT scan, or MRI; despite this, the pain nerve injuries cause is very real and incredibly debilitating.
When nerves are injured, they will naturally try to regrow. But when they’re damaged, they can’t do so properly. This can cause nerve signals to deviate course to the brain and result in pain. Sometimes, the pain is caused by a neuroma (a mass of nerve and scar tissue that forms in the nerve) or surrounding tissues compressing the nerve. Pain, numbness, or tingling that lasts more than three months after a trauma, surgery, accident, or injury may be a sign of nerve damage.
Nerve pain can feel different for different people, varying in severity. Some describe the feeling as “pins and needles,” while others say it feels like a lightning bolt has sent shock waves through their body. Burning, electric shocks, or extreme sensitivity to touch and temperature are also common descriptors.
The good news is that nerves can be surgically repaired — fixing the source of the pain and in some cases restoring lost function. Recent advances in microsurgery make it possible to repair nerves, removing the source of the pain, to allow normal signals to the brain to be restored.
From a man in his 20s who experienced agonizing pain in his lower leg due to a suture that was accidentally put through his peroneal nerve during surgery, to a woman in her 80s whose left hand was in extreme pain and unusable because broken glass sliced her palm and median nerve — many people find immediate relief with nerve surgery because we are addressing the root cause and fixing it.
If you have chronic pain after a traumatic injury, sports injury, surgery or amputation, and your health care providers keep telling you to wait for the pain to go away or that nothing can be done — get more opinions, including that of a surgeon who specializes in nerve function and repair. I have seen too many cases of patients who were told to wait for their pain to improve — when there was no chance of it improving on its own because it stemmed from an injured nerve. If nerve surgery is necessary, getting it sooner is better for both pain levels and overall outcomes.
Not enough people, including health care providers, know about the devastating effects of nerve injuries, how they lead to constant pain, or that there are ways to more permanently fix the cause and resolve it. Neuropathic pain (nerve pain) is the most common type of chronic pain, affecting one in 10 people, which means there are millions of people suffering who could be helped. Yet, people often see more than 20 providers before being evaluated by a peripheral nerve surgeon.
If you’re living with constant pain, I implore you to think about when your pain started. If it happened after an injury or previous surgery, seek out the consult of a surgeon who specializes in peripheral nerve surgery to learn more about nerve damage and surgical nerve repair options. I also encourage you to speak with others, so you don’t have to suffer alone. You can find a Pennsylvania-based pain support group through the American Chronic Pain Association.
People’s lives shouldn’t be defined or ruled by pain. Let’s bring more awareness to nerve pain and get more people the relief they deserve.
Dr. Adam Strohl, of Philadelphia, is a plastic reconstructive and peripheral nerve surgeon who practices at the Philadelphia Hand to Shoulder Center, which has 14 area offices, including locations in Langhorne, Willow Grove and Lansdale. It is affiliated with Jefferson Health.
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