tel. 314-434-7784

    Dr Robert Hagan's Thoughts

    For news and information on Diabetic Neuropathy, Chronic Pain and Surgical Procedures to fix them!

    Dr. Robert R. Hagan received his MD from Saint Louis University School of Medicine. He received his general surgery training at The Lahey Clinic in Boston, Massachusetts and his plastic surgery training at The Lahey Clinic and Harvard Medical School hospitals. He continued his education as a fellow at Harvard Medical School in Boston, Massachusetts specializing in hand and microsurgery. Upon returning to the Midwest he completed a craniofacial fellowship at Washington University in St. Louis, MO.


    Currently, Dr. Hagan maintains a private practice at Neuropax Clinic in St. Louis, MO. He has special interests in peripheral nerve surgery and hand/extremity surgery. His diverse training in plastics, hand, peripheral nerve, craniofacial, reconstructive and microsurgery has served him well to understand the many challenges of today's pain and peripheral nerve disorders.


    Peripheral nerve itself includes diabetic neuropathy, compression neuropathies (carpal tunnel, cubital tunnel, tarsal tunnel, etc.), nerve trauma, chronic joint pain, chronic groin pain, chronic migraines, and RSD/causalgia.
     
    Dr. Hagan is committed to the research and further development of peripheral nerve surgery. Neuropax Clinic provides a multi-center platform for clinical research and advancement of surgical techniques. Dr. Hagan has many ongoing studies focused on improving the diagnosis of and treatment of peripheral nerve and pain disorders.


    Dr. Hagan and Neuropax Clinic together provide fellowship training in peripheral nerve surgery to teach other surgeons their advanced diagnostic and surgical techniques. He is also a clinical instructor for the Saint Louis University, Department of Surgery, Division of Plastic Surgery.
     
    Dr. Robert Hagan's professional hospital appointments include Missouri Baptist Hospital, St. Luke's Hospital, St. John's Mercy Medical Center; all located in St. Louis, Missouri.

    Your Phone Can Give You Migraines

    Your Phone Can Give You Migraines

    While eyestrain and stress can give you headaches from looking at your phone too much, the real danger isn’t the screen. It’s your posture. Your phone can give you migraines just by how it makes you stand to look at it, and you may not notice until it’s too late.

    Looking down is a natural neck motion. It’s one of the things your body was designed to do, certainly. However, you are not built to look straight down at your phone, laptop, tablet, or smart watch for hours on end, which is what we have started to develop. While Twitter and Facebook are interesting, you need to take a break from them to relax your neck and give your posture a chance to reset.

    Migraines are caused by impingement on the occipital nerve. This nerve, when it is pushed or pulled in a direction that it’s not used to, causes migraine headaches. Yes, you can get severe migraines by looking down at your phone for too long.

    The cure? Well, take a break from your phone. Look where you’re going when you walk. Hold your phone up to your face when you’re watching a YouTube video (not too close, don’t ruin your eyesight too), but just don’t let your neck sit in an awkward position for too long. Children are getting their occipital nerves twisted at a young age and it can affect the rest of their lives.

    If you damage the occipital nerve and are getting migraines, though, they can be fixed. Peripheral nerve surgery for migraines and headache surgery can fix these issues by relieving the pressure on the occipital nerve, which can reduce or end these headaches and stop them from ruining your life.

    If you suffer from migraines, call the offices of Dr. Robert Hagan at Neuropax Clinic. You can reach them at 314-434-7784 or visit www.neuropaxclinic.com to make an appointment. Don’t live with migraines any linger than you have to.

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    Peripheral Nerve Problems Leading To Migraines

    headache 1910649 1280

    Migraines that are caused by peripheral nerves can be treated with peripheral nerve surgery. The surgery involves freeing the nerve from the surrounding tissue to relieve the irritation. This can alleviate, reduce, or even end the pain of migraines once and for all. Peripheral nerve problems leading to migraines are a problem that can be solved.

    What causes this pain? Just like with any peripheral nerve issue, there can be multiple causes. Some people are born with a proclivity toward migraines through physiology or build, and they develop them naturally.

    Another is lifestyle. It is no coincidence that migraines have increased as we have become more dependent on screens and phones, items that cause our bodies to contort to strange shapes to utilize properly.

    Looking down at a screen all day can cause an impingement of the occipital nerve in the neck that can lead to migraines and pain. All it takes is a bit of pressure on the occipital nerve and you can be debilitated for hours.

    Migraines are a real health problem. They can lead to job loss and loss of quality of life, as they can cause sufferers intense pain and remove their ability to concentrate or work.

    It can make you irritable or short-tempered, with the need to get away and lie in a dark room more important than spending time with your family. Migraines have a cascading effect on the rest of your life, but they can be fixed.

    Repairing a damaged or impinged peripheral nerve can be a lifechanging experience and lead to a better life, and can also be often held as an outpatient surgery with a short recovery time.

    If you suffer from migraines, call the offices of Dr. Robert Hagan at Neuropax Clinic. You can reach them at 314-434-7784 or visit www.neuropaxclinic.com to make an appointment. Don’t live with migraines any linger than you have to.

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    Carpal Tunnel Syndrome in Kansas City

    hands 2217668 1280

    Carpal Tunnel Syndrome is caused by repeated and frequent pressure on the median nerve. This is the nerve that gives feeling and movement to the different part of the hand, and it’s located in the wrist. Carpal Tunnel is common in people that work primarily with their hands, fingers and wrists with repetitive actions. Carpal Tunnel Syndrome warning signs are there to be found, and many people suffer from Carpal Tunnel Syndrome in Kansas City.

    If we watch for these early signs, we can keep on top of it. A really early sign is tingling or numbness in the palm, thumb, middle, ring and index fingers. If you start to notice these, you may have inflammation in the tissues of the wrist pressing on the median nerve. This causes the increased pain and numbness in the palm and fingers.

    Also watch for fine finger coordination issues. If you find yourself dropping or carrying things awkwardly, you may have carpal tunnel syndrome. You can also watch for weakened hand grip.

    Severe cases will give you a stiffening, locking or tightening of the hand, wrist, forearm and elbow. This can be so bad that it’s difficult to sleep or concentrate.

    Keep track of loss of strength or even muscle atrophy in the palm and fingers, noticeably in the thumb. If you suddenly can’t open a pickle jar, you could be experiencing the extreme signs of Carpal Tunnel Syndrome.

    If you feel that you may be suffering from Carpal Tunnel Syndrome, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

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    Nerve Decompression Surgery for Migraines in Springfield

    upset 2681502 1280

    Migraines are a scourge. They can ruin your entire life if untreated. A migraine can leave you lying in a dark room or home early from work. Nerve compression surgery for migraines can help.

    There are 180 different defined types of headaches. Headaches are common in the US, with a variety of different causes. Chronic, daily or even continual headaches can be from migraines. There are over 30 million people believed to be suffering from migraines today. While some can be treated with medication and therapy, some require surgery.

    13% or more of migraines are thought to be related to occipital neuralgia. When the Greater occipital nerve is impinged, with tissue causing pressure on the nerve, the symptoms begin. If they remain untreated, it leads to migraine headaches.

    Although the Greater occipital nerve is the most common nerve involved, other nerves can be involved as well. The lesser occipital nerve and dorsal (or least) occipital nerve which are located in the back of the head/scalp. Headaches may originate from the forehead or frontal region as well. The nerves involved in this area include the supra-orbital and zygomatico-temporal nerves.

    When no other underlying diseases or conditions are found, you may be a candidate for a nerve decompression surgery that can reduce or end your migraine headaches.  This is an outpatient surgery with short recovery times. Results are often immediately evident but may take several weeks. Neuropax surgeons can assess if nerve decompression surgery would help to alleviate or significantly reduce your debilitating symptoms.

    If you feel that you may be suffering from migraines, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

    Continue reading
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    Carpal Tunnel From Repetitive Stress

    treatment 1327811 1280

    If you’ve been diagnosed with a repetitive strain injury, you probably have something like carpal tunnel syndrome, tendonitis or "dorsal wrist syndrome." Millions of Americans suffer these maladies, but each person’s cause can be different. Any job has different requirements that may cause repetitive stress to a different part of the body that may not be designed for it.

    Repetitive strain damage comes from structural changes in the muscle fibers and decreased blood flow in the affected areas. It may be a nerve problem, but the nerve ISN’T the problem! If you have these issues, it’s because inflamed tissue around the nerve is impinging on the nerve. Some activity is moving the joint or muscles in a way that they aren’t supposed to, and it’s causing the inflammation.

    Symptoms may often be relieved without surgery. Identifying and treating medical conditions, changing the patterns of hand use, or keeping the wrist splinted in a straight position may help reduce pressure on the nerve. Wearing wrist splints at night may relieve the symptoms that interfere with sleep. A steroid injection into the carpal tunnel may help relieve the symptoms by reducing swelling around the nerve.
     
    When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve. Pressure on the nerve is decreased by cutting the ligament that forms the roof (top) of the tunnel on the palm side of the hand (see Figure 3). Incisions for this surgery may vary, but the goal is the same: to enlarge the tunnel and decrease pressure on the nerve.
    Following surgery, soreness around the incision may last for several weeks or months. The numbness and tingling may disappear quickly or slowly. It may take several months for strength in the hand and wrist to return to normal. Carpal tunnel symptoms may not completely go away after surgery, especially in severe cases.


    If you feel that you have a repetitive stress issue, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

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    Nerve Decompression Surgery for Migraines in Kansas City

    headache 388870 1280

    Migraines are a scourge. They can ruin your entire life if untreated. A migraine can leave you lying in a dark room or home early from work. Nerve compression surgery for migraines can help.

    There are 180 different defined types of headaches. Headaches are common in the US, with a variety of different causes. Chronic, daily or even continual headaches can be from migraines. There are over 30 million people believed to be suffering from migraines today. While some can be treated with medication and therapy, some require surgery.

    13% or more of migraines are thought to be related to occipital neuralgia. When the Greater occipital nerve is impinged, with tissue causing pressure on the nerve, the symptoms begin. If they remain untreated, it leads to migraine headaches.

    Although the Greater occipital nerve is the most common nerve involved, other nerves can be involved as well. The lesser occipital nerve and dorsal (or least) occipital nerve which are located in the back of the head/scalp. Headaches may originate from the forehead or frontal region as well. The nerves involved in this area include the supra-orbital and zygomatico-temporal nerves.

    When no other underlying diseases or conditions are found, you may be a candidate for a nerve decompression surgery that can reduce or end your migraine headaches.  This is an outpatient surgery with short recovery times. Results are often immediately evident but may take several weeks. Neuropax surgeons can assess if nerve decompression surgery would help to alleviate or significantly reduce your debilitating symptoms.

    If you feel that you may be suffering from migraines, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

    Continue reading
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    Diabetic Neuropathy On the Rise in St. Louis

    diabetes 2058045 1280

    With Type 1 and Type 2 Diabetes rates climbing, the sufferers of diabetic neuropathy increase as well.  These patients suffer from debilitating pain that radiates from the hands, feet, legs and arms.  It has been referred to for years as an irreversible disease, and treated as such by physicians.  They look to prevent the disease's progression, and minimize pain with medication, or specialized footwear.

    However, new breakthroughs in the field of nerve decompression have opened up pathways to new treatments for the pain of diabetic neuropathy.  Nerve decompression works to ease the pain that inflamed tissue puts on the nerves in the extremities and has shown to be VERY effective in the fight against diabetic neuropathy.  Clinical trials and studies back nerve decompression as a breakthrough treatment.

    The goals are simple for this surgery:  restore sensation and eliminate the pain.  When the sensation is restored, it severely reduces the risk for ulceration and infection that leads to amputation.  Many patients find that their need for the medications is lessened after the surgery is complete.

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach.

    Continue reading
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    Do You Have Carpal Tunnel Syndrome in St. Louis?

    Carpal Tunnel Syndrome is caused by repeated and frequent pressure on the median nerve. This is the nerve that gives feeling and movement to the different part of the hand, and it’s located in the wrist. Carpal Tunnel is common in people that work primarily with their hands, fingers and wrists with repetitive actions. Carpal Tunnel Syndrome warning signs are there to be found.

    treatment 1327811 1280

    If we watch for these early signs, we can keep on top of it. A really early sign is tingling or numbness in the palm, thumb, middle, ring and index fingers. If you start to notice these, you may have inflammation in the tissues of the wrist pressing on the median nerve. This causes the increased pain and numbness in the palm and fingers.

    Also watch for fine finger coordination issues. If you find yourself dropping or carrying things awkwardly, you may have carpal tunnel syndrome. You can also watch for weakened hand grip.

    Severe cases will give you a stiffening, locking or tightening of the hand, wrist, forearm and elbow. This can be so bad that it’s difficult to sleep or concentrate.

    Keep track of loss of strength or even muscle atrophy in the palm and fingers, noticeably in the thumb. If you suddenly can’t open a pickle jar, you could be experiencing the extreme signs of Carpal Tunnel Syndrome.

    If you feel that you may be suffering from Carpal Tunnel Syndrome, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

    Continue reading
    198 Hits
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    Nerve Decompression Surgery for Migraines in St. Louis

    woman 2775271 1280

    Migraines are a scourge. They can ruin your entire life if untreated. A migraine can leave you lying in a dark room or home early from work. Nerve compression surgery for migraines can help.

    There are 180 different defined types of headaches. Headaches are common in the US, with a variety of different causes. Chronic, daily or even continual headaches can be from migraines. There are over 30 million people believed to be suffering from migraines today. While some can be treated with medication and therapy, some require surgery.

    13% or more of migraines are thought to be related to occipital neuralgia. When the Greater occipital nerve is impinged, with tissue causing pressure on the nerve, the symptoms begin. If they remain untreated, it leads to migraine headaches.

    Although the Greater occipital nerve is the most common nerve involved, other nerves can be involved as well. The lesser occipital nerve and dorsal (or least) occipital nerve which are located in the back of the head/scalp. Headaches may originate from the forehead or frontal region as well. The nerves involved in this area include the supra-orbital and zygomatico-temporal nerves.

    When no other underlying diseases or conditions are found, you may be a candidate for a nerve decompression surgery that can reduce or end your migraine headaches.  This is an outpatient surgery with short recovery times. Results are often immediately evident but may take several weeks. Neuropax surgeons can assess if nerve decompression surgery would help to alleviate or significantly reduce your debilitating symptoms.

    If you feel that you may be suffering from migraines, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

    Continue reading
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    Carpal Tunnel Syndrome Warning Signs

     treatment 1327811 1280

    Carpal Tunnel Syndrome is caused by repeated and frequent pressure on the median nerve. This is the nerve that gives feeling and movement to the different part of the hand, and it’s located in the wrist. Carpal Tunnel is common in people that work primarily with their hands, fingers and wrists with repetitive actions. Carpal Tunnel Syndrome warning signs are there to be found.

    If we watch for these early signs, we can keep on top of it. A really early sign is tingling or numbness in the palm, thumb, middle, ring and index fingers. If you start to notice these, you may have inflammation in the tissues of the wrist pressing on the median nerve. This causes the increased pain and numbness in the palm and fingers.

    Also watch for fine finger coordination issues. If you find yourself dropping or carrying things awkwardly, you may have carpal tunnel syndrome. You can also watch for weakened hand grip.

    Severe cases will give you a stiffening, locking or tightening of the hand, wrist, forearm and elbow. This can be so bad that it’s difficult to sleep or concentrate.

    Keep track of loss of strength or even muscle atrophy in the palm and fingers, noticeably in the thumb. If you suddenly can’t open a pickle jar, you could be experiencing the extreme signs of Carpal Tunnel Syndrome.

    If you feel that you may be suffering from Carpal Tunnel Syndrome, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

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    Signs You Have Thoracic Outlet Syndrome

    pexels photo 275768

    Thoracic outlet syndrome refers to a group of conditions that develop when the blood vessels or nerves in the thoracic outlet become compressed. The thoracic outlet is the narrow space between your collarbone and first rib. Blood vessels, nerves, and muscles that extend from the back to the arms pass through this area. If the space in the thoracic outlet is too narrow, these structures can become compressed. The increased pressure on the blood vessels and nerves may cause pain in your shoulders, neck, and arms. It can also cause numbness or tingling in your hands.

    pain in parts of the neck, shoulder, arm, or hand

    numbness in the forearm and fingers

    weakness of the hand

    Compressed blood vessels can cause:

    swelling of the arm

    redness of the arm

    hands or arms that feel cold to the touch

    hands or arms that become easily fatigued

    You may also find it difficult to lift objects above your head. You might also have a limited range of motion in your shoulders and arms.

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    Peripheral Neuropathy Needs To Be Treated

    diabetes 2058045 1280

    Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include:

    • Numbness or reduced ability to feel pain or temperature changes
    • A tingling or burning sensation
    • Sharp pains or cramps
    • Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing
    • Muscle weakness
    • Loss of reflexes, especially in the ankle
    • Loss of balance and coordination
    • Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain

    Seek medical care if you notice:

    • A cut or sore on your foot that doesn't seem to be healing, is infected or is getting worse
    • Burning, tingling, weakness or pain in your hands or feet that interferes with your daily routine or your sleep
    • Dizziness
    • Changes in your digestion, urination or sexual function

    Diabetic neuropathy can cause a number of serious complications, including:

    • Loss of a limb. Because nerve damage can cause a lack of feeling in your feet, cuts and sores may go unnoticed and eventually become severely infected or ulcerated — a condition in which the skin and soft tissues break down. The risk of infection is high because diabetes reduces blood flow to your feet. Infections that spread to the bone and cause tissue death (gangrene) may be impossible to treat and require amputation of a toe, foot or even the lower leg.
    • Charcot joint. This occurs when a joint, usually in the foot, deteriorates because of nerve damage. Charcot joint is marked by loss of sensation, as well as swelling, instability and sometimes deformity in the joint itself. Early treatment can promote healing and prevent further damage.
    • Urinary tract infections and urinary incontinence. Damage to the nerves that control your bladder can prevent it from emptying completely. This allows bacteria to multiply in your bladder and kidneys, leading to urinary tract infections. Nerve damage can also affect your ability to feel when you need to urinate or to control the muscles that release urine.
    • Hypoglycemia unawareness. Normally, when your blood sugar drops too low — below 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L) — you develop symptoms such as shakiness, sweating and a fast heartbeat. Autonomic neuropathy can interfere with your ability to notice these symptoms.
    • Low blood pressure. Damage to the nerves that control circulation can affect your body's ability to adjust blood pressure. This can cause a sharp drop in pressure when you stand after sitting (orthostatic hypotension), which may lead to dizziness and fainting.
    • Digestive problems. Nerve damage in the digestive system can cause constipation or diarrhea — or alternating bouts of constipation and diarrhea — as well as nausea, vomiting, bloating and loss of appetite. It can also cause gastroparesis, a condition in which the stomach empties too slowly or not at all. This can interfere with digestion and cause nausea, vomiting and bloating, and severely affect blood sugar levels and nutrition.
    • Sexual dysfunction. Autonomic neuropathy often damages the nerves that affect the sex organs, leading to erectile dysfunction in men and problems with lubrication and arousal in women.
    • Increased or decreased sweating. When the sweat glands don't function normally, your body isn't able to regulate its temperature properly. A reduced or complete lack of perspiration (anhidrosis) can be life-threatening. Autonomic neuropathy may also cause excessive sweating, particularly at night or while eating.

    Diabetic neuropathy has been considered an irreversible disorder with traditional treatments focused on preventing the progression of the condition; or reducing the pain symptoms with drugs or specialized footwear.  However, treatment with nerve decompression surgery to address the symptoms of diabetic peripheral neuropathy now have an established clinical track record.  Many clinical studies have been published reporting the value of nerve decompression surgery in the treatment of peripheral diabetic neuropathy.

    Goals of the surgery are to restore sensation to the hands or feet, reduce or eliminate pain and to regain strength. If sensation is restored to the feet, the risk of having an ulceration or infection leading to an amputation is nearly eliminated.  Many patients are able to discontinue their medications relating to neuropathy after this procedure. 

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach.

    Continue reading
    354 Hits
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    Don't Live With Diabetic Neuropathy In St. Louis

    diabetes 2058045 1280

    With Type 1 and Type 2 Diabetes rates climbing, the sufferers of diabetic neuropathy increase as well.  These patients suffer from debilitating pain that radiates from the hands, feet, legs and arms.  It has been referred to for years as an irreversible disease, and treated as such by physicians.  They look to prevent the disease's progression, and minimize pain with medication, or specialized footwear.

    However, new breakthroughs in the field of nerve decompression have opened up pathways to new treatments for the pain of diabetic neuropathy.  Nerve decompression works to ease the pain that inflamed tissue puts on the nerves in the extremities and has shown to be VERY effective in the fight against diabetic neuropathy.  Clinical trials and studies back nerve decompression as a breakthrough treatment.

    The goals are simple for this surgery:  restore sensation and eliminate the pain.  When the sensation is restored, it severely reduces the risk for ulceration and infection that leads to amputation.  Many patients find that their need for the medications is lessened after the surgery is complete.

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach.

    Continue reading
    455 Hits
    0 Comments

    Repetitive Motion Can Lead to Carpal Tunnel

    grinder 2175150 1280

    If you’ve been diagnosed with a repetitive strain injury, you probably have something like carpal tunnel syndrome, tendonitis or "dorsal wrist syndrome." Millions of Americans suffer these maladies, but each person’s cause can be different. Any job has different requirements that may cause repetitive stress to a different part of the body that may not be designed for it.

    Repetitive strain damage comes from structural changes in the muscle fibers and decreased blood flow in the affected areas. It may be a nerve problem, but the nerve ISN’T the problem! If you have these issues, it’s because inflamed tissue around the nerve is impinging on the nerve. Some activity is moving the joint or muscles in a way that they aren’t supposed to, and it’s causing the inflammation.

    Symptoms may often be relieved without surgery. Identifying and treating medical conditions, changing the patterns of hand use, or keeping the wrist splinted in a straight position may help reduce pressure on the nerve. Wearing wrist splints at night may relieve the symptoms that interfere with sleep. A steroid injection into the carpal tunnel may help relieve the symptoms by reducing swelling around the nerve.
     
    When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve. Pressure on the nerve is decreased by cutting the ligament that forms the roof (top) of the tunnel on the palm side of the hand (see Figure 3). Incisions for this surgery may vary, but the goal is the same: to enlarge the tunnel and decrease pressure on the nerve.
    Following surgery, soreness around the incision may last for several weeks or months. The numbness and tingling may disappear quickly or slowly. It may take several months for strength in the hand and wrist to return to normal. Carpal tunnel symptoms may not completely go away after surgery, especially in severe cases.


    If you feel that you have a repetitive stress issue, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

    Continue reading
    352 Hits
    0 Comments

    Relief For Diabetic Neuropathy

    Peripheral neuropathy is the most common form of diabetic neuropathy. Your feet and legs are often affected first, followed by your hands and arms. Signs and symptoms of peripheral neuropathy are often worse at night, and may include:

    • Numbness or reduced ability to feel pain or temperature changes
    • A tingling or burning sensation
    • Sharp pains or cramps
    • Increased sensitivity to touch — for some people, even the weight of a bed sheet can be agonizing
    • Muscle weakness
    • Loss of reflexes, especially in the ankle
    • Loss of balance and coordination
    • Serious foot problems, such as ulcers, infections, deformities, and bone and joint pain

    Seek medical care if you notice:

    • A cut or sore on your foot that doesn't seem to be healing, is infected or is getting worse
    • Burning, tingling, weakness or pain in your hands or feet that interferes with your daily routine or your sleep
    • Dizziness
    • Changes in your digestion, urination or sexual function

    Diabetic neuropathy can cause a number of serious complications, including:

    • Loss of a limb. Because nerve damage can cause a lack of feeling in your feet, cuts and sores may go unnoticed and eventually become severely infected or ulcerated — a condition in which the skin and soft tissues break down. The risk of infection is high because diabetes reduces blood flow to your feet. Infections that spread to the bone and cause tissue death (gangrene) may be impossible to treat and require amputation of a toe, foot or even the lower leg.
    • Charcot joint. This occurs when a joint, usually in the foot, deteriorates because of nerve damage. Charcot joint is marked by loss of sensation, as well as swelling, instability and sometimes deformity in the joint itself. Early treatment can promote healing and prevent further damage.
    • Urinary tract infections and urinary incontinence. Damage to the nerves that control your bladder can prevent it from emptying completely. This allows bacteria to multiply in your bladder and kidneys, leading to urinary tract infections. Nerve damage can also affect your ability to feel when you need to urinate or to control the muscles that release urine.
    • Hypoglycemia unawareness. Normally, when your blood sugar drops too low — below 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L) — you develop symptoms such as shakiness, sweating and a fast heartbeat. Autonomic neuropathy can interfere with your ability to notice these symptoms.
    • Low blood pressure. Damage to the nerves that control circulation can affect your body's ability to adjust blood pressure. This can cause a sharp drop in pressure when you stand after sitting (orthostatic hypotension), which may lead to dizziness and fainting.
    • Digestive problems. Nerve damage in the digestive system can cause constipation or diarrhea — or alternating bouts of constipation and diarrhea — as well as nausea, vomiting, bloating and loss of appetite. It can also cause gastroparesis, a condition in which the stomach empties too slowly or not at all. This can interfere with digestion and cause nausea, vomiting and bloating, and severely affect blood sugar levels and nutrition.
    • Sexual dysfunction. Autonomic neuropathy often damages the nerves that affect the sex organs, leading to erectile dysfunction in men and problems with lubrication and arousal in women.
    • Increased or decreased sweating. When the sweat glands don't function normally, your body isn't able to regulate its temperature properly. A reduced or complete lack of perspiration (anhidrosis) can be life-threatening. Autonomic neuropathy may also cause excessive sweating, particularly at night or while eating.

    Diabetic neuropathy has been considered an irreversible disorder with traditional treatments focused on preventing the progression of the condition; or reducing the pain symptoms with drugs or specialized footwear.  However, treatment with nerve decompression surgery to address the symptoms of diabetic peripheral neuropathy now have an established clinical track record.  Many clinical studies have been published reporting the value of nerve decompression surgery in the treatment of peripheral diabetic neuropathy.

    Goals of the surgery are to restore sensation to the hands or feet, reduce or eliminate pain and to regain strength. If sensation is restored to the feet, the risk of having an ulceration or infection leading to an amputation is nearly eliminated.  Many patients are able to discontinue their medications relating to neuropathy after this procedure. 

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach.

    Continue reading
    424 Hits
    0 Comments

    Do You Have a Migraine?

    If you think you’re suffering from migraines, it’s very frustrating. Many people just take Tylenol and deal with them. For some, it’s not something that can be managed, but needs to be treated by a doctor. Here’s when to see a doctor about migraine pain.

    Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.

    If you start to see symptoms like these, make an appointment immediately or go to the emergency room, as you may have severe migraine issues:

    • An abrupt, severe headache like a thunderclap
    • Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
    • Headache after a head injury, especially if the headache gets worse
    • A chronic headache that is worse after coughing, exertion, straining or a sudden movement
    • New headache pain if you're older than 50

    Many migraines go completely untreated. If you’re experiencing migraine attack symptoms, keep notes on what you do to deal with them, and how effective it is. Then call Neuropax Clinic to discuss your headaches.

    Dr. Robert Hagan of Neuropax Clinic is ready to help with your migraine attacks. Call the office today at 314-434-7784 to schedule an appointment to talk about how peripheral nerve surgery can help with your migraine pain. Don’t live with migraines a day longer than you have to. Let us help.

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    Did Repetitive Stress Give You Carpal Tunnel?

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    If you’ve been diagnosed with a repetitive strain injury, you probably have something like carpal tunnel syndrome, tendonitis or "dorsal wrist syndrome." Millions of Americans suffer these maladies, but each person’s cause can be different. Any job has different requirements that may cause repetitive stress to a different part of the body that may not be designed for it. Repetitive strain damage comes from structural changes in the muscle fibers and decreased blood flow in the affected areas. It may be a nerve problem, but the nerve ISN’T the problem! If you have these issues, it’s because inflamed tissue around the nerve is impinging on the nerve. Some activity is moving the joint or muscles in a way that they aren’t supposed to, and it’s causing the inflammation. Symptoms may often be relieved without surgery. Identifying and treating medical conditions, changing the patterns of hand use, or keeping the wrist splinted in a straight position may help reduce pressure on the nerve. Wearing wrist splints at night may relieve the symptoms that interfere with sleep. A steroid injection into the carpal tunnel may help relieve the symptoms by reducing swelling around the nerve. When symptoms are severe or do not improve, surgery may be needed to make more room for the nerve. Pressure on the nerve is decreased by cutting the ligament that forms the roof (top) of the tunnel on the palm side of the hand (see Figure 3). Incisions for this surgery may vary, but the goal is the same: to enlarge the tunnel and decrease pressure on the nerve. Following surgery, soreness around the incision may last for several weeks or months. The numbness and tingling may disappear quickly or slowly. It may take several months for strength in the hand and wrist to return to normal. Carpal tunnel symptoms may not completely go away after surgery, especially in severe cases. If you feel that you have a repetitive stress issue, please call the office at Neuropax Clinic at 314-434-7784 to make an appointment. Don’t live in pain another day if you don’t have to. Visit www.neuropaxclinic.com for more information.

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    Diabetic Neuropathy in St. Louis

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    With Type 1 and Type 2 Diabetes rates climbing, the sufferers of diabetic neuropathy increase as well.  These patients suffer from debilitating pain that radiates from the hands, feet, legs and arms.  It has been referred to for years as an irreversible disease, and treated as such by physicians.  They look to prevent the disease's progression, and minimize pain with medication, or specialized footwear.

    However, new breakthroughs in the field of nerve decompression have opened up pathways to new treatments for the pain of diabetic neuropathy.  Nerve decompression works to ease the pain that inflamed tissue puts on the nerves in the extremities and has shown to be VERY effective in the fight against diabetic neuropathy.  Clinical trials and studies back nerve decompression as a breakthrough treatment.

    The goals are simple for this surgery:  restore sensation and eliminate the pain.  When the sensation is restored, it severely reduces the risk for ulceration and infection that leads to amputation.  Many patients find that their need for the medications is lessened after the surgery is complete.

    If you suffer from diabetic neuropathy, physicians from Neuropax Clinic can determine whether surgery might be appropriate for you. A comprehensive evaluation will be performed to determine whether you have compressed nerves that may respond to surgery. We have already helped many patients regain sensation and get relief from pain with this surgical approach.

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    Why Does My Wrist Hurt?

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    Carpal Tunnel Release Surgery, or Carpal Tunnel Surgery, is a procedure designed to release the pressure or impingement on the median nerve, relieving the symptoms of carpal tunnel syndrome. This syndrome is expressed by pain and numbness in the hand and wrist, and is often caused by repetitive stress and holding the hand/wrist in an awkward position. People who type often, use a hammer, or work in a factory setting are all candidates for this syndrome.

    During the surgery, an incision on the base of the hand is made, letting us examine the transverse carpal ligament. We are then able to clean up the area, suture the wound, and you are usually released that day. Carpal tunnel surgery is not typically an overnight hospital stay and is usually done under local anesthesia. It’s a one-day procedure and you should sleep in your own bed that night.

    After the procedure, you need to keep the hand wrapped for 10-14 days, until the stitches are removed. The pain and numbness may go away right away, or may linger for a few months. You really should take it easy with the wrist for at least 3 months. If it’s your dominant hand, you want to give it a little longer to rest before returning to work. Non-dominant hand surgery patients can usually return to non-physical labor in a day or two, but if it’s your dominant hand or you have a very physical job, you may need physical therapy and more rest than that.

    The surgery is generally recommended after nonsurgical treatment has failed. Braces and anti-inflammatory medicines can help the situation, along with rest, but surgery is the last step. This also assumes that there is no nerve damage. Nerve damage patients should have surgery more quickly to avoid the situation becoming worse.

    If you feel that you are suffering from carpal tunnel syndrome and you are ready to do something about it, Neuropax Clinic and Dr. Robert Hagan are ready to help. If you suffer from numbness or pain in your wrist or hand, call us at 314-434-7784 to schedule an appointment or visit www.neuropaxclinic.com for more information. Don’t live with wrist pain any longer than you have to.

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    Am I Having a Migraine?

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    Thousands of people suffer from migraines every day. They are debilitating headaches that can cause you to shut down your entire day to deal with them. How do you know if you’re dealing with a migraine or a regular headache?

    A migraine attack can last anywhere from four to 72 hours if you leave it untreated. There’s no set time for the definition. Likewise, there’s no set amount of migraine attacks that you will see per month. Some people can see one a month, some people can suffer from them daily. However frequent, there are signs that it is actually a migraine. Look for:

    Pain on one side or both sides of your head – You can experience intense, throbbing or pulsing pain across your entire head, or it can be localized in certain areas of your head.

    Sensitivity to light, sounds, and sometimes smells and touch – You may want to find a dark, quiet room to ride it out. A cold compress across the eyes can also help give you some relief.

    Nausea and vomiting – Headaches bad enough to generate vomiting and nausea are generally going to be referred to as migraines, although not every vomiting spell comes from a migraine.

    Blurred vision – Your eyesight doubles and you have trouble seeing, often leading to balance issues.

    Lightheadedness, sometimes followed by fainting – when you have this, it’s time to stop moving. Get off the road if you’re driving, sit down if you’re walking, and get someplace safe.

    If you find yourself with these symptoms and repeated headaches, you may be suffering from migraines. Call Dr. Robert Hagan at Neuropax Clinic today to make an appointment to see if peripheral nerve surgery in our office can help. Call us at 314-434-7784 to make an appointment. Don’t live another day with migraines. Let us help.

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