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    Nerve Surgery St Louis

    Our vision at Neuropax Clinic is to be a leader in creating a health care delivery platform that works more effectively for patients suffering from chronic pain, peripheral diabetic neuropathy, carpal tunnel, tarsal tunnel, chronic migraines/headaches, cubital tunnel, radial tunnel and other serious complications related to peripheral nerve damage. We fulfill this vision by offering proven, advanced diagnostic and surgical techniques to help patients stop suffering and reclaim their quality of life.

    Neuropax Clinic is also dedicated to bringing relief to our patients through the education of patients and physicians. We advance science and public awareness about the benefits of our surgical procedures and the results of those procedures.

    Nerve Compression Leads To Other Issues

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    When a nerve is compressed, it can cause all sorts of issues throughout the body.  The nerve will cause pain through different parts of the body, depending on the actual nerve affected.  Finding the nerve causing the issue is the best way for us to fix pain in the body.

    Nerve compression syndrome or compression neuropathy, also known as entrapment neuropathy, is a medical condition caused by direct pressure on a nerve. It is known colloquially as a trapped nerve, though this may also refer to nerve root compression (by a herniated disc, for example). Its symptoms include pain, tingling, numbness and muscle weakness. The symptoms affect just one particular part of the body, depending on which nerve is affected. Nerve conduction studies help to confirm the diagnosis. In some cases, surgery may help to relieve the pressure on the nerve but this does not always relieve all the symptoms. Nerve injury by a single episode of physical trauma is in one sense a compression neuropathy but is not usually included under this heading.

    A nerve may be compressed by prolonged or repeated external force, such as sitting with one's arm over the back of a chair (radial nerve), frequently resting one's elbows on a table (ulnar nerve), or an ill-fitting cast or brace on the leg (peroneal nerve).Part of the patient's body can cause the compression and the term entrapment neuropathy is used particularly in this situation. The offending structure may be a well-defined lesion such as a tumor (for example a lipoma, neurofibroma or metastasis), a ganglion cyst or a haematoma. Alternatively, there may be expansion of the tissues around a nerve in a space where there is little room for this to occur, as is often the case in carpal tunnel syndrome. This may be due to weight gain or peripheral oedema (especially in pregnancy), or to a specific condition such as acromegaly, hypothyroidism or scleroderma and psoriasis.

    Some conditions cause nerves to be particularly susceptible to compression. These include diabetes, in which the blood supply to the nerves is already compromised, rendering the nerve more sensitive to minor degrees of compression. The genetic condition HNPP is a much rarer cause.

    Migraines are also caused by nerve compression.  The headaches are caused by pinched nerves in the neck, which can come from a variety of places, including improper posture, sitting too much, or an accident or injury.  Peripheral nerve surgery can reduce or eliminate migraine pain. 

    If you have migraine issues, please call Neuropax Clinic at 314-434-7784 or visit www.neuropaxclinic.com for more information.

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    Symptoms of Migraines

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    You can develop symptoms of migraines at any time, before or after a headache.  These symptoms can include but are not limited to:

    • Moderate to severe pain, usually confined to one side of the head during an attack, but can occur on either side of the head
    • The pain is usually a severe, throbbing, pulsing pain
    • Increasing pain during physical activity
    • Inability to perform regular activities due to pain
    • Feeling sick and physically being sick
    • Increased sensitivity to light and sound, relieved by lying quietly in a darkened room
    • Some people experience other symptoms such as sweating, temperature changes, tummy ache and diarrhea.

    Migraines with aura

    Some people also experience migraines with an aura, which can cause:

    • Confusing thoughts or experiences
    • The perception of strange lights, sparkling or flashing lights
    • Zigzag lines in the visual field
    • Blind spots or blank patches in the vision
    • Pins and needles in an arm or leg
    • Difficulty speaking
    • Stiffness in the shoulders, neck or limbs
    • Unpleasant smells.

    Migraine sufferers that have unusual headaches that feel different than their usual headaches should seek medical help.

    Experiencing strange symptoms should not be ignored.  These can grow in strength and size, and can lead to other medical issues.

    For many migraine sufferers, the auras act as a warning, telling them that the headache is soon to come.

    Migraine sufferers can also find themselves with real debilitating problems, such as vision loss or headaches that require them to lay in a dark room.  If you have these issues, please call Neuropax Clinic at 314-434-7784 or visit www.neuropaxclinic.com for more information. 

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    Is Your Headache a Migraine

    headache

    Do you suffer from debilitating headaches?

    You probably do if you’re reading this.

    Right now, there are 180 different kinds of headaches defined. Almost everyone gets headaches from time to time. If they are chronic, daily or even continual, you may be suffering from migraines. There are at least 30 million US citizens currently suffering from some kind of chronic migraines. Some of these are responsive to medicine, and some are debilitating and med resistant.

    At least 13% of migraines are believed to be caused by occipital neuralgia. This is a symptom where the Greater occipital nerve is impinged, with tissue causing pressure on the nerve. If 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.

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    St. Louis Migraine Relief Is Here

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    Migraine headaches, real, chronic migraines, can ruin your life. That’s not hyperbole, it’s the truth. When you get migraines regularly, you know that they can cause you to miss work, school, or social events. You can end up curled up in bed for the day, in excruciating pain. Migraine headaches are a scourge on those that suffer from them. But what if there was a way to relieve these nightmares?

    Nerve compression surgery can help. It is estimated that up to 13 % (likely even higher) of all chronic headaches are related to occipital nerve neuralgia. Neuralgia is a general term for pain or irritation along the course of a nerve. We are addressing the irritation caused by nerve compression in this situation. Surgery by Dr. Robert Hagan of the Neuropax Clinic can help relieve the symptoms and causes of severe headaches, allowing the recipient to suffer far reduced migraines, or possibly end the headaches altogether.

    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 have persistent signs and symptoms suggestive of migraine pain, especially if they interfere with your normal activities and sleep patterns, see your doctor. If you leave the condition untreated, they'll only get worse.  For more information or to make an appointment with Neuropax Clinic, call us at 314-434-7784 or visit www.neuropaxclinic.com today to learn more.  Don't live with Migraine Pain any longer than you have to.

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    Open Carpal Tunnel Surgery for Carpal Tunnel Syndrome

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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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    Let’s Talk About Migraine Surgery

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    If you get severe headaches often, you may be suffering from migraines. Migraines are headaches with throbbing pain, usually described as worse on one side of your head or the other. Often debilitating, the migraine can stop you from fulfilling your daily activities and responsibilities. They can also last anywhere from hours to days. Migraine sufferers are as high as 1 in 10 in America, and 1 in 6 women. It’s also often misdiagnosed as a tension or sinus headache, and as such, mistreated.

    The difference between sinus and tension, and migraine headaches is that migraines can be SO severe that they send people to the emergency room. The throbbing, consistent pain can be moderate to severe, and will make everyday tasks very difficult.

    If you suffer from intense migraines often, peripheral nerve surgery may be a way to help you find relief. Many migraines are caused by nerve impingement in the neck. This is similar to the commonly treated carpal tunnel syndrome, where the nerve is pinched, causing pain in the wrist.

    Peripheral nerve surgery for migraines is a similar process.

    The surgery relieves the pressure on the nerve by removing the offending tissue from the area, allowing normal nerve function and relieving the headache symptoms.

    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.

    So call us today at 314-434-7784 to make an appointment to talk to Dr. Robert Hagan at Neuropax Clinic, and learn more about peripheral nerve surgery and migraine relief at www.neuropaxclinic.com now. Don’t live with a migraine if you don’t have to.

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    When to See a Doctor About Migraine Pain

    Migraine Surgery

    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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    What to Look for During a Migraine Attack

    Migraine

    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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    Is My Headache a Migraine?

    Migraine

    How Do you Define a Migraine?

    Migraine headaches are intense or severe and often have accompanying symptoms in addition to head pain. Symptoms associated with a migraine headache include:

    • nausea
    • pain behind one eye or ear
    • pain in the temples
    • seeing spots or flashing lights
    • sensitivity to light and/or sound
    • temporary vision loss
    • vomiting
    Did You Know?
    According to the U.S. Department of Health and Human Services, an estimated 29.5 million Americans experience migraines.

    When compared with tension or other headache types, migraine headache pain can be moderate to severe. Some people may experience headaches so severe they seek care at an emergency room. Migraine headaches will typically affect only one side of the head. However, it is possible to have a migraine headache that affects both sides of the head. Other differences include the pain’s quality: A migraine headache will cause intense pain that may be throbbing and will make performing daily tasks very difficult.

    Migraine headaches are typically divided into two categories: migraine with aura and migraine without aura. An “aura” refers to sensations a person experiences before he or she gets a migraine. The sensations typically occur anywhere from 10 to 30 minutes before attack. These can include:

    • feeling less mentally alert or having trouble thinking
    • seeing flashing lights or unusual lines
    • tingling or numbness in the face or hands
    • unusual sense of smell, taste, or touch

    Some migraine sufferers may experience symptoms a day or two before the actual migraine occurs. Known as the “prodrome” phase, these subtler signs can include:

    • constipation
    • depression
    • frequent yawning
    • irritability
    • neck stiffness
    • unusual food cravings

    If these describe your symptoms, please contact Dr. Robert Hagan at Neuropax Clinic.  Call 314-434-7784 or contact us at http://neuropaxclinic.com/contact-usss.html today.  Don't live with migraine pain any longer.

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    What Is This Weakness In My Hand?

    If you're struggling from weakness or tingling in your hand or forearm, you could be suffering from Carpal Tunnel Syndrome.  The best way to find out if you have this malady is to contact a physician if the symptoms persist.

    Carpal tunnel syndrome usually starts gradually with numbness or tingling in your thumb, index and middle fingers that comes and goes. This may be associated with discomfort in your wrist and hand. Common carpal tunnel syndrome symptoms include:

    • Tingling or numbness. You may experience tingling and numbness in your fingers or hand, especially your thumb and index, middle or ring fingers, but not your little finger. This sensation often occurs while holding a steering wheel, phone or newspaper or, commonly, waking you from sleeping. The sensation may extend from your wrist up your arm.

      Many people "shake out" their hands to try to relieve their symptoms. As the disorder progresses, the numb feeling may become constant.

    • Weakness. You may experience weakness in your hand and a tendency to drop objects. This may be due to the numbness in your hand or weakness of the thumb's pinching muscles, which are controlled by the median nerve.

    When to see a doctor

    If you have persistent signs and symptoms suggestive of carpal tunnel syndrome, especially if they interfere with your normal activities and sleep patterns, see your doctor. If you leave the condition untreated, permanent nerve and muscle damage can occur.

    Call Neuropax Clinic today to make an appointment with Dr. Robert Hagan to address your newrve issues.  Neuropax Clinic is dedicated to your health.  Call us today at 314-434-7784 or contact us at http://neuropaxclinic.com/contact-usss.html now.

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    How To Identify Your Repetitive Strain Injuries

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    In simple medical terms, repetitive strain injury (RSI) is defined as a cumulative trauma disorder (CTD) stemming from prolonged repetitive, forceful, or awkward hand movements. The result is damage to muscles, tendons, and nerves of the neck, shoulder, forearm, and hand, which can cause pain, weakness, numbness, or impairment of motor control.

    You may wonder how seemingly innocuous activities such as typing and clicking a mouse button could possibly be harmful. Fine hand movements, repeated hour after hour, day after day, thousands upon thousands of times, eventually strain the muscles and tendons of the forearms, wrists, and fingers, causing microscopic tears. Injured muscles tend to contract, decreasing the range of motion necessary for stress free work. The sheaths that cover delicate tendons run out of lubrication because they aren't given time to rest, so tendon and sheath chafe, resulting in pain. Due to this abrasion, tendons become inflamed, and begin to pinch neighboring nerves. This can result in numbness, tingling, or hypersensitivity to touch. Unless this cycle is interrupted, it repeats itself over and over, and a long-term, chronic problem results.

    Repetitive strain injury can affect more than just your hands and wrists. Poor posture can lead to severe neck and back injuries. Staring at a computer screen can lead to eye strain. Repetitive reaching for a mouse can lead to arm and neck strain as well as spinal asymmetry.

    RSI is not a specific medical diagnosis, but rather a family of disorders. Many people mistakenly equate RSI with carpal tunnel syndrome, even though CTS is only one particular form of RSI. One recent study even reported that frequent computer users are no more likely to develop CTS than non-computer users. Don't let this mislead you, though. Many other forms of RSI do come on as a result of frequent computer use.

    If you feel like this applies to you, call Dr. Robert Hagan at Neuropax Clinic at 314-434-7784 or visit www.neuropaxclinic.com for more information.  Don't live in pain any longer than you have to.

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    Where Can St. Louis Migraine Sufferers Get Relief?

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    We are asked quite a bit whether we will see patients from St. Louis for migraine surgery, or if we’ll see out-of-town patients as well. Of course we do!  Anyone may be able to achieve significant and lasting relief no matter where they call home! We have helped patients from all across the United States, and as have partners in Europe as well. We are excited to help people from all over the globe as peripheral nerve surgery is an area to which I have dedicated a large portion of my practice and is something about which I remain very passionate. We wish to extend an invitation to everyone anywhere to look us up and decide for themselves whether we might be able to help to reduce or eliminate their chronic headaches with peripheral nerve surgery.

    Many patients have been living with their headaches for decades and had resigned themselves to a life of chronic pain despite medication. Happily, we proved that was not the case. Furthermore, because we see so many foreign and out of town patients, we have developed a system to help make your overall experience as seamless as possible. We can assist with travel planning, lodging, transportation to and from the operating room and even post-operative nursing care if required. In addition, Dr. Hagan is available for initial record review and evaluations via Skype or Google+ to help determine if a trip from home is a worthwhile endeavor. Finally, because post-operative follow-up is an extremely important part of the surgical experience and critical to achieving optimal outcomes, we use these same modalities to keep tabs on our patients after they have gone home and remain available to discuss issues with your local treating physicians if needed. This important time can be hard for patients as well as doctors that can't see their patients directly, but our practice has refined this process to ask the right questions and determine if any further action is needed.

    So if you suffer from chronic headaches, please visit us at www.neuropaxclinic.com or call us at 314-434-7784 to find out if we can reduce or eliminate your migraines. We look forward to hearing from you!

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    Headache Surgery In St Louis For Migraines

    Do you suffer from headaches?

    You probably do if you’re reading this.

    Right now, there are 180 different kinds of headaches defined. Almost everyone gets headaches from time to time. If they are chronic, daily or even continual, you may be suffering from migraines. There are at least 30 million US citizens currently suffering from some kind of chronic migraines. Some of these are responsive to medicine, and some are debilitating and med resistant.

    At least 13% of migraines are believed to be caused by occipital neuralgia. This is a symptom where the Greater occipital nerve is impinged, with tissue causing pressure on the nerve. If 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.

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    Repetitive Stress Leads to Carpal Tunnel

    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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    How Did I Get Thoracic Outlet Syndrome?

    Last week we talked about some symptoms of Thoracic Outlet Syndrome, so this month we wanted to discuss a few causes.  These activities and conditions can all lead to Thoracic outlet syndrome, which occurs when the thoracic outlet becomes narrowed and compresses the nerves and blood vessels.

    An Extra Rib

    Some people are born with an extra rib above their first rib. This reduces the size of their thoracic outlet and compresses nerves and blood vessels.

    Poor Posture and Obesity

    People who don’t stand up straight or who have excess abdominal fat may have increased pressure on their joints. This can cause a narrowing of the thoracic outlet.

    Injury

    Car accidents and other traumatic injuries can compress the thoracic outlet as well as the vessels and nerves in this area.

    Overuse of the Shoulders and Arms

    Repetitive activities, such as working at a computer or lifting heavy objects above the head, can cause damage to the tissues in the thoracic outlet. Over time, the size of the thoracic outlet may shrink, placing pressure on the vessels and nerves.

    If you experience

    • pain in parts of the neck, shoulder, arm, or hand
    • numbness in the forearm and fingers
    • weakness of the hand

    please call us at 314-443-7784 to make an appointment or visit www.neuropaxclinic.com for more information.  Don't keep living in pain.

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    I Have Numbness and Tingling in My Hands, Is It Thoracic Outlet Syndrome

    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.

    If you experience any of these symptoms, please contact Neuropax Clinic today.  We are available at 314-434-7784 and more information can be found at www.neuropaxclinic.com.  Don't live your life in pain.

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    What Is This Pain In My Thigh?

    Meralgia Paresthetica is a constellation of symptoms caused by a compression neuropathy (pinched nerve) of the Lateral Femoral Nerve (LFN). The LFN arises from the second and third lumbar spinal levels (L2,L3). As the LFN travels from the spine to the thigh region, the nerve can be pinched at the anterior pelvic tunnel. This tunnel is made by the bone of anterior superior iliac spine, the dense fibers of the inguinal ligament and overlaying musculature. Pressure on this nerve causes feelings of burning, pain and numbness along the front and lateral part of the thigh, extending all the way from anterior and lateral hip, groin and gluteal area to the knee. In some, there can even be very deep groin and testicular or labial pain.

    It is not uncommon for the severity of symptoms to be significantly debilitating, especially if the problem is not addressed. It is important to understand that this a very treatable problem. Its like having carpal tunnel of your hip. Early or old teachings that suggest there is nothing to do, still permeate the medical community regarding this problem.

    This compression neuropathy (pinched nerve condition) can be caused by several different mechanisms. Anatomical studies have shown that at least 5% of the population has an abnormal nerve tunnel. This anatomic variant is highly vulnerable for compression but any nerve can become compressed or damaged. History of pelvic fracture, Blunt trauma in or near the nerve and tunnel, can cause direct trauma to the nerve or trauma to the surrounding tissues that leads to compression of the nerve as well.

    Even just having surgery in the area of the hip, groin or abdomen can lead to changes in the tissue surrounding the nerve and lead to compression. Prior hip surgery, hernia surgery, bone graft harvest, cesarean sections are some of the most common.

    Some professional activities (i.e. police officers, firefighters and construction workers, etc.) require wearing heavy and loaded belts around the waist. This exposes the nerve to excess and repetitive pressure, especially if anatomical nerve path abnormalities already exist. Various sports like karate/kickboxing, football, soccer, rugby and others can all produce injuries that result in this problem. Body habitus such as abdominal obesity or pregnancies can also contribute to repetitive stress and stretching of the nerve.

    It is also important to recognize the affects of diabetes on this clinical problem. Diabetic patients, due to abnormal glucose metabolism, may develop swelling of the nerve, as well as narrowing of the tunnel itself. This alters the normally perfect relationship between the nerve and its tunnel, making it now too narrow for the more swollen nerve, resulting in lateral femoral cutaneous nerve neuropathy. Therefore, diabetic patients are at much higher risk for experiencing symptoms of Meralgia Paresthetica than the general population.

    Once you have been identified to have symptoms consistent with Meralgia Paresthetica or compression of the Lateral Femoral Nerve (LFN) several diagnostic points should be addressed. In some cases, lower spine or lumbar spine pathology should be ruled out with an MRI. This study can also include a study of the pelvis to rule out any mass or tumor causing compression to the nerve along its course. Ultrasound guided, site specific, diagnostic injections are routinely utilized for confirming the diagnosis. In some cases, the addition of steroid to this injection can provide symptomatic relief for some variable length of time. If there is no spinal or pelvic pathology and the severity of symptoms are not too severe, conservative care is a very appropriate initial treatment. This may include: nerve modulator medicines (i.e. neurontin, amitriptyline, etc. ), topical compound cream, lifestyle changes, weight loss and physical therapy. If conservative therapies have been tried and fail after 3 months, surgical decompression should be considered. Accessory treatment modalities such as radio frequency ablation(RFA), sclerosing or spinal cord stimulators do not treat the problem and should not be utilized for this clinical problem.

    Surgical decompression of the nerve is successful in 80-85% of cases. In the residual population that fail decompression, 80% of these patients will respond to going back and resecting (neurectomy) the nerve.

    The success of the surgery depends on how long the nerve has been compressed, the severity of the compression, the extent of nerve damage due to injury and the possible presence of underlying medical or spine problems.

    The surgery performed in an outpatient setting. The surgical incision is generally very small, however body habitus can dictate a larger incision. The post-operative course is consistent but is affected by the amount of decompression required. In general, people can return to light duty work after 2 to 3 weeks and unlimited/unrestricted activity at 6 weeks.  For more information on Meralgia Paresthetica and ways it can be treated, visit www.neuropaxclinic.com and call 314-434-7784 for more information.

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    I Have Wrist Pain Is It Carpal Tunnel Syndrome?

    Carpal tunnel syndrome is numbness, tingling,weakness, and other problems in your hand because of pressure on the median nerve in your wrist.

    The median nerve and several tendons run from your forearm to your hand through a small space in your wrist called the carpal tunnel . The median nerve controls movement and feeling  in your thumb and first three fingers (not your little finger).

    Pressure on the median nerve causes carpal tunnel syndrome. This pressure can come from swelling or anything that makes the carpal tunnel smaller. Many things can cause this swelling, including:

    • Illnesses such as hypothyroidismrheumatoid arthritis, and diabetes.
    • Making the same hand movements over and over, especially if the wrist is bent down (your hands lower than your wrists), or making the same wrist movements over and over.
    • Pregnancy.

    Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain in the fingers or hand. Some people may have pain in their arm between their hand and their elbow.

    Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring finger. If you have problems with your other fingers but your little finger is fine, this may be a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little finger.

    You may first notice symptoms at night. You may be able to get relief by shaking your hand.

    Neuropax Clinic and Dr. Robert Hagan will help you.  Call us today at 314-434-7784 or visit www.neuropaxclinic.com for more information.

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    What is Foot Drop, and What is the Treatment in St Louis

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    What is peroneal nerve injury (foot drop)?

    A peroneal nerve injury (also called foot drop or drop foot), is a peripheral nerve injury that affects a patient’s ability to lift the foot at the ankle. While foot drop injury is a neuromuscular disorder, it can also be a symptom of a more serious injury, such as a nerve compression or herniated disc.

    Causes of peroneal nerve injury (foot drop)

    Foot drop injury can be caused by an injury to the spinal cord or from other underlying diseases, such as amyotrophic lateral sclerosis (ALS)multiple sclerosis (MS), or Parkinson's disease. Sometimes, drop foot is a complication from hip replacement surgery, or other injuries (e.g., knee or joint dislocation or fracture, herniated disc).

    Symptoms of peroneal nerve injury (foot drop)

    Symptoms of peroneal nerve injury (foot drop) may include:

    • Inability to point toes toward the body (dorsi flexion)
    • Pain
    • Weakness
    • Numbness (on the shin or top of the foot)
    • Loss of function of foot
    • High-stepping walk (called steppage gait or footdrop gait)

    Diagnosis of peroneal nerve injury (foot drop)

    Proper diagnosis of drop foot requires the expert attention of experienced neurologists and nerve specialists.

    Diagnosis will include:

    • A comprehensive clinical exam, including neurological exams
    • Complete medical history
    • Electrical testing
    • Imaging studies, such as X-rays or high-resolution 3-T MRI (magnetic resonance imaging)
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    Reduce Migraine Pain In St Louis

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    MIgraine headaches in St. Louis have become a real problem.  Thousands of people in the city suffer from this debilitating issue.  It costs people in many ways.  You can't work.  You don't want to spend time with your family and friends.  It can be a nightmare for people that have to deal with it daily.  It's not all a loss, though.  There is a solution that can work for people who have migraines that won't go away.

    Peripheral nerve surgery has been proven to reduce, and in some cases remove migraine pain from chronic migraine suffering.  This surgery reduces the stress on your nerves that cause migraines by relieving the stress on the nerve.  Tissue around the nerve is removed, giving the nerve a clear path and stopping the irritation. 

    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.

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