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RUNNER’S “HIGH” – THE RELATIONSHIP BETWEEN EXERCISE & PAIN

Posted August 07, 2024 in Curriculum

Anyone who knows me, knows that exercise has always been an important part of my life.  From my days as a competitive swimmer to my time doing Ironman, sport has always been a source of happiness, pride, and peace.  I always knew that there were physiologic benefits to exercise, for example cardiovascular fitness and muscle […]

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Sensation Preserving Mastectomy Surgery

Posted August 05, 2024 in Curriculum

This picture is the first of it’s kind to my knowledge. It is from a recent sensation preserving mastectomy case. The mastectomy has been completed and the sizer is in place to gauge how big an implant to place a few moments later. What you can see is an intercostal nerve that I was able to preserve 8.3 cm of length […]

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COVID-19 AND OCCIPITAL NEURALGIA

Posted August 04, 2024 in Curriculum

I always knew it was just a matter of time and it finally happened.  I was speaking with a patient of mine who was a bit more than one year out from her occipital neuralgia operation.  She was doing extremely well with “over 90% relief” at the one-year mark, when she was diagnosed with COVID-19.  […]

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TRIGGER POINT INJECTIONS vs NERVE BLOCKS – WHAT’S THE DIFFERENCE?

Posted August 03, 2024 in Curriculum

Simple question, somewhat nuanced answer. Basically, nerve blocks are injections of local anesthetic aimed at temporarily and chemically inactivating a nerve – pure and simple.  Where things get a bit more complicated is the amount and type of local anesthetic used and if it is mixed with anything else.  Each type of local anesthetic has […]

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THE STAGED APPROACH TO CHRONIC HEADACHE/MIGRAINE RELIEF

Posted August 02, 2024 in Curriculum

I was recently asked why some people require more than one operation to obtain optimal relief.  A great question and one with a multi-part answer.   Let me try to break it down in the next few paragraphs. Let me preface these remarks by stating that what I write below is my opinion only and how I approach patients, […]

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MEDICATION OVERUSE HEADACHE (MOH) OR ‘REBOUND HEADACHES’

Posted August 01, 2024 in Curriculum

I have been asked recently to write a little something about so-called “rebound headaches”. This topic can be quite confusing, and as you will read, is not very well understood. The precise medical term for this disorder is Medication Overuse Headache (MOH) or analgesic rebound headache. The prevalence of this problem is about 1% in […]

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THE NERVE WAS CUT, BUT I STILL FEEL THAT AREA – HOW IS THAT POSSIBLE?

Posted July 31, 2024 in Curriculum

Over the years, I seem to have had this question come up on a fairly consistent basis and the answer is actually relatively straightforward.  Let’s take as an example, an arbitrary portion of the scalp which is innervated by 3 different nerves.  What that means is that three different nerves each supply sensation to the […]

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TO DECOMPRESS OR TRANSECT: THAT IS THE QUESTION

Posted July 30, 2024 in Curriculum

This query is one of the great ones – a $64,000 question that continues to be raised both in my office as well as online.   What is the difference between neurectomy/muscle implantation (i.e., transection of the nerve and implanting it in the local muscle) and decompression?  Along with this primary query come many misconceptions […]

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Dr. Peled is active in several online nerve pain communities, particularly those focused on specific conditions, such as occipital neuralgia. He shares general advice, answers questions, and provides support for those seeking clarity about their condition.

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