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What Is Peripheral Nerve Surgery?

Posted May 13, 2026 in Nerve Surgery

Table of Contents Understanding the Nervous System There are several ways to understand and classify the nervous system, but it helps to start with the basics. The nervous system is composed of specialized cells called neurons. When many of these neurons travel together in organized bundles, they form nerves—the pathways that carry signals back and […]

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The Staged Approach To Chronic Headache/Migraine Relief

Posted May 07, 2026 in Headache Surgery, Occipital Neuralgia, Uncategorized

Table of Contents Why Are Some Occipital Neuralgia Treatments Performed in Stages? Patients often ask why more than one procedure may be recommended to achieve the best possible outcome. It’s a thoughtful question, and the answer is nuanced.  Before I explain, it’s important to note that what follows reflects my personal approach and clinical experience. […]

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What About Radiofrequency Ablation? (Part 1)

Posted March 11, 2026 in Occipital Neuralgia

I’m often asked: “What do you think about radiofrequency ablation (RFA) for occipital neuralgia?” It’s a very reasonable question. Many patients have heard that RFA can be effective for certain types of nerve pain, so it seems logical to assume that it should work for occipital neuralgia as well. However, once the anatomy and underlying […]

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I Have A Morton’s What?!?

Posted March 04, 2026 in Nerve Pain

Have you ever heard the term ‘Morton’s Neuroma’?  This medical condition was first described in 1876 by surgeon TG Morton in Philadelphia.  It typically refers to a tender spot at the balls of the foot or between the toes that can cause pain and sometimes numbness in the space between the involved digits.  Once diagnosed, […]

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Can Stress Make Occipital Neuralgia Worse?

Posted February 26, 2026 in Occipital Neuralgia

This is one of the most common questions raised in my office. In my view, stress is an underrecognized but meaningful contributor to many aspects of health, including peripheral nerve function. Here, I will specifically discuss the mechanical forces that stress can generate – forces that are directly relevant to the pathology we address surgically […]

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The Nerve Was Cut, But I Still Feel That Area – How Is That Possible?

Posted February 26, 2026 in Nerve Pain

Over the years, this question has arisen with some regularity, and the explanation is relatively straightforward although it requires some nuance. Consider an arbitrary area of skin or scalp that is innervated by three separate sensory nerves. In practical terms, this means that all three nerves contribute to sensation in the same region of skin. […]

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The MRI Was Negative…..Now What?!?

Posted February 12, 2026 in Nerve Pain

Like many things in medicine—and in life—a result can be viewed from more than one perspective. A “negative” or “normal” MRI does not mean that nothing is wrong. It simply means that certain serious conditions were not found. And that’s an important place to start. On the positive side, your scan might show: No brain […]

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What Causes Compressed Nerves To Malfunction?

Posted February 12, 2026 in Occipital Neuralgia

What Happens to a Nerve Under Long-Term Compression? As I’ve written previously, the occipital nerves can be compressed by a variety of surrounding structures—muscle, fascia, scar tissue, or even nearby blood vessels such as the occipital artery. Patients often understand that compression can cause pain. A more interesting question is: What actually happens to the […]

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Which Came First The Muscle Or The Nerve?

Posted February 12, 2026 in Nerve Pain, Occipital Neuralgia

Over the past week alone, several patients have asked essentially the same question, “Are my tight neck muscles irritating the nerves, or are irritated nerves causing my muscles to tighten?” It’s a fair question, and frustratingly, the answer is often: both. In many cases, it’s less a straight line of cause and effect and more […]

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