As with many things in life, there are positive and negative ways to perceive just about anything.  Just because the MRI was negative, clearly does not mean that there is nothing wrong.  Let me explain why below.  First, however, let’s look at the bright side. You do not have a brain tumor.  You do not have an aneurysm.  It does not appear as if you’ve had a stroke.  And you

Perhaps one of the most common questions I get asked is, “What is recovery like?”  How much time do you have?  There are so many facets to this question that it is often something worth spending a bit of time on with your surgeon before any operative procedure. While I wish there were a single, short answer, the reality is somewhat the opposite. In order to make sense of these often intricate

I hear this question a lot from just about every patient I see, whether for chronic headaches or tarsal tunnel syndrome.  The answers have to do with the technical aspects of the surgical procedure, the physiology of peripheral nerves as well as the wound healing process itself.    As you can imagine, a compressed nerve is usually compressed on all sides because it is a three-dimensional structure.  Therefore, when decompressing

One of the first things to assess is whether your surgeon has formal and specific training in peripheral nerve surgery. Since the operations for chronic headaches/neuralgia potentially involve many nerves within the peripheral nervous system, the person performing such operations should have had focused training on the workup, evaluation, and management of patients with any number of peripheral nerve problems (chronic headaches included). Because peripheral nerve surgery is performed on

People often confuse migraine symptoms with something called neuralgia. The former refers to an often disabling neurological condition characterized by severe and sometimes frequent headaches. The latter literally means “nerve pain” with the implication that the condition in question is secondary to some type of nerve injury or dysfunction.  While migraines can be sub-classified in any number of ways, at their core, migraines are caused by chemical dysregulation.  This dysregulation

Just this past week, several patients have asked about the tight muscles in their necks and upper backs. They have all wondered at some point whether it’s the tight muscles that are irritating the nerves, or the nerves that are irritating the muscles and causing them to spasm. In most cases, this question ends up being like the one about the chicken or the egg – in other words, difficult

As I have written previously, neur-algia simply means ‘nerve pain’.  The question always becomes, can you figure out which ‘neur’ (i.e., nerve) is causing the ‘algia’ (i.e., pain).  Secondly, if you can figure that answer out, what can you do about it?  That being said, temporal neuralgia refers to nerve pain occurring in the temple regions of the head/face.  As with the frontal region, there are two primary nerve targets

There are a number of ways to characterize and define the nervous system. First of all, the primary cells that comprise the nervous system are called neurons.  Groups of neurons all heading in a certain direction and bundled together are called nerves.  Nerves can be classified along several parameters. To begin, nerves can be either purely motor, purely sensory or mixed.  Motor nerves are those responsible for moving a muscle. 

As before, neur-algia simply means ‘nerve pain’.  The question always becomes, can you figure out which ‘neur’ (i.e., nerve) is causing the ‘algia’ (i.e., pain).  Secondly, if you can figure that answer out, what can you do about it?  Therefore, frontal neuralgia refers to nerve pain occurring in the front of the face, specifically the region above the eyeballs and forehead, often extending into the hairline.  There are two primary

Surgical intervention (whether decompression or neurectomy/muscle implantation) for chronic headaches is performed as an outpatient procedure at an accredited surgery center or in the outpatient department of the California Pacific Medical Center. The procedures can last anywhere from 1 hour to 3 hours, depending on the number and locations of the nerves being treated and what actually needs to be done with each individual nerve.  This plan will be thoroughly

Migraine headaches have traditionally been thought to arise from within the central nervous system (i.e. the brain and/or spinal cord) and then produce symptoms elsewhere such as throbbing in the back of the head, forehead or temples. There are many theories as to what exactly within the central nervous system causes these chronic and often debilitating headaches. Some of these theories include pathologic blood vessel dilatation and constriction (loosening and tightening),