Tag Archives forneuropathy

Dellon Nerve Decompression (Surgical Management)


In the past, neuropathy was approached as a painful disease state for which symptoms could only be masked, but could rarely be cured. Some doctors subscribe to the theory that the nerve dies from the effects of neuropathy, and that the only treatment is to mask the pain and live with the disease.

We now know that the nerve is not dead, but has poor conducting abilities, similar to that of a short in electrical wiring. This is caused by the compression around and within the nerves. This compression is much like that seen in carpal tunnel syndrome where the hand experiences numbness, tingling and burning due to compression of the wrist nerve. In fact, if the compression continues long enough within the carpal tunnel, loss of muscular strength will also occur.

Dellon Decompression is an exciting new treatment option for patients that suffer from peripheral neuropathy, drop foot and neuritis. This procedure was developed by Dr. A. Lee Dellon, a Plastic Surgeon from John Hopkins University School of Medicine. This has truly been a revolutionary procedure that has helped thousands of patients. The surgical procedure for lower extremity neuropathy is similar to that done for carpal tunnel, and relieves pressure in the legs, ankles and feet. Studies have found that by performing a surgical nerve decompression, 80% of all patients have good to excellent relief from their neuropathic pain or numbness.

Small Fiber Peripheral Neuropathy


Peripheral nerves in a general sense, can be subdivided into large and small nerve fibers. Typically, small nerve fibers are affected before large nerve fibers. Small fiber neuropathy, aka: small fiber sensory neuropathy (SFSN), or C fiber neuropathy is a newer focus of neuropathy that is able to offer an earlier detection of neuropathy. Small nerve fibers are the nerve fibers near the skin's surface, which is why the symptoms deal with sensation. Usually the symptoms start in the feet and lower legs. The symptoms may include insensitivity to heat and/or cold, tingling, numbness, muscle weakness, cramps, pain, and other symptoms. Some people describe the pain as an electric shock, or walking on broken pieces of glass, or bags of ice on their feet. Sometimes people experience a loss in the ability to feel and do not even know it.

The disorder can be caused by diabetes, alcoholism, or other conditions, but many times it is idiopathic. Identifying that you have small fiber neuropathy is the first step. Other tests to identify potential causes is the next step, as therapy often consists of treating the underlying cause, as well as relieving the symptoms.

Peripheral Neuropathy


Burning, tingling, numbness, pain or shooting to your feet?! Does this sound familiar? Are you experiencing some or all of the symptoms? You may be experiencing classic signs of peripheral neuropathy. You may also be experiencing a cramping in the feet, curling of the toes, or weakness and loss of control to your legs and feet. Many people experience the same complaints in their hands.

Peripheral neuropathy is actual nerve damage that results from a systemic disease. The most common form of neuropathy is from diabetes. There are many other causes of neuropathy like chemotherapy, thyroid disorders, arthritis (rheumatoid, lupus), vitamin deficiencies, heavy metal toxicity, drug-induced, leprosy, and alcoholism. Many people today are overweight, have high cholesterol, and high blood pressure. They are "Pre-diabetic" (Metabolic Syndrome / aka Syndrome X). Their neuropathy is often an earlier phase of diabetic peripheral neuropathy. Many times the cause of neuropathy is unknown, that is called idiopathic neuropathy.

Anyone who is a diabetic or knows a diabetic understands the havoc it can wreak on the body. The nerves are included in this path of destruction and this includes the nerves to your lower extremity and your feet. The damage to the nerves in your feet makes you unable to really feel your feet and can lead to open wounds (ulcerations). Ulcerations can lead to amputations. How does this happen?

Neuropathy can affect the motor nerves which control the muscles in your body. Damage to these types of nerves produces weakness in the muscles. This weakness can affect your balance. Loss of motor nerve function also causes loss of the tone of the muscle (atrophy of the muscle).This causes your foot to lose its original shape and produces areas of increased pressure. This increased pressure can cause breakdown of the foot which can lead to skin ulcerations.

Neuropathy can also affect the autonomic nerves which affect your skin's ability to maintain moisture. This loss of moisture makes your skin dry. Dry skin can lead to cracking, and this cracking in your skin can lead to ulcerations.

The most devastating effect neuropathy has is on the sensory nerves. This numbness, burning and/or tingling is the loss of sensation you may be experiencing. This can affect part of your foot, your whole foot, or even your entire lower extremity. This loss of sensation means a loss of your body's ability to perceive increased pressure areas or changes in temperature. This loss of natural protection puts you at risk for ulcerations.

When you hear of a diabetic losing part of his or her foot, or one or both legs, you can now understand why this at any time could become your battle. The damage produced by neuropathy does not occur rapidly. On the contrary, it usually occurs so slowly and subtly that it is not enough for you to notice. The longer you have neuropathy, the longer you are undiagnosed, or the longer you have uncontrolled diabetes, the more danger you place on your limbs and your life.

Why is controlling this important? The amputation of part of the foot dramatically increases the likelihood of further amputation of your foot or your limb within the next few years. The loss of one limb puts increased pressure on the other limb and this increased pressure inevitably results in breakdown of this foot and loss of this limb. The lifetime expectancy for a single amputee is five years. The lifetime expectancy for a double amputee is less than five years.

Are you experiencing numbness, burning, and/or tingling in your feet? Whether you have a history of diabetes in your family or not, we urge you to come in to have this evaluated. There are many times where these symptoms have resulted in a diagnosis of diabetes. At the very least, this discovery alone could save your limbs. At the very most, this discovery could save your life.

Got Neuropathy?

Introduction & Acknowledgement

neuropathy treatment tucson

Welcome to the world of peripheral nerves and neuropathy. While the author has had significant training in his profession, current HENS president Dr. Richard Jacoby of the Scottsdale Neuropathy Institute and Dr. A. Lee Dellon exposed him to a novel approach to help preserve and improve nerve function in 2007. This remains a relatively new frontier and perhaps a well kept secret to many, even those in the medical profession.

There are two types of nerves: cents. nerves, primarily the brain and spinal cord, and peripheral nerves, nerves that extend to your arms and legs. When central nerves are damaged, they do NOT regenerate. When Christopher Reeves fell off his horse, he was left paralyzed with little chance of recovery because he injured central nerves within his neck. This publication will focus on peripheral nerves. The most exciting aspect of peripheral nerves is that following injury, they have the ability to regenerate) Carpal tunnel is an example of a peripheral nerve disorder, which can be improved with surgery.

Who is Dr. Dellon and Why Listen?

Dr. A. Lee Dellon, TAD, PhD is arguably the world's foremost authority in Peripheral Nerve Surgery. He has dedicated a life's work to understanding and treating nerve pa.. Follow.; graduation from John Hopkins School of Medicine in 1970, he completed 8 years of additional training including 2 years of research with the National Institutes of Health. Currently a Professor of Plastic Surgery a Neurosurgery at the John Hopkins University School of Medicine a the University of Arizona, Doctor Dellon has won fifteen national research awards, authored 72 book chapters, and published more than 375 articles in peer-reviewed journals.

He recently received a PhD for his basic science and clinical research into the surgical treatment of compressed nerves in the patient with diabetic neuropathy. He received his PhD from the University of Utrecht in the Netherlands on March 6, 2007.

Dr. Shih, Director of Neuropathy Services at Head to Toe Healthcare, is committed to improving & restoring sensation to neuropathic feet. He has completed the Lower Extremity Peripheral Nerve Surgery advanced train.g in Baltimore, accredited by the American Society of Plastic Surgeons and directed by Dr. A. Lee Dellon. There are roughly 220 surgeons, primarily consisiting of plastic, orthopedic, general, and podiatric surgeons worldwide who have received this training. Dr. Slob is a Fellow of the Association of Extremity Nerve Surgeons (AENS)

Why I Wrote This Book

Peripheral neuropathy afflicts millions of Americans. It is important to note that there are several types and causes. The most common form of peripheral neuropathy is diabetic peBpheral neuropathy. More than 60% of non-traumatic lower limb amputations are due to diabetic neuropathy. One in six diabetics will have ulcers of the lower extremity. One in six diabetics who have ulcerations will have amputations. Over 200,000 lower extremity amputations were performed in the United States and Europe last year. This is simply too much!

There is now hope for patients suffering from diabetic neuropathy, as well as other neuropathy causes. A relatively new surgical technique is allowing neuropathic patients to retain their limbs, live pain-free and have a better quality of life. For patients who had tittle chance for symptomatic improvement, we may now have the real opportunity to prevent ulcers and amputations in many diabetics.

Other causes of peripheral neuropathy are related to alcoholism, various chemotherapeutic agents, certain drugs, m well as a large group of idiopathic neuropathy (unknown muse). There are several scientific studies available that suggest an underlying theme with many of these varying types of peripheral neuropathy. Many of these peripheral neuropathies may be aggravated by a compression or squeezing of the nerve in tight tunnels the nerves must pass through.

What a Patient Has to Say about Peripheral Nerve Decompression?

Dr. Shih,

Thank you for the follow up about my surgery. I am doing great after the surgery. I am no longer in pain and I have full strength back to my right foot. This is remarkable since it had been about 8 years that I started experiencing foot pain. After seeing 4 different foot doctors over the years and getting several orthotics. I still had pain. The shoe Inserts helped but did not fix the problem. After the surgery I can wear any shoe type and do any activity I want. I am 48 years old and I hike long and hard now. Thank You!

I am glad you had the technical expertise to find the real prob-lem with the foot pain and not just tell me to wear another shoe insert. As an Engineer I respect that level of competence in flooding the root cause of the problem and not just working on the symptom.

I would like to thank your office staff They were at as times very friendly and helpful.

Thanks again,