who are peripheral nerve surgeons and what do they do?

Nerve pain is unrelenting and all too often, unbearable. When the time comes to take care of the problem at its source, who do you call?

just who is a nerve surgeon?

Simply put, nerve surgeons specialize in the surgical repair of peripheral nerves, but since nerves run throughout every inch of our bodies, there is not one specific type of surgeon or title that aligns precisely with the specialty of nerve surgery. Instead, there are several types of doctors who specialize in nerve repair. These doctors undergo extensive microsurgical training to become experts in their field.

While injured or damaged nerves can certainly cause a large amount of pain, they are very tiny structures and repairing them can require the use of magnification and specialized knowledge of nerve repair techniques.

The most common physicians who perform nerve surgery are:

  • plastic reconstructive surgeons
  • orthopedic hand surgeons

Additionally, there a select number of other specialists have undergone training for microsurgical nerve repair, such as:

  • neurosurgeons
  • oral maxillofacial surgeons
  • doctors of podiatric medicine (DPMs)

Let’s dive in and learn a little bit more about these specialists, and how each—while not necessarily called a “nerve surgeon”—is qualified to treat nerve damage that may be the cause of chronic pain.

plastic reconstructive surgeons

You may be thinking, “Why would I go to a plastic surgeon for help with nerve pain?”

It’s a common misconception that plastic surgeons only perform cosmetic surgery. In fact, plastic surgery is generally broken down into two areas of concentration: cosmetic and reconstructive.

Cosmetic or aesthetic plastic surgeons often focus on breast augmentation, facelifts, rhinoplasty, etc.

Reconstructive plastic surgeons typically focus on more complex cases that may involve, for example, helping to save a patient’s limb after a traumatic injury or helping to rebuild an area of the face that has been badly damaged.

The word “reconstructive” means “to rebuild after something has been damaged or destroyed,” and these surgeons are trained to reconnect ligaments, muscle tissue and blood vessels to repair damage to a patient’s body. In addition, they often reconstruct and repair nerves.

With extensive microsurgical training, nerve repair is something that reconstructive plastic surgeons perform regularly, especially with patients facing chronic pain caused by a nerve injury.

orthopedic hand surgeons

You may think of an orthopedic surgeon as someone who you see when you break your arm or injure your knee, or when you need a hip replacement. That’s a fair assumption. Orthopedic surgeons specialize in treating your musculoskeletal system—your bones, joints, tendons, muscles and ligaments. They are experts at understanding where and how your body fits together.

And they can also specialize in nerve repair.

As doctors who specialize in muscles and nerves, many orthopedic hand surgeons have made nerve repair a primary focus. But don’t let the term “hand surgeon” fool you. The most common location for a nerve injury is the hand, and these surgeons have received extensive training on the intricacies of nerve repair, not just in the hand, but throughout the rest of the body.

neurosurgeons

While the term “neuro” and “nerve” may seem to go hand in hand, many neurosurgeons are mostly focused on the central nervous system (the brain and spinal cord), rather than the peripheral nervous system (the nerves running all through the body). The function of each is quite different and they serve different purposes.

There are some neurosurgeons who also specialize in working on the peripheral nervous system who are trained to deal with nerves throughout the body.

oral maxillofacial or Ear Nose and Throat (ENT) surgeons

Oral maxillofacial and ENT surgeons focus on the hard and soft tissues in the head, neck, face and jaw. These dental experts can help treat cleft lips, head trauma injuries, and perform reconstructive surgery on head and neck cancer patients.

Some oral maxillofacial and ENT surgeons are also skilled in performing nerve repair on injuries sustained to nerves in the face or jaw. For example, these specialists often work on nerve injuries that can sometimes occur during wisdom tooth extractions or other dental procedures.

foot and ankle surgeons, or doctors of podiatric medicine (DPMs)

It is important to recognize that most DPMs focus only on the tendons, bones and ligaments of the foot and ankle, and do not often specialize in nerve repair.

However, there are a small number of DPMs who have undergone microsurgical training to be able to perform nerve surgery in the feet and lower legs.

is there a qualified nerve specialist near me?

Take our quiz to see if you qualify as a candidate for surgical nerve repair. And then use our Find a Surgeon tool to see who might be a good fit for your needs and where they are located.

Not all plastic surgeons, orthopedic surgeons or neurosurgeons work with peripheral nerves. However, every doctor suggested through our Find a Surgeon tool—whether ortho, plastic or neuro—has taken specific interest in and developed a passion for helping patients with peripheral nerve injuries.

surgical nerve repair alleviated bonnie’s chronic migraine pain

Prior to 2015, Bonnie was an avid traveler and busy professional working as a construction manager. Life was hectic, but good.

“I was very, very active. I was traveling 70% of the time nationwide and working 60 to 80 hours in any given week. I was just go, go, go, go, go all the time. Which is the way I had been all my life,” said Bonnie. “It was during that time, truly at the height of my career when my health failed.”

The sudden onset of pain

One morning that all changed. Bonnie woke up with a terrible headache—one that never went away. Instead, it only continued to intensify.

“The thing is at first it was just a bad headache. And I just don’t get headaches.” But that headache lasted for nearly five years. Unrelenting pain took over every aspect of her life. She couldn’t work or even perform mundane tasks like unloading the dishwasher or checking the mail. The pain was often so bad, she could barely open her eyes.

“It’s not like I just gave up. I tried twice to go back to work, but I ended up in the ER seven times with migraine pain, but they couldn’t help,” Bonnie said. “I lost my career and as a result we lost two thirds of our income. We had to sell our home. We had to move into small apartments, some not very nice ones.”

A loss of independence

With all this pain, Bonnie lost her sense of independence, which is very difficult for someone who’s been independent all her life.

“It made me feel very vulnerable. [Suddenly, I was] dependent on someone else, regardless of whether that’s my spouse, a friend, whomever to help take care of me, or whether that be financially, or driving me somewhere to doctor’s appointments, or sitting with me after I’ve had one of my procedures. You feel vulnerable to the world.”

Having family and friends around helped Bonnie to feel support, but her emotional support animals pulled her through dark times when she was by herself. “It doesn’t matter if you can’t get up and cook lunch. It doesn’t matter if you can wash clothes, they love you anyway. I didn’t have to feel vulnerable around them. I didn’t have to feel less-than around them because I couldn’t do the things that I’d always done in my life.”

Even more important, was the love and patience from her wife, Jody. “She sacrificed an inordinate amount of her life while she took care of me and everything else. She has stayed by my side and helped me during the toughest times, those times when I felt so helpless and hopeless. She was always there to catch me, both literally and figuratively… and always reminding me not to give up. I’m honestly, not sure I could have gotten to this point without her.”

Taking matters into her own hands

For five years, Bonnie bounced from doctor to doctor. She underwent scans, procedures and was prescribed dozens of drugs, including several addictive narcotics. She spent months in physical therapy. Nothing helped.

Most days she was barely able to walk and the doctors she visited started to dismiss her as a person just seeking more pain medication. “We all have that moment where we just yank ourselves up by the bootstraps and jump right back into it. And when I realized I was, I was killing myself with narcotics [I didn’t even want to take], that’s what I did.”

Realizing she had no hope other than to find help on her own, Bonnie decided to start looking for different answers. And that’s the advice Bonnie has for others experiencing chronic pain. “Don’t give up hope, keep trying. And if [one] doctor can’t help you, just take that file, stick it in the pile of the files you have, and go on and try and find another one. That’s what I kept doing.”

Bonnie’s search led her to Dr. Ivan Ducic at the Washington Nerve Institute. After reviewing her history and symptoms, he explained that the source of her pain was likely neuromas (tangled mass of scar tissue) that had formed in her occipital nerves as the result of several earlier surgeries Bonnie had undergone to her cervical spine. Bonnie couldn’t believe it, but it made so much sense.

A life-changing procedure

In November 2020, Dr. Ducic performed nerve surgery on Bonnie to remove the neuromas and scar tissue on Bonnie’s occipital nerves that were the source of her pain. The goal of the procedure was to restore normal signals to the brain and allow Bonnie to regain her quality of life.

Once Dr. Ducic removed the neuroma, he used a nerve cap to protect the nerve end and minimize the risk of the neuromas reforming.

Returning to normal

Today, Bonnie has her life back and is pain free.

“I had to fight and scratch and cry and bloody my knees on the crawl to get here. But I was not going to give up on the chance of having my life back.”

Bonnie is back to some of her old hobbies, tending to a growing collection of plants, as well as enjoying outdoor photography. Her life might not look the same as it did five years ago, but that’s okay she says. “My life is different, [but] my life is beautiful.”

 

Each patient outcome is dependent upon the nature and extent of nerve loss or damage, the timing between nerve loss and repair, and the natural course of the patient’s recovery. These testimonials reflect the experience of the particular individual and may not represent typical results.