Jonathan Cheng, M.D. Answers Questions On: Peripheral Nerve Conditions and Disorders

Nerve compression syndromes typically affect people who are naturally predisposed to develop these disorders. The most common one is carpal tunnel syndrome, which is worsened by repetitive hand use.

Cubital tunnel syndrome affects the ulnar nerve, which is the one that gives you that funny bone feeling at the elbow. You can get this type of injury from spending lots of time with the elbow bent or from resting on the elbow for long periods of time.

Tarsal tunnel syndrome affects the nerves at the ankle that give you feeling on the bottom of the foot. This type of disorder is common among people with diabetes.

My philosophy is to try to avoid surgery and allow the body to heal itself. Splinting and rest actually work quite well for people with mild carpal tunnel syndrome. For severe cases, we still try splinting first. If the patient already has weakness in the hand and loss of feeling, I will usually do a surgical release. This might be using a classic open procedure, or we can do minimally invasive through a special camera.

For people with nerve compression problems, posture is a big issue. Bad posture is very common among computer users, especially those who use laptops. I recommend a workspace evaluation, which means putting the monitor, keyboard, mouse, and chair in the right place – and even improving lighting.

I also suggest getting up from the desk, and walking for 5-10 minutes every hour to change position and relieve the stress on the arms and wrists. I ask my patients to work with a hand therapist to optimize these areas.

With facial rejuvenation, I like to take a graded approach. We start patients on skin care, topical treatment, lasers, and peels before we move on to more invasive treatments.

Facial reanimation is for people who have the lost ability to smile because of injury to the nerves of the face or because they were born without those nerves. Basically, we’re restoring their smiles.

This involves transferring a muscle from the thigh up to the face and reconnecting its blood vessels and nerves, which we perform using a microscope.