Nerve Center Treatments

Dr. Kim Burchiel, an internationally esteemed neurosurgeon, offers exceptional expertise in surgical techniques to repair nerves and treat nerve pain.
Dr. Kim Burchiel, an internationally esteemed neurosurgeon, offers exceptional expertise in surgical techniques to repair nerves and treat nerve pain.

The OHSU Nerve Center brings you exceptional expertise and the latest therapies for nerve disorders. You’ll find:

  • Expert doctors, rehabilitation specialists and other providers who will work with you to relieve nerve pain and restore function.
  • Highly skilled neurologists and neurosurgeons who are part of nationally ranked OHSU Brain Institute programs.
  • The most advanced treatments for nerve disorders and injuries, including the only nerve-transfer and facial animation surgeries in Oregon.
  • The rare skills needed for precise injections of therapeutic botulinum toxin, such as Botox, reducing the need for opioids to control pain.

Getting early treatment

Nerve injuries and other nerve disorders often need immediate care. A “wait and see” approach can leave you with permanent nerve damage.

If you have symptoms of a nerve disorder or injury, OHSU Nerve Center specialists can give you an accurate diagnosis and treatment plan. You can expect the best chance of a successful outcome.

Treatments

Your care team will start with the least-invasive option most likely to offer results. Even if you had past treatment that was unsuccessful, we may be able to find new treatments that work for your condition.

Because nerve pain can be persistent, we also may refer you to the OHSU Pain Center to ease your symptoms.

Treatments for peripheral nerve disorders may include:

Bracing

Splints, braces or orthotic support devices can restrict movement to reduce nerve injury and pain. A brace or orthotic support may ease pain and improve balance.

Complementary therapies

OHSU’s Neurology Wellness Clinic offers acupuncture and other therapies to help ease neuropathic pain. These therapies can be used alongside more traditional treatments.

Medication

Nerve conditions often come with burning, stinging or shooting pain. Medications can help with nerve pain (also called neuropathic pain). They include:

  • Anticonvulsants: Medications originally developed for epilepsy can calm nerves and relieve pain.
  • Antidepressants: Tricyclic antidepressants and SNRIs (serotonin and norepinephrine reuptake inhibitors) can ease nerve pain. They also help with the depression that can result from chronic pain. For pain alone, these medications are given in lower doses than for mood disorders.
  • Opioids: These painkillers can control intense pain but are generally recommended only for short-term use (10 days or fewer) because they carry the risk of addiction and abuse.
  • Combination therapy: Your doctor may recommend two medications together to target the pain from different angles.
  • Topical medications: Ointments and patches can ease pain concentrated in a particular area. Ointments with capsaicin, an ingredient derived from hot chili peppers, for example, may hinder nerves from sending pain signals.

Therapeutic toxin injection

Injecting botulinum toxin (Botox is one example) into muscles can relieve pain and other symptoms. The toxin blocks the pain signals nerves send to the brain. The technique helps patients who have nerve pain related to diabetes, for example, or who are recovering from a nerve injury or nerve surgery.

These injections can provide pain relief for months. They also help patients reduce reliance on opioids. At OHSU’s neurotoxin injection clinic, you’ll find some of the nation’s most experienced doctors in giving these injections. They use a precise technique that can take years to master.

Rehabilitation therapy

Our rehabilitation team includes experts in:

Our specialists can teach you how to ease pressure on certain nerves to prevent pain and further injury. They can help you retrain your brain after nerve transfer surgery. They can also help improve coordination and balance. We offer state-of-the-art equipment and facilities.

Nerve blocks

Your doctor may inject a nerve-numbing solution, possibly combined with a steroid to fight inflammation, into the affected area. This can stop nerves from sending pain signals.

Surgery

Our neurosurgeons, orthopaedic surgeons, and plastic and reconstructive surgeons offer the most advanced surgeries and surgical techniques to treat nerve disorders. They are highly skilled in the exacting techniques needed to treat nerves and the delicate structures in the hands, face and other parts.

Dr. Myriam Loyo Li offers facial reanimation surgery, an innovative procedure that transfers nerves to restore your smile and facial symmetry.
Dr. Myriam Loyo Li offers facial reanimation surgery, an innovative procedure that transfers nerves to restore your smile and facial symmetry.

Endoscopic surgery: This approach uses small incisions for less pain and a quicker recovery. Your surgeon places a viewing scope through one of the incisions to assess the nerve. The surgeon uses another incision and specialized tools to make repairs.

Facial reanimation surgery: OHSU is the only center in Oregon and among the few on the West Coast to offer facial reanimation surgery. This surgery can restore symmetry and the ability to smile for patients who may have been told nothing could be done. We transfer facial nerves to return function to patients with facial paralysis from nerve damage, a stroke or another disorder.

Nerve transfer surgery: If you’ve lost muscle function, you may be eligible for nerve transfer surgery. Our surgeons are the only providers in Oregon to offer this innovative procedure. Your surgeon will take one end of a normal but less important nearby nerve and attach it to the affected muscle. Bypassing the damaged nerve can restore function, while retraining helps the brain recognize and control the muscle.

Nerve repair surgeries: For nerves with the potential to heal, we offer:

  • Nerve repair surgery to reattach two damaged ends. 
  • Nerve graft surgery to stitch a nerve between two damaged ends to serve as a bridge while the nerve heals and grows back together.

'Love to See You Smile'

OHSU’s Dr. Myriam Loyo Li describes how facial reanimation surgery works, with illustrations and before-and-after photos.

Watch or share this video

For patients

Referral: To become a patient, please ask your doctor for a referral.

Locations

Parking is free for patients and their visitors.

We offer clinics for nerve conditions on our Marquam Hill and South Waterfront campuses.

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Smiling again

Jarmila Hawes facial reanimation surgery before and after

Learn how Jarmila Hawes got her smile back with facial reanimation surgery by OHSU’s Dr. Myriam Loyo Li. OHSU is one of the few centers on the West Coast to offer this advanced procedure.