Just Announced: London Clinic with Dr. Aaron G. Filler, MD PhD, December 11-13

Due to popular response and patient interest, we have added an additional London Clinic date this year.

There is an upcoming London Clinic scheduled for December 11-13 that will coincide with the opening of the first genuine MR Neurography centre in the U.K.

Appointment availability is limited, so please contact the scheduling office by emailing This e-mail address is being protected from spambots. You need JavaScript enabled to view it as soon as possible.

New Edition of "Do You Really Need Back Surgery" in 2012

Dr. Aaron G. Filler, MD PhD, has recently completed the sequel to his widely reviewed book Do You Really Need Back Surgery?

The book that prompted thousands of medical providers to look at alternatives to spine surgery and put Piriformis Syndrome on the clinical treatment map will be augmented by this new book. Look for the new book in early 2012.

If you do not already own a copy of the first edition, check out Amazon.com or BarnesandNoble.com for hard cover and Kindle editions.

December 2011 Case Study: 31-Year-Old Female with Sciatica Symptoms

Welcome to the December 2011 Case Study from the Institute for Nerve Medicine.

Many patients mistakenly believe that if they are diagnosed with Piriformis Syndrome, they can follow a cookie-cutter treatment plan. This case highlights the fact that a diagnosis for Piriformis Syndrome is not always straightforward. Some patients are surprised to learn that complex pain symptoms can provide a misleading or false-positive diagnosis for Piriformis Syndrome.

How much will this cost me out of pocket?

Now that it is closer to the end of the year, most patients have met their deductible — meaning that their out of pocket costs will be considerably lower.

If you are interested in obtaining medical services through the Institute for Nerve Medicine, but would first like to know what your insurance benefits will cover, please contact Network Medical Billing for solutions. Email the NMB team at This e-mail address is being protected from spambots. You need JavaScript enabled to view it to discuss your insurance questions before planning your visit.

November 2011 Case Study: 33-year-old Woman with Piriformis Syndrome

This month’s newsletter features a 2001 patient who recently sent a thank you card to Dr. Aaron Filler, medical director of The Institute for Nerve Medicine.

The case study focuses on a 33-year-old woman who has a four-year history of right buttock pain. She has had a variety of evaluations and a series of epidural injections with little benefit. A Botox injection has been recommended but she has not proceeded with this because of her experience with other injections have been too painful. Her in-network physicians have made a tentative diagnosis of a right sided Piriformis Syndrome, however, due to lack of Open MR guidance capability within her insurance plan, she is now referred for further evaluation and management.

Pay Online at NerveMed.com

By request of so many of our patients, the Institute for Nerve Medicine now offers a 24/7 online billpay feature, located at our homepage, NerveMed.com.

Just click here to visit the payment page. We use the world's leading payment gateway, PayPal. It's safe and secure, and you don't need a PayPal account to use it - just click the alternate option and your major credit card is welcome.

If you have a balance, save time and money today by using the NerveMed.com online billpay feature. There is no additional charge to use this payment method, and we encourage all our patients to use this safe and secure system. It's available 24 hours a day, 7 days a week.

September 2011 Case Study: 41-year-old female with Piriformis syndrome

Welcome to the September 2011 edition of the Institute for Nerve Medicine's Case Study.

This month’s patient is a return patient who was first seen in 2005. The patient was 35 years old at the time of the initial injury. She suffered from low back and knee pain following a horse back riding accident in which her foot became caught in the stirrup, and as a result she twisted in the saddle partially catching herself during a fall. Following knee surgery performed by her local doctors to repair the torn meniscus, the patient was referred to The Institute for Nerve Medicine for Peroneal Nerve release surgery because she continued to experience pain in her knee. She reported that her symptoms were worse with sitting and that she had tried several medications such as anti-inflammatory over the counter drugs without improvement.

Answers to Your Questions

Each month, The Institute for Nerve Medicine receives hundreds of emails from people all around the world, many asking questions about our medical practice and Dr. Aaron G. Filler, MD PhD, in particular.

Here are a couple of questions recently asked and answered:

What is Dr. Filler’s success rate?
Unlike many practicing neurosurgeons, Dr. Filler has several publications in peer reviewed academic journals to support his treatment methods. Patient outcomes are provided through double-blind studies and are objectively published by these major clinical references:

• Aaron G. Filler, M.D., Ph.D., et al.: Sciatica of nondisc origin and piriformis syndrome: diagnosis by magnetic resonance Neurography and interventional magnetic resonance imaging with outcome study of resulting treatment (Large Scale Formal Outcome Trial of Neurography in Sciatica): Journal of Neurosurgery: Spine, February 2005. 2(2) 99-115
• Diagnosis and management of pudendal nerve entrapment syndromes: Impact of MR Neurography and open MR-guided injections. Neurosurgery Quarterly 18:1-6 (2008).
• Diagnosis and treatment of pudendal nerve entrapment syndrome subtypes: imaging, injections, and minimal access surgery. Neurosurg Focus 26 (2) E9: (2009)
• Surgical outcomes for Thoracic Outlet Syndrome are published in Neurosurgery Focus: Endoscopic thoracic discectomy. Neurosurg. Focus 9(4): Article 11 (2000).

In addition to medical papers, Dr. Filler is also the author of several books including the very popular “Do You Really Need Back Surgery? A Neurosurgeon’s Guide to Back Surgery” (Oxford University Press).

If you are interested in Dr. Filler's opinions on back surgery, you may purchase this book at Amazon by clicking here.

The second installment and follow up to "Do You Really Need Back Surgery?" is currently in development and is targeted for an early 2012 release.

Why isn’t Dr. Filler contracted with insurance?
Contracted providers are bound by insurance plan guidelines that may not meet the standard of care, because it is simply easier for insurance plans to have less-experienced providers complete less-efficient treatments.

Dr. Filler is only interested in completing procedures that meet or exceed the standard of care. Consequently, he prefers to remain out of network.

Patients questioning the standards of in-network doctors should look at their own case handling. Why are they seeking help outside of the network? What are the reasons behind in-network doctors and their methods not working?

The fact is that many expert and specialty doctors are out of network because they want to practice excellent medicine - not practice medicine defined by insurance plan quotes and cookie-cutter injections or surgeries that simply do not work.

Quality of care is something that should never be compromised due to an insurance plan limitation. Patients who are considering treatment or surgery are urged to seek second opinions from board-certified neurosurgeons and peripheral nerve specialists like Dr. Filler before completing any procedure.

If you would like to take advantage of having an expert take a second look at your case please contact The Institute for Nerve Medicine by email This e-mail address is being protected from spambots. You need JavaScript enabled to view it or call 310-314-6410.

August Case Study: 28-year-old Male with Long-Term Pain

Welcome to the Institute for Nerve Medicine's August Case Study.

In this edition, we review the case of a young man who had minimally invasive surgery for Piriformis muscle resection.

History of present illness: The patient is a 28-year-old, right-handed male with reports of left lower back and buttock pain for approximately 10 years.

Initially he began experiencing pain during high school while participating on the wrestling team. He experienced left lower extremity radiating pain throughout college, even though he was no longer athletically involved with wrestling. With the decrease in physical activity, the patient has gained approximately 30 pounds and appreciates that this may be a factor to the current pain conditions.

Dr. Aaron Filler Speaking Engagements

Institute for Nerve Medicine clinical director Dr. Aaron G. Filler, MD PhD FRCS, recently presented a professional poster at the International Brain Mapping & Intraoperative Surgical Planning Society (IBM-ISPS) Conference in June 2011 in San Francisco.

A rare honor, Dr. Filler's presentation was given before a national panel of medical and technology experts on Open MR Guided Interventional Treatment for Thoracic Outlet Syndrome. As Dr. Filler is a recognized expert in this field, his presentation was well attended, and the presentation poster used by him during the event is depicted above. You may click to download a PDF version of the poster here (6MB download, PDF format, requires Adobe Reader).

Dr. Filler will be an invited speaker on June 27, 2011, at the House Clinic and the Children's Tumor Foundation at the Century City (CA) Hyatt. This is a professional lecture for esteemed experts on schwannoma (nerve tumors). Dr. Filler will present a talk on imaging of nerve sheath tumors, and will follow his presentation with participation in a medical expert panel for discussions on clinical management.

June Case Study: Complex Pelvic and Lower Extremity Pain Syndrome

Welcome to the June 2011 Case Study from the Institute for Nerve Medicine.

This patient has been suffering from a complex pelvic and lower extremity pain syndrome.

This is a 34-year-old, left-handed female who reports left sided joint pain radiating down the posterior lower extremity, as well as right groin pain. The patient states that when she was in college she suffered a fall on her backside while participating in a student rally, landing on a hard gym floor she immediately experienced stabbing lower back pain. In addition, about two years ago while taking a yoga class, she developed a sensitive area in the right groin region. Along with the pain sensitivity, she has sensations of intermittent weakness in the lower extremity. This was managed over time and she was able to have a normal life with minimal pain until recently when she developed persistent stabbing pain symptoms in the left thigh and joint area.

May Case Study: Female in Pain With No Direct Cause

Welcome to the May 2011 Case Study from the Institute for Nerve Medicine.

In this issue we explore the case of a female suffering from burning and pain that seemed to have no direct cause.

History: This patient presented with a history of left vaginal burning and right lower back/buttock pain for 3-4 years. The patient reports a sudden onset of constant left vaginal burning. There was no injury, accident, trauma prior to the onset of the injury. During a pregnancy she also developed right lower back/buttock pain. She has trialed physical therapy, dry needling, acupuncture with no relief. She has had at least four different Ob/Gyn evaluations with no significant finding. She has also been trialed on Neurontin, Lyrica, Amtriptyline, Zoloft and Elmiron. She notes that over time her symptoms have worsened in severity level. She denies any loss of sensation or strength. The patient denies any changes in bowel or bladder function. She has some relief lying down and taking baths. Her symptoms are aggravated by walking and sitting.

Insurance Talk

The Institute for Nerve Medicine receives many inquiries about our acceptance of insurance.

We work with every patient to help them get the care they need. To that end, we accept insurance for all authorized and pre-certified surgical procedures.

For patients who have financial concerns about undergoing specialty medical services that are out of network, this is important to understand. It allows them to proceed with with their needed surgical procedure(s) as long as they have met their deductible and are willing to work with their insurance company to limit their own out-of-pocket expenses.

This applies to surgery only. If you have any questions, please do not hesitate to contact us at 310-314-6410, or click here to send us an inquiry.

April 2011 Case Study: Neck and Arm Pain

Welcome to the April 2011 Case Study from the Institute for Nerve Medicine.

In this case, we meet a female patient who suffered numerous injuries in a car accident years ago, resulting in painful nerve conditions that persisted until she came to the Institute for Nerve Medicine for treatment.

Case History: This is a female that presented with left occipital pain for the past seven years in addition to left and right forearm pain for the past four weeks.

The patient was involved in a motor vehicle accident in 1996 that resulted in severe whiplash laterally. She notes that following the injury she developed left neck pain with radiating upper extremity pain; however, she was diagnosed with stress and referred for stress reduction.

London Clinic: April 24-26, 2011

The Institute for Nerve Medicine is pleased to confirm the dates for our upcoming London Clinic.

Dr. Aaron G. Filler, MD PhD FRCS, will be seeing patients at the Institute's Harley Street office between April 24-26, 2011.