Peripheral nerve surgery covers operations to free a compressed nerve or repair an injured nerve outside the brain and spinal cord, such as the nerves of the hand, arm and leg. It may be considered when nerve damage causes numbness, weakness or pain and other options have not helped.
Note: This is general information. Numbness and weakness have many causes, and diagnosis needs an in-person examination and often nerve testing.
When This Surgery May Be Considered
The following symptoms may point to a problem with a peripheral nerve:
- Numbness, tingling or burning in the hand or foot
- Muscle weakness or difficulty gripping
- Loss of feeling in a particular area
- Pain that follows the path of a nerve
- Wasting of the hand or forearm muscles
- Weakness that appears after an injury or a cut
Why Peripheral Nerves Are Damaged
Nerves can be damaged by:
- Compression in a narrow passage, as in carpal tunnel syndrome and nerve compression at the elbow
- Cuts, wounds and fractures that involve the nerve
- Stretching or severe bruising
- Benign growths near the nerve
- Long-term conditions such as diabetes
- Repeated pressure or long-held positions
Diagnosis
Assessment begins with a clinical examination of feeling, strength, reflexes and the path of the nerve. Nerve conduction and muscle tests are usually requested, and sometimes an ultrasound or MRI.
Locating the problem and judging how severe it is needs an in-person examination and careful assessment.
Treatment options
Non-surgical treatment
In mild cases, or those expected to improve by themselves, treatment may begin with non-surgical options.
- Rest and avoiding positions that press on the nerve
- Splints to support the joint in a suitable position
- Physiotherapy and nerve-gliding exercises
- Treating an associated cause such as diabetes
- Treatments under medical supervision to ease pain
- Regular follow-up to watch feeling and strength
Surgical treatment
Operations vary with the problem. In nerve release the surgeon removes whatever is pressing on the nerve. When a nerve is cut it may be stitched or bridged with a nerve graft. In some cases nerves or tendons are transferred to restore a lost function. Operations are done under anesthesia, mostly with delicate techniques.
Nerves regrow slowly, improvement can take time to appear, and feeling or strength may not fully return. The surgeon explains what to expect in your case and the risks beforehand. A common example is carpal tunnel release.
Recovery and rehabilitation
Recovery time varies from person to person and is set by the surgeon after assessment. Nerves take a relatively long time to recover, so patience and follow-up matter.
- Wound care and protection of the treated nerve
- Moving neighboring joints to prevent stiffness as the surgeon directs
- Physiotherapy to regain movement and strength
- Sensory retraining when needed
- Regular follow-up to assess nerve recovery
- A gradual return to activities
When to see the doctor
See an orthopedic surgeon if you have:
- Persistent numbness or weakness in the hand or foot
- Loss of feeling after an injury or a cut
- Muscle wasting
- Nerve-path pain that does not ease
- Numbness that grows or spreads over time