INTRODUCTION AND DEFINITION
Peripheral nerves lie outside the brain and spinal cord; surgery is considered for selected entrapments, injuries or nerve tumors.
This page provides general patient information rather than an individual diagnosis. Decisions depend on symptoms, examination findings, relevant tests and patient preferences. Two people with the same diagnosis may require different care plans.
CAUSES AND SYMPTOMS
Carpal tunnel syndrome, trauma and masses can cause numbness, pain, weakness and loss of fine movement.
The intensity of symptoms does not always match the extent of changes seen on scans. New significant weakness, walking difficulty or changes in bladder or bowel control require urgent medical assessment.
DIAGNOSIS AND ASSESSMENT
Examination, nerve-conduction/EMG studies, ultrasound or MRI may locate the problem and characterize the injury.
Assessment begins with the clinical history and an appropriate examination of strength, sensation and reflexes. X-rays, MRI, CT or nerve studies are used when they can answer a specific clinical question. A scan report alone does not establish the need for surgery.
TREATMENT OPTIONS
Splinting, reducing aggravating activities, rehabilitation and treatment of the cause may be tried when appropriate.
Management depends on the underlying cause, severity, overall health and realistic goals of treatment. Depending on the condition, monitoring, nonoperative care, activity modification, rehabilitation or clinician-selected medication may be considered. No single treatment suits everyone.
SURGICAL PROCESS WHEN INDICATED
Nerve release, direct repair, grafting or tumor surgery are different operations for different problems; surgery does not resolve all numbness.
Before surgery, the team should discuss likely benefits, alternatives and individual risks. Depending on the operation, complications may include bleeding, infection, anesthesia problems, nerve or spinal cord injury, and persistent symptoms; no outcome can be guaranteed.
RECOVERY AND POSTOPERATIVE PERIOD
Nerves recover slowly, so results depend on injury severity and duration and may require prolonged therapy.
Follow-up, movement restrictions and return to work or sport vary with the procedure and neurological findings. New or worsening weakness, fever, wound drainage or bladder and bowel changes require prompt medical review.