Peripheral Nerve Surgery
Fast facts
- Persistent numbness, tingling, or weakness warrants early evaluation before the nerve suffers permanent damage.
- Most decompression surgeries (carpal tunnel, cubital tunnel) are day-care procedures with tiny incisions.
- Advanced imaging, nerve conduction studies, and ultrasound mapping guide targeted surgery.
- Hand therapy and ergonomic coaching are built into every recovery plan.
Entrapment neuropathies limit hand dexterity, grip strength, and quality of sleep. Dr. Sayuj Krishnan combines ultrasound-guided nerve assessment, precise microsurgical decompression, and coordinated rehabilitation so that patients regain function quickly while protecting long-term nerve health. Surgery is considered once splints, physiotherapy, workplace modification, and injectables fail to control symptoms—or when weakness appears on examination. (For cranial nerve disorders like trigeminal neuralgia, specialised skull base procedures are available).
Carpal Tunnel Release
Carpal tunnel syndrome occurs when the median nerve is compressed under the transverse carpal ligament. Early surgery prevents muscle wasting and improves nighttime numbness. Options include mini-open and endoscopic release; both are performed under regional or local anaesthesia with return home the same day.
- Indicators: Weak pinch strength, persistent numbness despite splints, nerve conduction delay.
- Technique: 2–3 cm palmar crease incision protecting sensory branches; endoscopic when anatomy allows.
- Recovery: Gentle finger motion immediately, sutures off at 10–12 days, desk work in 7–10 days.
Ulnar Nerve Decompression
Cubital tunnel syndrome causes tingling in the ring and little fingers, often worse when the elbow is bent. Surgical options include in-situ decompression or anterior transposition of the ulnar nerve, chosen based on nerve subluxation, elbow anatomy, and occupational demands.
- Indicators: Intrinsic hand weakness, nerve conduction block across the elbow, failed night splints.
- Technique: 4–5 cm incision along the medial elbow with protection of the medial antebrachial cutaneous nerve.
- Recovery: Sling for comfort for 2–3 days, gradual elbow movements, strengthening from week three.
Other peripheral nerve procedures
Peroneal nerve decompression
Addresses foot drop caused by compression at the fibular neck. We release fascial bands, dynamic fibrous tissue, and utilise nerve wraps when scarring is present. Night splints and gait training follow immediately.
Nerve repair & grafting
Traumatic nerve transections are repaired microscopically. For gaps, we use sural nerve grafts or processed nerve allografts. Early referral (within weeks) yields the best motor recovery.
Nerve tumour excision
Schwannomas and neurofibromas are removed using intra-operative nerve stimulation to identify functional fascicles. Enucleation preserves motor power while relieving pain and tingling.
Revision surgery
Recurrent symptoms after prior decompression are evaluated with ultrasound and MRI neurography. Scar release, nerve wrapping, or transposition are performed to restore glide and reduce pain.
Recovery & rehabilitation
Day 0–3
Protect dressing, keep hand elevated, begin tendon-gliding and nerve-gliding drills taught before discharge.
Week 1–2
Suture removal, progressive grip exercises with therapy putty, scar desensitisation, ergonomic coaching.
Week 3–6
Strengthening, proprioception retraining, gradual return to manual duties after surgeon review.
Frequently asked questions
- Do I always need surgery for nerve compression?
- No. We begin with splints, physiotherapy, ergonomic changes, ultrasound-guided steroid injections, and diabetes control. Surgery is advised if symptoms persist or weakness appears.
- Will my numbness disappear immediately?
- Pins-and-needles often improve within days, but longstanding numbness may take months as the nerve recovers. Early surgery gives the best chance of full sensation.
- When can I drive again?
- Typically after the first post-op review once grip strength and reaction time are safe—usually 7–10 days for carpal tunnel and 14–21 days for elbow procedures.
- Is physiotherapy compulsory?
- Yes. Guided rehabilitation prevents stiffness, scar tethering, and strength loss. Our hand therapy partners provide home exercise videos and follow-ups.
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Clinical References
- American Association of Neurological Surgeons – Peripheral Nerve Disorders
- Johns Hopkins Medicine – Peripheral Nerve Surgery
External links are provided for transparency and do not represent sponsorships. Each source was accessed on 19 Oct 2025.
Medically reviewed by Dr. Sayuj KrishnanConsultant Neurosurgeon, Yashoda Hospital MalakpetLast reviewed 19 October 2025
This information is for educational purposes only and should not replace professional medical advice. Please consult with Dr. Sayuj for personalized medical guidance.