Peripheral Nerve Decompression Surgery is a microsurgical procedure used to relieve chronic neuropathic pain caused by nerve entrapment or compression along its anatomical pathway. When a peripheral nerve is compressed by tight muscles, fibrous tissue, scar formation, or trauma, it may lead to burning, tingling, or shooting pain — often misdiagnosed as spinal or orthopedic pain. By releasing the pressure on the affected nerve, decompression surgery aims to restore normal nerve function, reduce pain, and prevent permanent damage. This technique is highly effective for select cases of nerve entrapment syndromes and post-traumatic neuropathic pain.
Common Conditions Treated
Peripheral nerve decompression may be indicated for:
- Entrapment neuropathies:
Carpal tunnel syndrome (median nerve)
Cubital tunnel syndrome (ulnar nerve)
Peroneal nerve entrapment at the fibular head
Tarsal tunnel syndrome (posterior tibial nerve)
Meralgia paresthetica (lateral femoral cutaneous nerve) - Post-traumatic nerve compression (after fracture or surgery)
- Chronic neuropathic pain following trauma or prolonged pressure
- Nerve entrapment after scar formation or repetitive strain
Each condition requires detailed neurological assessment and imaging to confirm the compression site.
Symptoms
- Burning, stabbing, or electric-shock–like pain in the distribution of the nerve
- Tingling or numbness (paresthesia)
- Weakness or muscle wasting in advanced cases
- Pain worsened by limb position or activity
- Sleep disturbance or functional limitation from persistent pain
If untreated, chronic compression can lead to irreversible nerve degeneration and long-term disability.
Diagnosis
- Clinical Evaluation: Detailed history and neurological examination identify pain distribution and sensory deficits.
- Electrodiagnostic Studies (EMG & NCS): Confirm conduction delay or nerve injury, localizing the compression site.
- Imaging:
High-resolution ultrasound can visualize focal nerve swelling or entrapment.
MRI neurography helps identify compression from scar, bone, or mass. - Selective nerve blocks may be performed to confirm the pain source before surgery.
Surgical Procedure
1. Preparation
- Performed under local or general anesthesia, depending on location and complexity.
- The surgical site is marked according to clinical and imaging findings.
2. Decompression Technique
- Through a small incision, the surgeon uses microsurgical instruments to release the tight bands, fascia, or scar tissue compressing the nerve.
- The nerve is freed along its course until it moves and pulses freely without restriction.
- In some cases, neurolysis (removal of scar tissue around the nerve) or nerve wrapping (using biological material to prevent re-scarring) is performed.
3. Closure & Recovery
- The wound is closed in layers, and a soft dressing is applied.
- Most patients can go home the same day or after a short hospital stay.
Expected Benefits
- Reduction or resolution of neuropathic pain
- Improved sensory and motor function
- Restored daily activity and sleep quality
- Decreased reliance on pain medications
- Prevention of further nerve damage
Pain relief may begin immediately after surgery or gradually improve over several weeks as the nerve heals.
Risks & Complications
- Infection or hematoma at the incision site
- Scar formation (rare with modern nerve wrapping techniques)
- Temporary numbness or hypersensitivity during recovery
- Incomplete relief if pain originates from multiple or central causes
Careful patient selection and precise surgical technique minimize risks.
Recovery & Follow-Up
- Wound healing: within 1–2 weeks
- Return to light activities: in 1–3 weeks, depending on nerve location
- Physiotherapy: recommended to prevent stiffness and maintain nerve mobility
- Neuropathic medication tapering: can begin once improvement is stable
- Follow-up EMG/NCS: may be performed 3–6 months postoperatively to assess recovery
Long-term results are excellent when compression is released before irreversible damage occurs.
Patient Advisory
Peripheral nerve decompression is indicated only after thorough neurological evaluation confirms a focal entrapment as the pain source. Every patient’s condition is unique — some respond best to conservative therapy or injections, while others require surgery for lasting relief. The decision should always be made by your treating neurosurgeon or pain specialist. Do not rely solely on online information to determine suitability for surgery.