Treatment for Peripheral Nerve Injury (Peripheral Neuropathy)

Our peripheral nervous system is made up of 43 pairs of motor and sensory nerves that connect our brain and spinal cord to our bodies. These nerves send messages to your body, controlling functions that include sensation, movement and motor coordination. These nerves are protected by surrounding tissues, but are fragile and easily damaged.

A peripheral nerve injury, also called peripheral neuropathy, affects your brain's ability to communicate with your muscles and organs. In many cases, peripheral nerve damage is not permanent.

Causes of Nerve Damage

Peripheral nerve damage comes in all shapes and sizes. Nerve damage in the hands can be caused by common conditions such as carpal tunnel syndrome and cubital tunnel syndrome that increase pressure or compression of a major nerve to the hand.

The most common cause of nerve damage in the legs and feet is due to diabetes, also called diabetic neuropathy. High blood sugar can injure nerves and blood vessels throughout the body, most often starting with the nerves in the toes and feet. According to the American Diabetes Association, about half of all people with diabetes have some form of nerve damage. Nerve pain in the feet can also be caused by nerve entrapment, or pinched nerves in the foot or ankle.

Nerve damage throughout the body can also be caused by accidents, sports and work-related injuries and lacerations that stretch, compress or cut these nerves.

Additionally, peripheral nerve injuries may be caused by unrelated surgical procedures. Post-surgical neuropathies may be a consequence of stretching or inflammation of a nerve during a surgical procedure. It’s important for patients to seek care if they experience nerve pain following a procedure.

Peripheral nerve damage is very common and affects patients of all ages and genders.

Peripheral Nerve Damage Symptoms

Symptoms of peripheral nerve damage range from mild to severe depending on the condition, and vary significantly based on the nerve fibers affected.

• Motor nerve damage results in muscle weakness or painful cramps.
• Damage to sensory nerves that affect touch, may result in numbness or tingling of the hands and feet. You may also have trouble sensing pain or changes in temperature.
• Damage to autonomic nerves that regulate breathing and thyroid functions, can result in excessive sweating, changes in blood pressure or neuropathy.

It’s important to seek help if you experience any of these symptoms. Symptoms will generally continue to get worse without treatment. Early diagnosis and treatment may prevent complications and permanent damage.

Diagnosing Nerve Damage

To confirm peripheral nerve damage and determine the best course of treatment, our team of physicians may recommend diagnostic testing after a comprehensive exam and medical history review. Tests may include the following.

• CT scan
• Electromyography
• Nerve conduction study
• MRIs

Determining a Treatment Path

Depending on the severity of the injury, treatment paths vary greatly. If your nerve is only injured, you may recover over time without surgery. Nerves heal slowly, sometimes over many months. For these mild nerve injuries, nonsurgical treatment options include medication, physical therapy or massage therapy.

Peripheral nerve surgery can reconstruct or repair damaged nerves. You may need surgery to repair severely compressed nerves, cut nerves or nerves that are not healing on their own.

If the nerve damage resulted from a medical condition, your doctor will work with you to treat the underlying condition. As part of eastern Wisconsin’s only academic health network, we have access to the full range of medical specialists when needed.

Surgical Treatment Options

When nerve damage requires surgery, we work closely with you to determine the best course of treatment based on your specific condition. The goal of treatment is to improve hand or foot function, as well as your quality of life.

Surgical options can include:

• Brachial plexus surgery to repair the network of nerves in the shoulder
• Nerve decompression to relieve the pain and numbness of carpal tunnel syndrome or cubital tunnel syndrome.
• Neurolysis to free a nerve from scar tissue that is restricting it.
• Nerve grafting to reconstruct a severed nerve with a graft taken from one of your nerves or from a cadaver.
• Nerve transfers that borrow a redundant motor nerve and plug it into a damaged nerve that’s more important for quality of life
• Thoracic outlet syndrome surgery in the space between your first rib and collarbone to relieve shoulder and neck pain, as well as numbness in your fingers

What to Expect

Overall, outcomes for peripheral nerve repair or reconstruction are very good. Depending on the procedure and extent of nerve damage, you may feel relief immediately after the procedure. In some cases, it will take longer for the nerves to heal, and you may need physical therapy or rehabilitation.

Nerve decompression recovery may be fairly minimal, while more involved nerve reconstructions have a longer timeline of recovery. Nerves can take a long time to heal and recover after an injury. Your physician will explain the recovery process based on the procedure recommended.

Experts in Nerve Injury Treatment and Repair

As a leading program, we have treated all forms of peripheral nerve injuries, from the common to the most complex. Our multidisciplinary team of plastic and reconstructive surgeons, orthopaedic surgeons and neurosurgeons collaborate to determine your best course of treatment. Many of our physicians have advanced training in microvascular surgery, which allow them to perform even the most intricate procedures. In addition to all of this expertise, we are an academic medical center focusing on research to advance and develop new peripheral nerve treatment methods.