What is Peripheral Nerve Surgery and Support?
Peripheral nerve surgery is typically performed to relieve nerve compression in the arms, hands, or legs. Peripheral nerves are nerves that extend from the spinal cord to the rest of the body, and they may become compressed or damaged due to injury, tumours, or other conditions.
At Brisbane Clinical Neuroscience Centre (BCNC), our team of neurosurgeons and neurologists work together to assess, diagnose, and manage a range of peripheral nerve disorders, offering both surgical and non-surgical treatment options.
Contact our friendly team for more information.
When may Peripheral Nerve surgery be required?
Surgery may be considered for peripheral nerve conditions such as:
- Nerve compression syndromes (e.g., carpal tunnel syndrome, cubital tunnel syndrome).
- Nerve injuries resulting from accidents.
- Peripheral nerve tumours, which may compress nearby nerves.
Before any surgery on the nerve is considered, the diagnosis is usually confirmed by a careful discussion of your symptoms, clinical examination and then some tests known as nerve conduction studies. We can perform these in-house with our neurology specialist, Dr Cullen O’Gorman. These tests involve measuring the speed at which the nerves conduct electrical signals, to give an objective measure of the degree of nerve impairment.
Peripheral nerve surgery for common indications such as carpal tunnel syndrome is usually very straightforward and carried out as a day procedure. Many of our surgeons employ modern endoscopic techniques to release the pressure on the nerve.
If your GP thinks you have one of the more common compressive peripheral nerve syndromes (such as carpal tunnel syndrome), you can obtain a referral to see Dr O’Gorman for nerve conduction studies before you see one of our surgeons, if indicated).
Common peripheral nerve problems that are treated surgically
Carpal tunnel syndrome
This is common and results in a troublesome numbness in the hand (often both hands) which involves the thumb, index and middle fingers. It usually wakes people at night and can be persistent through the daytime as the condition progresses. Sometimes, motor weakness in the hand can occur.
The cause is compression of the median nerve at the level of the wrist, as it runs underneath a ligament called the transverse carpal ligament. Surgical division of this ligament (via a small incision at the wrist) allows the tissues to relax, which may support improved nerve function and symptom relief over time.
Cubital tunnel syndrome
This is also common and presents with numbness in the ring and little fingers of the hand, again often worse at night. There is often a diffuse discomfort around the elbow and forearm. The nerve affected is the ulnar nerve, usually where it runs around the back of the elbow joint (this is the nerve that is bumped when you hit your ‘funny bone’ – resulting in that unpleasant numbness in the hand we all recognise). As with carpal tunnel syndrome, if the diagnosis is confirmed with nerve conduction studies it may be suitable for surgical decompression, which has been associated with symptom improvement in many patients.
Recovery from surgery
You will usually be discharged from hospital with a bandage around the surgical site, which is quite bulky and restrictive. This should remain in place for 3-5 days before being removed. At this stage, gentle movement of the joint (eg wrist or elbow) around the nerve can be resumed. Full healing may take a month or so, and your surgeon or one of our practice nurses will be able to provide specific guidance about the resumption of normal activity.
Other peripheral nerve conditions
Peripheral neuropathy
Many people develop numbness in their feet as they age, which can be quite disturbing – especially when trying to sleep at night. Sometimes the hands are also affected. The numbness has a ‘burning’ quality to it and it usually affects all of the toes or fingers equally. As it develops it feels like you have a sock or a glove on the affected extremity. This is usually due to metabolic factors such as elevated blood sugar or can be a side-effect of medicines or previous chemotherapy. As it does not result from physical injury or pressure on the nerve, it is not treatable with surgery. You may be assessed by a neurologist rather than a surgeon. Nerve conduction studies may again form part of the assessment or the condition.
Who are the members of our clinical team at BCNC that manage peripheral nerve disorders?
Dr Cullen O’Gorman is a neurologist with a special interest in the assessment of peripheral nerve disorders through the use of nerve conduction studies. These tests help to confirm the diagnosis of malfunction of a particular peripheral nerve and they may be requested by your GP directly, before referral on to a treating neurologist or neurosurgeon, as appropriate.
All of our neurosurgeons are experienced at managing the common peripheral nerve problems that arise and we can offer modern, minimally-invasive surgical techniques that aim to get you back to normal activity as rapidly as possible.
