Peripheral nerve release

You have two nervous systems in your body: the central nervous system, which includes your brain and spinal cord, and the peripheral nervous system, which consists of all nerves outside these two areas.

There are various causes of peripheral neuropathy, otherwise known as disease or damage to the peripheral nervous system.

The most common peripheral nerve injuries are caused by: 

• Nerves becoming trapped and compressed
• Tear or laceration in the nerve tissue
• Traction injuries, such as shoulder dislocation

Common compressed nerves are: 

• Carpal tunnel in the wrist
• Ulnar nerve in the elbow or arm
• Peroneal nerve in the knee
• Tarsal tunnel in the ankle

Pain in the lower back and/or leg can be caused by an injury to the network of peripheral nerves in the pelvis (lumbar plexus).  While pain in the neck and top of the back may come from compressed nerves and blood vessels between your collarbone and first rib, this is called thoracic outlet syndrome (TOS).

We also see iatrogenic injuries, where nerves can be compressed as a result of surgery, for example, injury to the sciatic nerve following a hip replacement. In such cases, our peripheral nerve consultants work closely alongside our orthopaedic consultants to relieve any compressed nerves.

 

Peripheral nerve surgery may involve decompression or release of the pinched/trapped nerve from the surrounding tissue that is compressing it. If the nerve is cut or damaged, then surgery may involve a direct end-to-end repair. If the damage is more extensive and the gap between the severed ends is too large, a nerve graft or conduit may be necessary to bridge the defect and facilitate a successful repair.  

Trauma such as a car accident, repetitive movement such as weightlifting, and sometimes pregnancy can cause thoracic outlet syndrome (TOS), the compression of nerves and blood vessels located between the neck and shoulder. However, a main cause is cervical rib. This is a rare condition where some people are born with an extra rib growing from the neck. This presses down on the nerves and blood vessels, which causes pain.

Nerve ablation is a treatment which involves damaging a malfunctioning nerve. This damage can help alleviate and reduce chronic pain by preventing the damaged nerve from sending signals to your brain. Basivertebral nerve ablation is a treatment we offer for chronic lower back pain by our spinal neurosurgeons.

Peripheral nerve surgery may be performed using local or general anaesthetic, depending on the area and complexity of the procedure.

Often, nerve decompression can be done as a minimally invasive treatment, offering relief and faster recovery. Your consultant will recommend the best approach for you.