Nerve decompression surgery is a procedure to relieve pressure on a nerve. Any nerve can be compressed at any point in its course, but certain nerves are at particular risk of compression due to the way surrounding bones are structured. The aim of this type of surgery is either to open up narrow spaces to give the nerves more room or to remove whatever is pressing on the nerve. You will normally be offered nerve decompression if you have already tried other more conservative approaches, such as a support or in some cases, an injection.
There are good success rates for nerve decompression surgery, however recovery depends on the severity of the condition and which part of the nerve is involved. Like with any type of surgery there a few risks such as a wound infection, scar sensitivity and worsening of symptoms, but these do not occur commonly.
Carpal tunnel decompression
Carpal tunnel syndrome is the result of narrowing in a part of the wrist called the carpal tunnel. A number of tendons pass through this narrow space with the median nerve, which can become compressed.
Carpal tunnel decompression is performed under local anaesthetic in most cases, although it can be done under general anaesthetic if the patient prefers. Through a wound on the front of the wrist, the surgeon divides the roof of the carpal tunnel, called the transverse carpal ligament, to create more space and relieve pressure on the median nerve. A bandage is worn for a few days, followed by a small waterproof dressing. A gradual return to full activity is recommended after 10-12 days, when the stitches have been removed.
Cubital tunnel decompression
Cubital tunnel syndrome is compression of the ulnar nerve – one of the main nerves in the arm – at the elbow. The nerve runs over one of the elbow bones (the ‘funny bone’), very close under the skin. It is a painful condition that can cause numbness and tingling of the little and ring fingers, pain and weakened grip.
Surgery is normally performed under general anaesthetic, but local anaesthetic could be considered for patients unable to have a general anaesthetic for medical reasons. The surgeon creates a wound over the inner part of the elbow in order to cut the ligament over which forms the roof of the cubital tunnel.
Sometimes the nerve is compressed over a quite a distance, so the wound may have to made a little bit longer to adequately perform the surgery.
Occasionally, the surgeon will find that the nerve has a tendency to move unnaturally over the bone when bending the elbow. In this instance the nerve is moved forwards to a more secure position, this is called a ‘transposition’. A sling and bandage are worn initially after the operation. After a few days the bandage is removed and gentle exercises are started. Dissolving stitches are normally used, but the wound needs to remain covered and is checked for healing after approximately two weeks.
This is a surgical procedure to free up a nerve that cannot move smoothly due to the formation of scar tissue around or within the nerve. This condition can develop if the nerve has previously been operated on or injured in an accident, resulting in horrible shooting pains at rest or whenever the affected joint is moved. If the constriction is severe there may also be a loss of function. Neurolysis is a very delicate microsurgical procedure to release any scar tissue around or within the nerve to help it move more smoothly.
Whatever your diagnosis we will always have a detailed discussion with you about the pros and cons of each treatment option available. You will be given time and space to think through each option carefully.
Suffering from nerve pain is a horrible experience. We work with the best neurophysiologists who will help diagnose the exact site of your nerve problem, and whether there is any sign of natural recovery. When surgery is needed we will arrange this promptly, and perform it using the latest microsurgical techniques, so that you can start getting a good nights sleep again.