Peripheral Nerve Surgery

What is peripheral nerve pain?

Peripheral Nerve Surgery at the University of Michigan Health System, Section of Plastic Surgery is cutting edge surgical treatment for pain caused by injury and/or compression of nerves.  

The Peripheral Nervous System consists of all the nerves that are outside of the brain and the spinal cord: the nerves in your arms and legs, in your face, and in your chest and abdomen. Whether caused by injury, surgery, or conditions such as diabetic neuropathy, damage to the peripheral nerves can lead to chronic pain that is difficult to diagnose and to find solutions to treat.

Who is a good candidate for nerve surgery?

Plastic Surgery at The University of Michigan Health System is one of only a handful of institutions in the country that are currently offering this surgery as an option for patients who have exhausted other methods of treating pain.

Patients come to us with pain caused by conditions including:

  • Diabetic neuropathy in the legs and feet.
  • Persistent leg/foot/joint pain after sports injuries.
  • Pain in the knee or ankle following surgery (e.g. total knee replacement)
  • Groin pain after hernia repair
  • Unrelenting pain after laparoscopic surgery, breast reconstruction, Caesarian section, abdominoplasty, etc.

How is the Procedure Performed?

The type of procedure depends on the location and cause of the pain.  In many instances, the pain results from compression of (pressure on) a specific nerve or group of nerves.  In such cases, relieving the pressure relieves the pain.  This can usually be accomplished through relatively small incisions during an outpatient operation.  In other cases, the nerves may need to be divided and rerouted.  This can result in an area of limited numbness of the skin – often a welcome trade-off for the pain.

Planning for Your Consultation

Identifying the cause of your pain is not always straightforward.  Many patients will have seen several other physicians, physical therapists, pain specialists, etc. without complete relief of their pain.  We will work with you to obtain the necessary information ahead of time regarding these other consultations and/or interventions.  It may be helpful for you to have a temporary block of the involved nerve prior to your consultation to determine your diagnosis.

Planning for Your Surgery

The first step is to schedule a personal consultation with your surgeon. Communication is crucial in reaching your goals. You will have the opportunity to express your goals and the results you'd like to achieve. Together, you and your surgeon will reach an understanding about what you can expect from this procedure and the long-term benefits you will experience. Every patient is different, and your surgeon will choose the surgical technique and treatment plan that is right for you. During the initial consultation, you should expect:

  • To provide a complete medical history, including information about previous surgical procedures; past and present medical conditions; and any medications or herbal supplements you are taking.
  • Your surgeon to conduct a complete physical examination.
  • To discuss possible risks and complications of the procedure.

Preparing for Your Surgery

You will be given a pre-operative information packet that explains everything you should do and know before your surgery date. Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital, if needed.

Where Your Surgery Will be Performed

Your procedure will take place at the University of Michigan Hospitals, which provide state-of-the-art surgical suites and recovery areas. The majority of these procedures are completed on an out-patient basis.

Types of Anesthesia

You will remain comfortable throughout the entire procedure. In most cases, general anesthetic is used so that you will sleep throughout the procedure; although intravenous sedation augmented with local anesthesia is also an option for some patients.

After Your Surgery

It is very important that you follow your surgeon's instructions in order to promote healing and progress towards your new physical appearance. Also, it is important that you attend all follow-up appointments scheduled so that your surgeon can assess your long-term results and answer any questions or concerns you may have.

NOTE: If you smoke, recently quit smoking or have been unable to stop completely, or you are exposed to second-hand smoke, you may not be a candidate for surgery. Primary and secondary smoking decreases blood supply to the body's tissues, resulting in prolonged wound healing, skin loss, infection, increased scarring, and a number of other complications related to the kind of procedure performed.

To schedule a consultation, call 734-998-6022