Although there are a lot of purported “treatments” for the symptoms of neuropathy, the only measure (other than surgery) that has any proven effect is pain medication. However, reducing the pain related to neuropathy does nothing to treat the underlying cause. Therefore, these medications simply “mask” the symptoms, but fail to treat the cause. Neuropathy surgery, such as that performed at The Institute for Advanced Reconstruction, actually addresses the underlying cause of the neuropathy symptoms.
It relieves the points of compression along the nerve that in many cases is a major component of the development of those symptoms. The surgery we perform has been shown in many studies to be effective in reducing the symptoms and signs of neuropathy in a majority of well-selected patients. Our surgeons are among the fewer than 20 plastic surgeons in the world that have been specifically trained in this surgery.
Neuropathy Surgery Study Results
Although there had been positive reports dating from the early 1990’s on lower-extremity nerves decompressed with surgery for those with diabetes, a prospective study was conducted of 100 consecutive patients (60 with diabetes and 40 with idiopathic neuropathy). Each patient had neurolysis (nerve release) of the peroneal nerve at the knee (located outside of the lower knee) and the dorsum (back or upper surface) of the foot as well as tibial nerve release in the four medial (inner) ankle tunnels. After at least one year of follow up, 87 percent of patients with preoperative numbness reported improved sensation, 92 percent with preoperative balance problems reported improved balance, and 86 percent whose pain level was five or greater on a visual analog scale from 0 (no pain) to 10 (the most severe pain) before surgery reported an improvement in pain. The study concluded that decompression of compressed lower-extremity nerves improves sensation and decreases pain, and should be recommended for patients with neuropathy who have failed to improve with traditional medical treatment. (Source: **http://www.ncbi.nlm.nih.gov/pubmed/16166462)
Performed on an outpatient basis and taking less than an hour, the procedure done at The Institute for Advanced Reconstruction involves relieving the pressure on a nerve by surgically removing the constricting tissue or bone, or widening the canal encasing the nerve. In our experience, decompression surgery is successful in relieving the symptoms of neuropathy in up to 90 percent of well-selected patients. The procedure is minimally invasive, requiring only small incisions over the affected area thus promoting a quicker recovery.
At The Institute for Advanced Reconstruction, surgery for peripheral nerve disorders is performed on an outpatient basis, either at our own Center for Outpatient Surgery or at the hospital.
Recovery is gradual and can take two to three weeks depending on the procedure. Our physicians continually monitor for improved muscle tone and function, along with return of sensation. Usually your first follow-up visit to our office to remove bandages is a week following surgery. After three weeks, sutures are removed.
Physical and occupational therapy plays a role both before surgery (to keep joints and extremities mobile) and following surgery to enhance recovery. As in many surgical procedures, this therapy is an important aspect of the recovery process.