Compression · Injury · Recovery
Nerve Surgery
Nerves carry every sensation you feel and every command your muscles receive. When one is compressed or injured, the result is numbness, tingling, weakness or pain — and if the pressure is not relieved, some of that loss can become permanent. Nerve surgery aims to free the nerve or rebuild it before that happens.
(623) 264-3300Three Nerves, Three Patterns
Which fingers go numb is the single most useful clue about which nerve is involved.
Median Nerve
Compressed at the wristThumb, index, middle and part of the ring finger. Often worse at night.
Ulnar Nerve
Compressed at the elbowRing and small finger. May cause clumsiness and a weak pinch.
Radial Nerve
Compressed around the elbow or forearmBack of the hand and wrist. More often weakness or aching than numbness.
Recognizing the Problem
Numbness or Tingling in Your Hands?
Symptoms such as numbness, tingling, nighttime discomfort, weakness or dropping objects can sometimes be associated with nerve compression conditions such as carpal tunnel syndrome or cubital tunnel syndrome.
These symptoms can also have other causes, including problems in the neck, diabetes, thyroid conditions and other nerve disorders. An evaluation is what distinguishes among them — symptoms alone are not enough to make a diagnosis.
When to Be Seen Sooner
Progressive weakness, muscle wasting at the base of the thumb, or symptoms that no longer come and go deserve prompt evaluation. A nerve that has been compressed for a long time does not always recover fully once the pressure is relieved.
Symptoms That May Point to a Nerve
- Numbness or tingling in the fingers or hand
- A sensation of burning, buzzing or electric shocks
- Weakness when gripping, pinching or opening jars
- Dropping objects unexpectedly
- Symptoms that wake you at night
- Clumsiness with buttons, coins or keys
- Muscle wasting at the base of the thumb
- Pain that radiates from the elbow or wrist into the hand
This list is for general education only and is not a diagnosis. Similar symptoms can arise from several different causes.
The Two Most Common
Carpal Tunnel & Cubital Tunnel Syndrome
These are the two nerve compression conditions seen most often in the upper extremity. They involve different nerves, different locations and different patterns of symptoms.
Carpal Tunnel Syndrome
Commonly affects the thumb, index, middle and part of the ring finger due to compression of the median nerve at the wrist. Symptoms often wake patients at night and may be relieved by shaking the hand.
Learn About Carpal TunnelCubital Tunnel Syndrome
Often causes numbness or tingling involving the ring and small fingers due to irritation or compression of the ulnar nerve near the elbow. May cause clumsiness, a weak pinch or muscle wasting in advanced cases.
Learn About Cubital TunnelThis information is not intended to diagnose your symptoms. Many conditions produce similar numbness and tingling — professional evaluation is the way to know which one applies to you.
Before Surgery Is Considered
Not every compressed nerve requires an operation. Many patients improve with measures that reduce the pressure on the nerve without an incision.
Night Splinting
Holding the wrist or elbow in a neutral position overnight keeps the nerve from being compressed while you sleep.
Activity Modification
Changing how you grip, position your wrist or rest your elbow can remove the repetitive pressure driving symptoms.
Therapy
Nerve gliding exercises and targeted therapy can improve symptoms in some patients and support recovery after surgery.
Injection
A cortisone injection into the carpal tunnel can reduce inflammation around the nerve and relieve symptoms, at least temporarily.
Why Timing Matters
Non-operative treatment works well for many patients, but it has limits. When nerve testing shows significant compression, or when weakness and muscle wasting are progressing, waiting carries its own risk. The right moment to operate is a judgment made together with your treating physician.
Procedures
Nerve Procedures Performed
Decompression procedures relieve pressure on a nerve. Repair and transfer procedures rebuild function when a nerve has been injured or lost.
Carpal Tunnel Release
Dividing the transverse carpal ligament to take pressure off the median nerve where it passes through the wrist.
Learn about the conditionCubital Tunnel Release
Relieving compression of the ulnar nerve as it passes behind the inside of the elbow.
Learn about the conditionNerve Repair
Reconnecting a nerve that has been cut or otherwise divided so that sensation and muscle function can recover.
Nerve Transfer
Rerouting a working nerve to restore function when the original nerve cannot be recovered.
Nerve Decompression
Freeing a nerve from the tissue that is pinching it at points of compression along the arm.
Neuroma Treatment
Addressing a painful nerve thickening that can form after an injury or amputation.
Risks and benefits of any procedure should be discussed in detail with your treating physician. Non-operative treatment also carries risks and benefits.
Common Questions
Nerve Surgery FAQs
What is a compressed nerve?+
A nerve is like a cable carrying signals between the hand and the spinal cord. When it passes through a narrow tunnel or around a tight structure, that structure can press on the nerve. Pressure interferes with the signals it carries, which produces numbness, tingling, weakness or pain in whatever the nerve supplies.
What is the difference between carpal tunnel and cubital tunnel syndrome?+
They are different nerves compressed in different places. Carpal tunnel syndrome involves the median nerve at the wrist and typically affects the thumb, index, middle and part of the ring finger. Cubital tunnel syndrome involves the ulnar nerve at the inside of the elbow and typically affects the ring and small fingers. Because the two conditions produce different patterns of numbness, the distribution of your symptoms is one of the most useful clues.
Does a compressed nerve always need surgery?+
No. Many patients improve with non-operative measures such as night splinting, activity modification, therapy and — in some cases — cortisone injection. Surgery is generally considered when symptoms persist despite these approaches, when there is progressive weakness or muscle wasting, or when nerve testing shows significant compression.
What does nerve testing involve?+
Electromyography and nerve conduction studies (EMG/NCS) measure how well a nerve conducts signals and whether the muscles it supplies are affected. Testing can confirm the diagnosis, localize where the compression is occurring and establish a baseline for comparison over time. Your physician will discuss whether testing is appropriate for your situation.
Why does timing matter with nerve problems?+
Nerves can often recover from compression if pressure is relieved before permanent damage occurs. Once a nerve has been compressed long enough to cause muscle wasting, that muscle does not always return even after the pressure is removed. That is why progressive weakness or wasting is taken seriously rather than watched indefinitely.
What are the risks of nerve surgery?+
Risks include infection, bleeding, scarring, persistent numbness or tingling, injury to surrounding structures, and the possibility that sensation or strength does not fully return. Some soreness at the site of the decompression is common during recovery. Outcomes after surgery vary, and risks and benefits should be discussed in detail with your treating physician.
Numbness That Keeps Coming Back?
Tingling fingers, weakness in your grip or hands that wake you at night are worth evaluating. An examination can determine whether a nerve is being compressed — and what to do about it.