Peripheral Nerve Decompression Surgery in Gainesville and Atlanta

Freeing Trapped Nerves in the Arms and Legs

Numbness, tingling, burning or weakness in an arm or leg can make everyday tasks harder and keep you up at night. When a nerve is trapped along its path, peripheral nerve decompression can often correct the problem by freeing the nerve so it can heal.

What Is Peripheral Nerve Decompression?

Peripheral nerves travel from the spinal cord to the arms and legs. Along the way, they pass through narrow tunnels of bone, ligament and muscle where they can be squeezed, a problem called nerve entrapment or compression neuropathy. Peripheral nerve decompression is surgery to release the tissue pressing on the nerve.

Illustration of the median nerve running through the forearm and hand — Image: www.scientificanimations.com, CC BY-SA 4.0 (source)

Common nerve entrapments include:

Carpal tunnel syndrome: the median nerve at the wrist. See carpal tunnel release.
Cubital tunnel syndrome: the ulnar nerve at the elbow. See cubital tunnel release.
Peroneal nerve compression: the nerve at the outside of the knee, which can cause foot drop. See peroneal nerve decompression.
Meralgia paresthetica: the lateral femoral cutaneous nerve near the hip, causing burning and numbness on the outer thigh

Radial tunnel and posterior interosseous nerve (PIN) syndrome, where the radial nerve is trapped near the elbow, can usually be managed without surgery. When surgery is needed, Dr. Grunch refers these patients to an upper extremity specialist.

Diagram of the ulnar nerve in the arm showing where it can be trapped at the elbow and wrist — Image: Mangi, Zadow and Lim, CC BY 4.0 (source)

Who Needs Peripheral Nerve Decompression?

Numbness, tingling, burning pain or weakness in the area supplied by a single nerve
Symptoms that haven’t improved with splinting, activity changes, therapy or injections
Muscle weakness or wasting
Nerve testing or imaging confirming that a nerve is trapped

Treatments to Try First

Avoiding pressure and positions: that squeeze or stretch the nerve
Splints and braces: to rest the area, especially at night
Medications and injections: anti-inflammatory medicines, nerve pain medications and steroid injections
Physical or occupational therapy: including nerve gliding exercises

When symptoms persist or the nerve is losing function, surgery can often correct the problem.

How Peripheral Nerve Decompression Is Done

Testing: Nerve conduction studies and EMG, and sometimes ultrasound or MRI, pinpoint where the nerve is trapped.
Anesthesia: Most procedures are outpatient, with numbing medicine and sedation or general anesthesia.
Releasing the nerve: Through a small incision, the ligament, fascia or muscle band compressing the nerve is opened, protecting the nerve and its branches.
Closing: The incision is closed and a dressing is applied.

Watch Dr. Grunch explain meralgia paresthetica:

Video: Case Study 114, Meralgia Paresthetica, presented by Dr. Grunch on her Ladyspinedoc channel (YouTube)

Benefits and Risks

Benefits

Relieves numbness, tingling and nerve pain
Can stop weakness from progressing and help strength return
Most procedures are same-day outpatient surgeries

Risks

Numbness or tenderness near the incision
Infection or bleeding
Injury to the nerve or its branches, which is rare
Symptoms that don’t fully resolve, especially with long-standing compression
Risks related to anesthesia

Why Choose Dr. Betsy Grunch for Your Nerve Decompression

Duke-trained: Dr. Grunch completed her neurosurgical residency at Duke University School of Medicine, one of the top neurosurgery programs in the country.
A nerve specialist: Neurosurgeons are trained in the entire nervous system, from the brain and spine to the nerves in the arms and legs. Dr. Grunch can tell whether your symptoms come from a pinched nerve in the neck or back or from a trapped nerve in the limb, so the right problem gets treated.
Experience you can count on: She has been in practice since 2013 and performs 400 to 600 surgeries a year, more than 5,000 procedures over her career.
A teacher at heart: As “Ladyspinedoc,” she is known for explaining nerve and spine conditions clearly. You’ll leave your visit understanding your diagnosis and every option in front of you.

What to Expect

Before surgery

You’ll meet with Dr. Grunch or one of her physician assistants to review your symptoms, exam and nerve testing, and to decide together whether nerve decompression is right for you. Our team will review your medications (including blood thinners you may need to pause) and walk you through the day of surgery. You’ll usually have nerve testing to confirm exactly where the nerve is trapped.

Procedure day

Most nerve decompressions take less than an hour, and you go home the same day.

Recovery timeline

First days: Keep the arm or leg raised to limit swelling.
Two weeks: Follow-up visit and removal of any stitches.
Four to six weeks: Most people return to normal activities.
Months: Nerves heal slowly, about an inch a month. Numbness and strength can keep improving for up to a year.

Caring for yourself at home

Your incision: Remove the dressing on day three and leave the stitches in place. You may shower starting day three. Gently clean the incision and pat it dry without scrubbing. Leave it open to air, and don’t use ointments or creams. A small amount of brownish-red drainage for a few days is normal.
No soaking: Don’t soak the incision in a bath, hot tub or pool for six weeks and until any scabs are gone.
Swelling: For the first few days, raise your arm or leg above the level of your heart for about 30 minutes every two to three hours.
Activity: Limit heavy use of the operated arm or leg for about four to six weeks. Protect the incision from bumping or rubbing on hard surfaces.
Medications: Take pain medication with food and avoid alcohol while taking it. Most people need it for up to two weeks. Take a daily stool softener and a laxative as needed. Don’t take blood thinners such as aspirin, warfarin, Xarelto or Plavix for five to seven days after surgery, until the office tells you to restart them.
Driving: You may drive once you’re no longer taking narcotic pain medication. Riding as a passenger is fine.
Smoking: Smoking slows healing. Our office can help if you’d like to quit.
Follow-up: Your visit is about two weeks after surgery, when any stitches are removed. If you can’t work during recovery, our office can complete employer paperwork.

Call the office at 470-293-9800 if you have a fever over 101°F, redness, warmth or significant drainage from the incision, new weakness or numbness that wasn’t there before surgery, calf pain or swelling, or constipation that medication doesn’t relieve. Call 911 for chest pain or shortness of breath.

Download your patient instructions

Print these sheets or save them to your phone so you have them before and after surgery:

You’ll find instructions for other procedures on our Patient Resources page.

Frequently Asked Questions

How do I know if my nerve is trapped in my arm or pinched in my neck or back?

The pattern of symptoms, a careful exam and nerve testing tell them apart. Sometimes both are present, called a “double crush.”

How long does nerve recovery take?

Tingling and pain often improve first. Numbness and strength can take months to recover, because nerves regrow slowly.

Is nerve decompression an outpatient surgery?

Usually, yes. Most people go home the same day.

Can a trapped nerve heal without surgery?

Mild compression often improves with splints, activity changes and therapy. Surgery is considered when symptoms persist or weakness develops.

Will my symptoms come back?

Recurrence is uncommon after a complete release, but it can happen.

Take the Next Step

If numbness, tingling or weakness in your arms or legs is affecting your daily life, you don’t have to live with it. Whether you need a diagnosis, a treatment plan or a second opinion, Dr. Grunch and the Southern Neurosurgery team are here to help you understand your options.

Call 470-293-9800 to schedule an appointment or contact us online.

Have a question first? Ask our virtual assistant anything, 24/7.

We see patients across metro Atlanta and North Georgia at our offices in Gainesville, Sandy Springs and South Atlanta (Riverdale). Find the office nearest you.

This page is for educational purposes only and is not medical advice. It does not replace individualized care from a licensed physician. If you have sudden weakness, numbness or loss of function, call 911 or go to the nearest emergency room.