NERVE INJURY TREATMENT

Nerves play a vital role in connecting our body to the brain and spinal cord, transmitting electrical impulses that allow us to feel sensations, move muscles, and respond to our environment. However, when these delicate structures are damaged, it can result in serious conditions affecting the function of the muscles, sensations, and overall nervous system. Nerve injuries, such as peripheral nerve damage, can occur from various causes, including trauma, disease, or surgical complications, leading to symptoms like numbness, paralysis, and nerve pain.

At The Nerve Surgery Centre, our focus is on providing expert nerve injury treatment to restore function and improve quality of life. Our highly experienced surgeon, Mr. Tomas Madura, specialises in diagnosing and treating all types of peripheral nerve injuries. Whether the nerve damage is caused by trauma, such as a cut or tear, or from conditions affecting the nervous system, our clinic offers advanced treatments designed to support nerve regeneration and recovery. Through state-of-the-art nerve surgery and therapies tailored to each patient’s condition, we aim to achieve the best possible outcomes.

For those seeking relief from nerve pain and the debilitating effects of injured nerves, our peripheral nerve specialist works closely with patients to develop a personalised treatment plan. From non-surgical options such as physiotherapy to more complex procedures like nerve transfer or nerve grafts, we are committed to helping you regain muscle function and return to your normal activities.

To learn more about our nerve injury treatment, visit our nerve surgery page or meet our peripheral nerve specialist for more information.

Nerves are wire-like structures found throughout our body. Their main function is connecting parts of our body with the spinal cord and brain, by transmitting very small electric impulses. This allows us to feel and move parts of our body. The nerves also transmit pain impulses as a warning of an impending danger to the tissues and organs. The nerves are very fragile and are easily damaged. When a nerve is injured, it loses its ability to transmit electric signals and the affected area becomes paralysed with a loss of feeling and muscle power.

Following are examples of common nerve injuries and their mechanisms:

Nerve laceration (cut)
Glass cut in the forearm and hand (injured nerves are median, ulnar, radial nerves and nerves in fingers).

Nerve injury caused by a bone fracture
Radial nerve injury after fracture of humerus (the long bone of the upper arm) resulting in wrist drop and inability to straighten fingers.

Nerve tear caused by a joint dislocation
Dislocation of the knee with damage to the nerve responsible for lifting up the foot (foot drop after peroneal nerve injury) or dislocation of the shoulder with damage to the nerve responsible for lifting up the arm (axillary nerve).

Nerve damage during a surgical procedure for another problem
Nerve damage after knee surgery (saphenous nerve) or ankle surgery (peroneal or tibial nerve).

Stretching of the nerve
A fall from a motorbike on a shoulder, where the shoulder and head are pushed in opposite directions, causing tears to nerves in the base of the neck (brachial plexus injuries).

Electrical injury
Injury to the nerve supplying the hand after contact with a source of electric current.

Amputation
Pain in the stump after an amputation (amputation of a finger, hand, or a major amputation in the upper or lower limb). Read more about residual limb pain here.

There are several signs of nerve injuries to look for:

Pain
Nerve injuries are often associated with severe, unrelenting pain, which is often spontaneous (present without any stimulation). This type of pain is called neuropathic pain and is of a specific nature, typically described as:

• Shooting
• Burning
• Stabbing
• Electric shock-like pain

Also common is pain brought on by normally non-painful stimuli, such as cold (cold intolerance pain) or a gentle touch or pressure on the skin (allodynia). Patients can sometimes localise the site of the nerve damage and identify a well-defined point where a touch brings on the pain. The severity of pain may be such that it disturbs sleep, prevents doing daily activities, and causes low mood and depression.

Loss or Reduction in Feeling
When the nerve is damaged, the specific area on the skin, which the injured nerve connects with the brain, feels numb, or the sensation is reduced. The quality of the sensation is also altered, described as tingling, numbness, or a “pins and needles” feeling.

Total or Partial Paralysis of Muscles
When the nerve is damaged, the brain cannot control the muscles supplied by the nerve, and a complete or partial paralysis ensues, with the inability to move the affected parts of the body.

Nerve injuries can occur in many forms, and understanding their causes and impact on muscle function is key to effective nerve injury treatment. Nerves play an essential role in transmitting signals from the brain to different parts of the body, allowing for movement and sensation. When nerve damage occurs, whether due to trauma, disease, or surgical complications, the nervous system can be severely impacted, leading to numbness, pain, or loss of muscle function.

The severity of a nerve injury largely depends on the type of injury. Peripheral nerve injuries, for example, can range from mild compression to complete severing of the nerves. Common causes of nerve injuries include fractures, joint dislocations, or even pressure from repetitive movements. Other conditions, such as diabetes or autoimmune diseases, can also affect the health of the nervous system.

When nerves are injured, the affected area may lose sensation, experience nerve pain, or become partially or completely paralyzed. Injured nerves may also struggle to regenerate without proper care, and the muscles they control can weaken or atrophy. Effective nerve injury treatment often involves a combination of therapy, rest, and sometimes surgery to help restore function.

At our clinic, we specialise in treating all types of nerve injuries. Our approach involves diagnosing the extent of nerve damage, determining the causes, and providing targeted treatments to aid in recovery. Whether through nerve surgery, physiotherapy, or advanced nerve regeneration techniques, we aim to improve your overall health and return to normal function. Muscle rehabilitation is also an important aspect of our treatment plan, helping patients regain strength and mobility.

Patients with peripheral nerve injury should seek medical attention promptly to prevent further deterioration. Early intervention, such as those provided at leading centres, can significantly improve outcomes. Each nerve injury is unique, and our team tailors each treatment to the individual’s specific symptoms and needs to achieve the best possible results.

To book your initial consultation with us simply click here email info@nervesurgery.uk or call 07340 651908

The diagnosis is established by a combination of:

• History of the injury
• Physical examination
• Special investigations (nerve conduction studies, electromyography, ultrasound, and MRI imaging)

During the consultation, we firstly obtain circumstances of the onset of the problem, the mechanism of injury, and any past and current treatments. Particular attention is paid to identifying the presence of neuropathic pain. Special questionnaires may be used to determine the nature of the pain and quantify its intensity.

This is followed by a comprehensive physical examination of sensation and movement, leading towards the localisation of the nerve injury.

Finally, nerve injuries often require neurophysiological tests (electromyography and nerve conduction studies). These can measure the ability of the nerve to transmit electrical impulses. To further define the injury, specialised imaging of the nerves by ultrasound or magnetic resonance imaging (MRI) may need to be carried out.

In cases where the localisation of the nerve damage is particularly challenging, we may use local anaesthetic blocks. These are targeted injections of local anaesthetic, often done under ultrasound control, that aim to numb the damaged nerve and assess the degree of pain reduction after injection.

Effective nerve injury treatment is essential for restoring function and supporting the recovery of damaged nerves. After a thorough diagnosis has been made, which involves a combination of medical history, physical examination, and specialised tests, a bespoke treatment plan is formulated. The approach depends on the severity of the nerve injury, its location, and how much time has passed since the injury occurred. Early intervention is crucial in preventing long-term complications like nerve pain, numbness, or loss of muscle control.

For less severe nerve injuries, where the nerve has not been fully severed, non-surgical treatment options may be used. These may include:

• Physiotherapy to help restore movement and prevent joint stiffness
• Splinting to support the injured area and prevent joint stiffness
• Pain control to manage discomfort associated with the injury

In more serious cases, where the nerve has been completely divided or the damage is extensive, surgical intervention is necessary. Surgery may also be required for injuries that did not respond to conservative treatment.

During surgery, the injured nerves are explored to assess the extent of the damage. Depending on the findings, various techniques can be used to treat the nerve injury:

• Direct nerve repair: The two ends of the severed nerve are brought together and microsurgically reconnected.
• Nerve graft: If part of the nerve has been irreparably damaged, it is removed, and a nerve graft is used to bridge the gap. The graft is typically taken from another expendable nerve in the body.
• Nerve allograft: In some cases, a nerve allograft from a deceased donor is used to bridge a gap in the nerve, providing a scaffold for regeneration.
• Nerve transfer: To restore function more quickly, a healthy nerve near the site of the injury can be rerouted to take over the role of the damaged nerve. This approach, while effective, may result in the loss of function in the donor muscle.

Post-surgery, the recovery process involves continued therapy, pain management, and tailored physiotherapy. Splinting may also be used to support healing. The goal of nerve injury treatment is to promote the best possible recovery of sensation and muscle function, but the success depends on the severity of the nerve damage and how soon the injury is treated.

It is critical to seek prompt treatment for nerve injuries. Delayed care can worsen outcomes and lead to permanent numbness, loss of muscle function, and chronic pain. At our clinic, we provide expert care in peripheral nerve injury and nerve surgery, ensuring that each patient receives the most effective and appropriate treatments for their condition.

To book your initial consultation with us simply click here email info@nervesurgery.uk or call 07340 651908

For severe nerve injuries, microsurgical nerve repair is often necessary to restore function. This intricate procedure is designed to reconnect damaged nerves with extreme precision, helping to regain movement and sensation in the affected area. Two critical steps are involved in this advanced technique:

1. Trimming and Aligning Individual Fascicles of the Nerve
   Fascicles are small bundles of nerve fibres that carry signals between the brain and various parts of the body. In microsurgical nerve repair, these fascicles are carefully trimmed to remove any damaged or scarred tissue. This ensures a clean, healthy surface that can be reconnected. Once trimmed, the fascicles are meticulously lined up so that the correct pathways are restored, allowing electrical impulses to travel through the nervous system effectively. Proper alignment is essential for achieving optimal healing and restoring nerve function.
2. Suturing the Nerve EndingsThe second key step involves suturing the nerve endings by repairing the epineurium, which is the protective outer layer of the nerve. Using microsurgical tools, the nerve endings are brought together and the epineurium is then carefully sewn together to protect the internal structures and support the regeneration of the nerve. This process not only ensures that the nerve repair is structurally sound but also promotes the growth of new nerve fibres, allowing the injured nerve to recover its ability to transmit signals.

These steps are crucial for the successful recovery of nerve injuries and are part of the advanced treatments offered for complex nerve damage. By employing these precise techniques, microsurgical nerve repair aims to restore muscle function, reduce nerve pain, and improve overall recovery for patients.

Nerves are notoriously slow to heal. In the mildest grade of nerve injury, where the nerve is fully in continuity, function is likely to return within 3 or 4 months. In injuries where the nerve was completely divided, the return of function is unlikely to achieve pre-injury state, and it may take up to two years to see the final outcome. The pain associated with the nerve injuries should be cured or significantly reduced by the treatment, but may persist as a chronic condition, requiring further treatment with medications or surgery.

Discussion with Mr Tomas Madura is important to answer any questions that you may have. Please contact us for more information about any specific conditions not featured on the website.

The recovery process after a nerve injury varies depending on the severity of the nerve damage, the type of injury, and how promptly treatment was received. Nerves regenerate very slowly, often taking several months to years to fully recover. Here’s what you can expect during the recovery process:

In cases where the nerve is still intact but has been compressed or mildly injured, recovery may take a few weeks to months. Non-surgical treatments, such as physiotherapy, pain management, and splinting, help support muscle function and improve outcomes. As the nerve heals, patients may notice a gradual return of sensation, movement, and a reduction in pain.

For more severe nerve injuries, such as those requiring microsurgical nerve repair, nerve grafting, or nerve transfer, the recovery process can be much longer, often taking up to two years. After surgery, the nerve will slowly regenerate, with new nerve fibres growing along the repaired pathway. Patients may experience stages of partial sensation and muscle control returning over time. It’s important to engage in regular physiotherapy and follow-up care to support healing.

Throughout the recovery period, patients may experience nerve pain, tingling, or numbness, which can be managed with medications or specialised therapies. Consistent monitoring by your doctor or nerve specialist is essential to track progress and adjust the treatment plan as necessary. In some cases, the outcome may not fully restore pre-injury function, but advanced nerve injury treatments aim to maximise the recovery potential and improve quality of life.

Patience and ongoing care are key to a successful nerve injury recovery.

At our clinic, we are dedicated to providing exceptional care and personalised nerve injury treatment for all types of nerve injuries. Our highly skilled surgeon, Mr. Tomas Madura, specialises in advanced peripheral nerve surgery and has extensive experience in treating complex nerve damage cases. We offer a comprehensive approach to nerve injury repair, combining state-of-the-art surgical techniques with cutting-edge therapies to ensure the best possible outcomes for our patients.

Here are a few reasons to choose us for your nerve injury treatment:

• Expertise in Advanced Nerve Surgery: Our clinic is led by Mr. Tomas Madura, a renowned specialist in microsurgical nerve repair and complex nerve transfer techniques. His extensive experience ensures that each patient receives the most advanced and appropriate treatment for their unique condition.
• Personalised Treatment Plans: We understand that every nerve injury is different. That’s why we tailor each treatment plan to the individual needs of our patients, considering factors like the severity of the injury, its location, and the time since it occurred.
• Comprehensive Care: From the initial consultation to post-operative care and recovery, we provide a seamless, patient-centred approach. Our focus is on restoring function and improving quality of life, with a commitment to long-term support during the recovery process.
• Multidisciplinary Approach: Our clinic works closely with a team of experts, including physiotherapists and pain specialists, to provide holistic care for each patient. This ensures that every aspect of your nerve injury is addressed, from pain management to muscle rehabilitation.
• No Waiting Lists: We understand the urgency of nerve injury treatment and strive to offer timely care. Our clinic is designed to provide fast access to consultations, surgery, and follow-up appointments, ensuring you get the help you need without delay.

Choosing our clinic means placing your trust in a team committed to delivering exceptional nerve injury treatment and personalised care. We are here to guide you through every step of your journey towards recovery and the restoration of your health and function.

To book your initial consultation with us simply click here email info@nervesurgery.uk or call 07340 651908

How to repair damaged nerves naturally?

While severe nerve injuries often require medical intervention, some natural approaches may support nerve healing. Maintaining a healthy diet rich in vitamins B, C, and E, staying physically active with gentle exercises may promote nerve regeneration. However, always consult with a doctor for personalised advice.

What are the first signs of nerve damage?

Early signs of nerve damage can include numbness, tingling, a “pins and needles” sensation, or sharp, shooting pains. Muscle weakness or an inability to control certain movements can also be indicators. If you experience these symptoms, seek medical attention for a proper diagnosis and treatment.

What are the 3 types of nerve injury?

The three types of nerve injuries are:

1. Neurapraxia: A mild injury where the nerve is compressed but not cut, usually resulting in temporary loss of function.
2. Axonotmesis: A more severe injury where the nerve fibres (axons) are damaged, but the outer structure remains intact.
3. Neurotmesis: The most severe nerve injury, where the nerve is completely severed, often requiring surgical repair.

Can vitamins help with nerve damage?

Yes, certain vitamins, especially B vitamins, are known to support nerve health and regeneration. Vitamin B12 and B6 are particularly important in nerve repair, while vitamins C and E act as antioxidants that can help reduce inflammation and promote healing. Always consult with a doctor before starting any supplements.

What are the symptoms of nerve damage in the leg?

Nerve damage in the leg may cause numbness, tingling, burning sensations, or sharp pain. Muscle weakness, difficulty walking, or reduced reflexes are also common symptoms. If you notice these signs, it’s important to seek prompt medical care.

What are the signs of nerve healing?

As nerves begin to heal, you may notice a gradual return of sensation and motor function. Tingling, itching, or slight discomfort in the affected area may also be signs that the nerve is regenerating. While nerve healing is slow, consistent progress can signal positive recovery.

What is the best treatment for damaged nerves?

The best treatment for damaged nerves depends on the severity and cause of the nerve injury. Non-surgical options include physical therapy, splinting, and pain management. For more serious injuries, microsurgical nerve repair, nerve grafting, or nerve transfer may be necessary to restore function.

What are the symptoms of a traumatized nerve?

A traumatized nerve can cause a variety of symptoms, including sharp pain, numbness, tingling, and a burning sensation. Muscle weakness or paralysis in the affected area may also occur. These symptoms can be severe and require immediate medical attention.

Can damaged nerves regenerate?

Yes, damaged nerves can regenerate, but the process is slow and depends on the severity of the nerve injury. In mild cases, nerves may recover naturally over time. For more serious injuries, surgery may be required to repair the nerve with the recovery lasting months to years and only rarely reaching pre-injury level of sensation and muscle power.

How long does it take for a nerve injury to heal?

Nerve injuries heal very slowly, typically at a rate of 1 millimetre per day. Mild injuries may take several months to recover, while severe nerve damage requiring surgical intervention can take up to two years for complete healing. The recovery time varies depending on the location and severity of the injury. In severe injuries it is very common that the final outcome is not a complete return of function.

Mr Tomas Madura MD(Hons), PhD, FRCS(Plast), is a highly experienced Consultant Plastic Surgeon specialising in hand and peripheral nerve surgery, with over two decades in the medical field. He has been a Consultant at the Birmingham Hand Centre and Brachial Plexus and Peripheral Nerve Injury Service at the Queen Elizabeth Hospital in Birmingham since 2017. Mr Madura’s distinguished career includes a PhD in Neurobiology from Osaka University, multiple fellowships in reconstructive microsurgery and peripheral nerve surgery, and numerous contributions to research in the field of nerve injuries and paralysis.

He is a Fellow of the Royal College of Surgeons of Edinburgh and a full member of several prestigious organisations, including the British Association of Plastic Reconstructive and Aesthetic Surgeons and the British Society for Surgery of the Hand. Mr Madura has been recognised with the Syme Medal for outstanding contributions to surgical research.

For more information, please visit his About page.

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