Understanding the procedure
Neurectomy removes part of a nerve, sometimes including a painful neuroma: a disorganised growth of nerve fibres after injury. It is not a general solution for all neuropathic pain. The remaining nerve end needs a considered management plan.
When might it be considered?
- Localised pain associated with an injured sensory nerve or neuroma.
- Persistent symptoms despite appropriate non-operative treatment.
- A sufficiently clear pain source to justify the expected sensory or functional trade-off.
Specialist assessment
Assessment maps pain and sensation and examines the scar and nerve. Imaging and a diagnostic local anaesthetic block may help, but a temporary response does not guarantee surgical success. Other pain mechanisms are considered with pain specialists where appropriate.
Treatment & recovery
Options may include nerve preservation, reconstruction, excision with management of the nerve end, or selected reinnervation techniques. Removing a sensory nerve causes numbness; sacrificing a motor component risks weakness. Pain may persist, recur or worsen, and a new neuroma can form.
Common questions
Does cutting out the nerve guarantee pain relief?
No. Pain can have more than one mechanism, and the remaining nerve end may become painful again.
Will the area become numb?
Loss of sensation is expected in the territory of a sensory nerve that is removed. The extent and practical implications should be discussed before surgery.
General patient information from London Nerve Injury. Decisions about investigations and treatment require an individual clinical assessment.