Peripheral Nerve Surgery Program

About the Program

The Peripheral Nerve Surgery Program in the Department of Plastic and Reconstructive Surgery at Massachusetts General Hospital comprises a team that provides innovative surgical and non-surgical treatments for the full spectrum of nerve problems including peripheral

• Nerve compression
• Nerve injuries
• Neuromas (painful nerves)
• Other peripheral nerve disorders

We collaborate with many other specialties at Mass General to provide comprehensive care to our patients. Our patients travel from the Boston area, New England region and across the United States to receive specialized care with peripheral nerve disorders.

Comprehensive Treatment Options

At Mass General, we have comprehensive treatment for many nerve problems, including:

• Amputation pain: phantom limb pain
• Brachial plexus injury in shoulder or neck resulting in arm weakness or paralysis
• Carpal tunnel syndrome: the median nerve is compressed as it passes through an opening from the wrist to the hand
• Cubital tunnel syndrome: the nerve located on the inside of the elbow (ulnar nerve) is injured, inflamed, swollen or irritated
• Diabetic neuropathy resulting in numbness or nerve pain
• Exercise-induced nerve pain or numbness
• Groin pain after hernia repair
• Nerve pain after surgery
• Nerve pain after trauma
• Neuromas: disorganized growth of nerve cells at the site of a nerve injury resulting in pain
• Numbness, tingling or burning sensations related to nerve compression
• Piriformis syndrome: sciatic nerve pain resulting from compression of the nerve (pirifomis) in the buttock region
• Radial tunnel syndrome: condition that is caused by compression of the radial nerve near the elbow. Can cause pain near the outside of the elbow (lateral epicondyle) and back of the forearm (dorsal forearm)
• Thoracic outlet syndrome: uncommon disorder caused by pressure on the nerves in the shoulder and neck (brachial plexus) or on the blood vessels just behind the collarbone

Non-Surgical Treatment Options

There are many patients for whom non-surgical techniques such as splinting, diagnostic and therapeutic injections, and occupational/physical therapy may be effective.

For patients who are candidates for operative treatment, this may involve:

• Nerve release/decompression: to free the part of the nerve that is compressed (such as carpal tunnel syndrome)
• Nerve repair and/or nerve grafting: for injured nerves
• Nerve transfers and targeted reinnervation: transferring nerve signaling to be more useful and less painful
• Neurectomy: removal of a painful nerve ending in order to move this to a new position (and improve nerve pain)

Our Approach to Care

Our team treats a wide range of patients, including those who have experienced long-term, chronic symptoms and have been evaluated by other providers.

During your consultation, our surgeons will review your history including the beginning of your symptoms, prior treatments and goals for care. During this visit, previous imaging will be reviewed, and in-office ultrasound may be performed to further evaluate the anatomy of your nerve problem. Our team will discuss your treatment options, including both surgical and non-surgical treatments.

If surgery is indicated, it is commonly performed on an outpatient basis. Complex cases sometimes require a brief hospital stay. Recovery for peripheral nerve problems is often gradual and occurs over time, with slow, progressive improvement over months to years after surgery. Physical and/or occupational therapy are often required for improvement in range of motion and strength.

Research

Our providers perform innovative research with leading-edge technology, in an effort to move the field of peripheral nerve surgery forward and improve outcomes for our patients.