Nerve Damage

Nerves are the wires that allow the brain to communicate with the body. When you feel a sensation, it is your nerves telling communicating to your brain what you are feeling. Once damaged, injury stops nerves from getting sent signals from your brain, telling them to experience sensations, meaning that your injured nerves and your brain have stopped communicating. Nerve damage can occur as a result of an injury or underlying medical condition. It can primarily occur in your arms, feet and hands, however, it can also occur in other areas of the body. Common instances of injury can occur when the finger, hand or wrist is injured, such as being over stretched, burned, crushed, cut or too much pressure is applied. Car accidents, work-related injuries and falls are common causes of nerve damage. Whilst some nerves can heal themselves, severe trauma to nerves can permanently damage them, sometimes resulting in a loss of hand movement.

The symptoms of nerve damage range from minor to severe, such as numbness, difficulty moving the hand or wrist, a burning sensation, pain, loss of movement in the hand or wrist, twitching and weakness.

The Consultation

In your consultation with Dr. Laniewski, your nerve injury will be assessed, as well as your medical history. The severity of the nerve damage will need to be determined, and therefore, you will need to either have a physical examination, an electromyography (EMG) or magnetic resonance imaging (MRI). A physical examination is how most nerve injuries can be diagnosed as symptoms, and the physical exam will provide enough evidence of nerve damage. An EMG is a test that records nerve activity: the lower the activity, the higher the chance of nerve injury. An MRI is a test that creates images of the structure of the hand, which can then be examined further for signs of damage.

Nerve Damage Treatments

Treatment for nerve injuries differs based on the severity of the damage. Dr. Laniewski will tailor a treatment plan for your specific case. Mild damage can lead to nerves repairing themselves whereas severe damage can take weeks or months to heal. The key forms of treatment are pain relief medicines, rest of the hand/wrist, immobilisation of the hand/wrist and surgery. Surgery is usually recommended for severe cases, which involves the nerves being sewn together to support healing and to restore some control to the hand. There are four possible surgery options for hand nerve repair: an end-to-end closure, nerve transfer of an intact nerve to the torn nerve, nerve graft where an intact nerve is transplanted and vascularised nerve graft, which is done when there is no local blood supply, to the nerve. Nerve surgeries are done under local or general anaesthesia and can sometimes even be done as wide awake hand surgery (WALANT) so the surgeon can operate whilst the patient is awake.

Depending on the severity of the trauma, physical therapy can be suggested to aid the healing process and improve the mobility of the hand/wrist.


The recovery process for nerve trauma is between six to 12 months with surgery. You will need to start hand therapy to aid in your rehabilitation. After your surgery, your hand will be placed in a protective splint to protect the nerve repair and aid in the recovery process. The lack of hand movement and motor function will be focused on during hand therapy to ensure your hand regains its function again. To reduce pain and swelling, it is recommended that you elevate your hand after the surgery. To help your hands to heal sufficiently, you will need to prioritise wound care and take medication which your doctor will prescribe post-surgery. Dr. Laniewski will address your recovery plan further in your consultation.

Who is Eligible for Surgery?

Some hand nerve damage can heal by itself, but depending on the severity of the trauma, nerve damage can only be fixed with surgery. Dr Laniewski will examine you before deciding whether you require hand surgery. Factors such as the location of the injury on the hand, presence of symptoms such as numbness, pins and needles and weakness will all determine the likelihood for surgery. Often there is also tendon damage which will also requires surgery.

Are There Risks to Surgery?

All surgeries come with risks, and repairing nerve damage is no different. Possible complications include:

  • Bleeding after surgery, which will result in a second immediate surgery.
  • Minimal or no improvement.
  • Infection signs such as redness, swelling, pain and purulent discharge. Despite having antibiotics before and occasionally after the surgery, you will be monitored to make sure there is no infection. If infection occurs, antibiotics are the first solution, however, if it doesn’t improve, a secondary surgery will be needed immediately to clean out the infection.
  • Delayed wound healing. This is treated by applying specific dressings to protect the hand from any further trauma.
  • Scarring, which may be minimised with frequent massaging and moisturising of the hand.
  • Stiffness of the hand, which usually occurs when the hand is immobilised after surgery. Exercising the hand may help to avoid stiffness and allow your hand to regain movement.
  • Complex regional pain syndrome. This is for those who have sensitive hands that may be more at risk when faced with surgery or trauma. Pain relief and hand therapy can help to treat complex regional pain syndrome.


Can both hands be operated on at the same time?

This will vary depending on your case. If both of your hands have nerve damage, we suggest booking an appointment with Dr. Laniewski to discuss your options further.

What diet should I follow post-surgery?

It is recommended that you ease yourself into your regular diet post-surgery by beginning with liquids and light food first until you can stomach them easily.

Can I drive post-surgery?

Post-surgery, you will need to be driven home by a friend or family member to allow your hand to heal. Depending on the positioning of the nerve damage, it can be recommended to avoid driving for one to two weeks after the surgery.