What is a neuroma?
A disorganized growth of nerve fibers and scar tissue after nerve injury.
An injury-related neuroma is not cancer. It may cause electric, burning, or touch-sensitive pain, although some neuromas cause no symptoms.
Hand, Wrist & Upper Extremity
Neuroma Excision / Reconstruction – Upper Extremity
Upper-extremity neuroma excision and reconstruction removes painful nerve scar tissue and addresses the affected nerve to relieve symptoms and support function.
Does removal restore feeling?
Not necessarily. Pain relief and restored sensation are separate goals.
Reconstruction may give nerve fibers a pathway to grow, but recovery depends on the injury, the nerve involved, and whether a usable connection remains.
Is surgery always needed?
No. Treatment depends on symptoms and examination findings.
Therapy, desensitization, medication, or selected injections may be considered before surgery.
01 · Overview
Understanding a painful nerve injury
After a nerve is cut or damaged, its fibers try to regrow. When they cannot follow an organized pathway, a sensitive lump of nerve and scar tissue may develop. A neuroma can form at a severed nerve end or within a nerve that remains partly connected. [1]
Excision removes the painful segment, but the plan must also address the remaining nerve. Depending on the anatomy, the surgeon may reconnect healthy ends, bridge a gap, or give a disconnected nerve end a protected location or new target. [1]
This is different from carpal tunnel release, which relieves pressure on a nerve, and from removing a ganglion cyst. Pain alone does not confirm a neuroma; examination and sometimes imaging, nerve testing, or a diagnostic injection help guide treatment. [1]
- Treatment area
- Injured nerves in the fingers, hand, wrist, or arm
- Main goal
- Reduce nerve-related pain while preserving useful function
- Anesthesia
- Local, regional, or general anesthesia, depending on the repair
- Recovery
- Wound healing takes weeks; nerve recovery may take months or longer
How does the surgeon identify the source of pain?
The surgeon maps tenderness, sensation, and strength and reviews the original injury and any prior operations. Ultrasound or other imaging may help locate a nerve abnormality. Nerve studies can assess certain injuries, but small finger nerves may not be well evaluated by these tests.
Why does a partly connected nerve need special consideration?
Some fibers may still carry useful sensation or movement. Removing the entire scarred segment could sacrifice that function. The surgeon weighs preservation, selective treatment, and reconstruction against the chance of improving pain.
02 · Concerns & Goals
What may bring you to a consultation
Pain after a cut, surgery, or other nerve injury can affect everyday hand use. An evaluation helps determine whether a neuroma is responsible.
Electric or burning pain
A small area may trigger shocks or pain that travels along the nerve, especially when touched or bumped.
Sensitivity during daily tasks
Clothing, tools, typing, or gripping may become uncomfortable when they press on the injured area.
Numbness or altered feeling
The skin beyond the injury may feel numb, unusually sensitive, or different from the surrounding skin.
Limited hand use
Pain, weakness, or fear of triggering symptoms may interfere with work, sleep, hobbies, or rehabilitation.
03 · Options
How the approaches differ
The best approach depends on whether the nerve still functions, whether both healthy ends are available, and what would be lost by removing the neuroma.
Excision with direct nerve repair
Remove the damaged segment and reconnect healthy nerve ends.
How it worksThe ends are joined using microsurgical techniques when they can meet without harmful tension.
May suitSelected injuries with a short gap and a usable nerve beyond the injury.
Main tradeoffNot every gap can be closed safely, and pain relief or useful sensory recovery is not assured.
Excision with gap reconstruction
Bridge the space left after removal.
How it worksA nerve graft or, in selected small gaps, a nerve conduit provides a pathway between healthy ends.
May suitInjuries where direct repair would place too much tension on the nerve.
Main tradeoffGraft choice depends on nerve type and gap size. Using your own nerve creates a second surgical site and an area of altered sensation.
Excision with nerve-end relocation
Move the remaining nerve end away from pressure and irritation.
How it worksThe surgeon places the nerve end in a protected location, sometimes within muscle or other suitable tissue.
May suitSelected painful nerve ends without a usable connection farther along the nerve.
Main tradeoffThis generally does not restore feeling to the original skin territory, and a painful neuroma can return.
Reconstruction with a new nerve target
Give regenerating nerve fibers a new biological target.
How it worksSpecialized approaches include targeted muscle reinnervation or a regenerative peripheral nerve interface using a small muscle graft.
May suitSelected disconnected nerve ends, including some amputation-related or recurrent neuromas.
Main tradeoffThese approaches are not appropriate for every hand or arm injury and require specific surgical expertise.
Nerve repair, grafting, and nerve transfers serve different purposes. Ask which technique is proposed, what function it aims to preserve, and whether the main goal is pain control or nerve recovery. [1].
Why not simply remove the painful lump?
The remaining nerve can continue trying to grow and form another painful end. Planning what happens to that nerve is an important part of surgery.
Could a different operation be more appropriate?
Yes. If a functioning nerve is mainly trapped in scar or compressed, freeing it may be considered instead of removing it. If pain comes from a joint, tendon, or broader pain condition, neuroma surgery may not address it.
04 · Results
What may improve and what may remain
Pain and sensitivity
Reducing pain is often the primary goal.
- Touch-triggered pain may improve, but some symptoms can persist or worsen.
- A recurrent neuroma or another source of pain may require further evaluation.
Sensation and strength
Nerve recovery is slower and less predictable than wound healing.
- Useful recovery depends on the injury level, time since injury, and condition of the tissues.
- Numbness may remain permanent when the original nerve pathway cannot be restored.
- Strength recovery is relevant only when movement-related nerve fibers are involved.
Everyday function
Improvement is measured in activities that matter to you.
- Comfort with gripping, dressing, work, or sleep can be useful goals.
- Hand therapy may help with stiffness, sensitivity, and adapting to altered sensation.
A healed incision does not mean a repaired nerve has recovered. Follow-up over months may be needed to assess progress and discuss remaining symptoms. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on the nerve treated and whether surgery includes a repair, graft, or muscle procedure. Your surgical team will tailor protection, movement, and therapy to that plan.
Step 1 · Day of surgery
Treatment day
The arm or hand may have a dressing or splint. Before discharge, review pain control, protection while a nerve block is active, and whom to call with concerns.
Step 2 · First 1–2 weeks
Early wound care
Tenderness, swelling, and bruising may occur. Follow-up checks the wound and circulation and determines when dressings or stitches can be changed or removed.
Step 3 · Following weeks
Guided return to movement
Movement and hand therapy are adjusted to protect the reconstruction while limiting stiffness. Strengthening and scar work start only when the team considers them appropriate.
Step 4 · Months and sometimes longer
Nerve recovery and reassessment
Pain, sensation, and function are reassessed over time. Recovery may be incomplete, and persistent symptoms may lead to changes in therapy or further evaluation.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Desk workPlanning context: May be possible before heavier hand useWhat affects it: Pain, dominant-hand involvement, typing demands, and splint restrictions determine timing. Returning to work does not mean complete healing.
DrivingPlanning context: Requires safe control of the vehicleWhat affects it: Avoid driving while impaired by medication or unable to steer and respond safely. Ask about restrictions related to a splint or nerve block.
Lifting and manual workPlanning context: Usually needs specific clearanceWhat affects it: Gripping, vibration, and heavy loads may stress the surgical area. Restrictions depend on the repair and job tasks.
Exercise and sportsPlanning context: Resume in stagesWhat affects it: Contact, falls, weight-bearing through the hand, and repetitive pressure may require longer protection.
Ask for written restrictions matched to your work, home responsibilities, and surgical technique rather than relying on a general recovery calendar.
Before your procedure
- Bring records of the original injury, prior operations, imaging, and nerve tests if available.
- Describe the exact pain triggers and which daily activities are most affected.
- Review all medicines and supplements; change them only as directed by your treating clinicians.
- Discuss nicotine use, diabetes, and other conditions that may affect healing.
- Arrange transportation and help with tasks if anesthesia, a splint, or limited hand use is expected.
- Confirm wound-care instructions, therapy arrangements, follow-up visits, and after-hours contact details.
Will I need hand therapy?
Many patients benefit from therapy, but timing and exercises depend on the procedure. Therapy may address movement, swelling, sensitivity, and sensory retraining. Exercises that suit one repair may place another at risk.
How should I protect numb skin?
Reduced feeling can make it harder to notice pressure, cuts, or burns. Ask your team how to protect and check the area during daily activities. Ask your surgical team whether compresses are appropriate and exactly how to use them.
06 · Safety
Risks and what your clinician assesses
Temporary incision soreness, swelling, bruising, and changes in sensation can occur. Nerve symptoms may fluctuate during recovery, but new or worsening symptoms should be discussed with the surgical team.
Persistent or recurrent pain
Pain may not improve, may worsen, or may return if another neuroma develops.
Loss of sensation or strength
Removing or repairing nerve tissue can leave numbness, altered feeling, or weakness, especially when useful fibers are involved.
Incomplete nerve recovery
A repair or graft may not restore useful function, and further treatment may be considered.
Wound and surgical complications
Infection, bleeding, fluid collection, delayed healing, and anesthesia-related complications are possible.
Scarring, stiffness, or donor-site symptoms
Scars can remain sensitive, joints may stiffen, and a graft-harvest site can develop numbness or pain.
Complex regional pain syndrome
Uncommonly, persistent pain may occur with swelling, stiffness, and changes in skin color or temperature, requiring prompt assessment.
Discuss these risks and your individual health history with your surgeon. [1]
What your clinician assesses
- Whether symptoms and examination findings point to the same injured nerve
- Remaining sensation and strength that surgery could affect
- Injury timing, scar tissue, gap length, and available nerve targets
- General health, healing risks, pain history, and ability to participate in rehabilitation
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope, including the proposed nerve reconstruction, graft needs, anesthesia, and follow-up care.
Surgeon
Surgical care
The surgeon's care and planned neuroma excision or reconstruction.
Ask your surgeonAsk whether graft harvesting, additional nerve procedures, and postoperative visits are included.
Facility
Anesthesia and facility
Anesthesia services and use of the operating facility.
Ask your surgeonConfirm whether these are billed separately and whether the clinicians and facility participate in your insurance.
Supplies
Supplies and follow-up
Possible graft materials, splints, dressings, therapy, and additional testing.
Ask your surgeonAsk which items are included and which may create separate charges.
TRC
Patient Services
Any separately described scheduling, education, or care-coordination services.
Ask TRCAsk whether a separate fee applies, what it includes, and whether it is optional.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Is this the same as a nerve tumor?
An injury-related neuroma is a reactive growth of nerve fibers and scar tissue, not cancer. Other nerve masses exist, so an unexplained lump should be evaluated rather than assumed to be a neuroma.
Can surgery make the area more numb?
Yes. Removing a painful nerve segment can increase numbness. Reconstruction may offer a pathway for recovery, but normal feeling is not guaranteed.
Can an old nerve injury still be treated?
Sometimes. Pain treatment may remain possible long after an injury, but restoring sensation or muscle function can become more difficult with time. Consultation helps separate these goals.
Will insurance cover the procedure?
Coverage depends on your plan, documented symptoms, and the proposed treatment. Ask about prior authorization, network participation, therapy benefits, and your expected out-of-pocket responsibility.
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Prepare for your consultation
Bring these to help your consultation:
- Understand the pain diagnosis and the function surgery could affect.
- Confirm the proposed nerve procedure and individualized recovery plan.
- Review the written estimate, follow-up arrangements, and urgent contact instructions.
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Sources
- [1]Mayo Clinic — Peripheral nerve injuries: Diagnosis and treatmentEvaluation of peripheral nerve injuries; nonsurgical symptom management; surgical nerve repair, grafting, and transfers; rehabilitation and the slow, potentially incomplete course of nerve recovery.
- [2]MedlinePlus — Peripheral Nerve DisordersPeripheral nerve injury symptoms including pain, numbness, and weakness; the relationship between nerve function, diagnostic evaluation, and treatment selection.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.