Peripheral nerve surgery · London
Decompression and neurolysis of nerves — releasing a trapped nerve, properly.
Carpal, cubital, tarsal tunnel and beyond — a consultant who does peripheral nerve work week in, week out, with NCS-guided planning and imaging when the picture is not obvious.
Why patients choose us
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Peripheral nerve and hand surgery specialists
A named consultant — hand, plastic, orthopaedic or neurosurgical — who does nerve decompressions week in, week out. Not a generalist dabbling.
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NCS-guided workup, imaging when it matters
Nerve conduction studies and EMG to confirm which nerve, where and how bad. High-resolution ultrasound and MR neurography when the picture is not obvious.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private nerve decompression costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
Open carpal tunnel release in our network: £1,800–£3,200, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Carpal tunnel release (open, LA) | £1,800–£3,200 | 20–30 min | Same visit |
| Carpal tunnel release (endoscopic) | £2,400–£4,200 | 30–45 min | Same visit |
| Cubital tunnel decompression | £2,800–£5,500 | 45–75 min | Same visit |
| Tarsal tunnel release | £3,200–£5,800 | 45–75 min | Same visit |
| Common peroneal decompression | £3,000–£5,500 | 45–60 min | Same visit |
| Meralgia paraesthetica release | £2,800–£5,200 | 45–60 min | Same visit |
| Revision release with nerve wrap | £4,500–£8,500 | 60–120 min | Same visit |
| Consultation and NCS package | £450–£850 | 60 min | Same visit |
Prices vary by clinic, by which surgeon does the case, by the anaesthetic chosen, and by whether extra work (nerve wrap, ganglion removal, transposition) is added on the day. We come back with a firm quote within one working day.
The problem
The right nerve, the right site, the right operation.
Nerve compression is a diagnosis that rewards precision. Wrong nerve, wrong level or a missed second site of compression is why so many operations disappoint.
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Not sure it is a nerve?
NCS and EMG confirm which nerve, where, and how bad — before anyone reaches for a scalpel.
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Not sure surgery is needed?
A splint, an ergonomic change or a single steroid injection can be enough. We say so before you agree to surgery.
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A previous release that did not work?
Revision nerve surgery is its own discipline — imaging with MRN, and a surgeon who does revisions, not their first one.
The journey
From nerve studies to rehab — what happens, in order.
NCS first, imaging if needed, decision, surgery, rehab — one clinician from first message to review.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Which fingers or toes, night pain, weakness, wasting, how long, what you have tried.
- 02
Before
Nerve conduction studies and EMG
Where the nerve is compressed, and how severe — the objective baseline surgery is planned against.
- 03
Before
Imaging if the picture is not clean
High-resolution nerve ultrasound or MR neurography (MRN) for atypical sites, revision cases, or a suspected mass, ganglion or tumour.
- 04
Before
A recommendation and a plan
Within one working day: the right operation for the right nerve, the right anaesthetic, and an indicative price. If splinting or injection is worth trying first, we say so.
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On the day
The procedure itself
Day case in a proper theatre — LA, regional block or GA. Open or endoscopic release; external or internal neurolysis as needed; nerve wrap in revision surgery.
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On the day
Home the same day
A short recovery, written aftercare, a light dressing or splint, and home within a few hours.
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After
Rehab, review and recovery
Hand therapy or physio guided by the surgeon. Sensation improves over weeks to months; motor recovery and any wasting takes longer.
Typical end-to-end: 2–4 weeks from enquiry to surgery. Full recovery: weeks to months, depending on nerve.
Which nerve, and where
The nerves we most commonly decompress.
Every peripheral nerve has favourite pinch points. The right diagnosis names both nerve and site — and rules out a second one.
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Carpal tunnel (median at wrist)
Numbness and tingling in the thumb, index, middle and half the ring finger — often waking you at night. Thenar wasting in advanced cases.
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Cubital tunnel (ulnar at elbow)
Pins and needles in the little and ring fingers, weak grip, elbow pain. Interosseous wasting in the hand if left too long.
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Guyon’s canal (ulnar at wrist)
Ulnar-sided numbness or weakness from a ganglion, repetitive pressure, or a hook of hamate injury.
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Radial tunnel and posterior interosseous
Deep, aching lateral forearm pain — sometimes mistaken for tennis elbow — with or without weakness of finger extension.
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Common peroneal at the fibular neck
Foot drop, tripping, numbness across the top of the foot — often after weight loss, prolonged squatting or a leg cast.
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Tarsal tunnel (posterior tibial at ankle)
Burning, tingling or shooting pain in the sole of the foot, worse on standing and at night.
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Meralgia paraesthetica (lateral thigh)
Numb, burning patch over the outer thigh from lateral cutaneous nerve compression at the groin. Often settles with weight, belts and posture — surgery for the ones that do not.
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Red flag: progressive motor loss or wasting
Visible muscle wasting, foot drop, or a hand you can no longer grip with is not a wait-and-see situation. Sooner is better than later.
Procedure options
The techniques on the table.
Open or endoscopic, external or internal neurolysis, with or without a nerve wrap — the right choice depends on the nerve, the severity, and whether this is a first or a revision operation.
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Open carpal tunnel release
Small palm incision to divide the transverse carpal ligament. Reliable, quick, done under LA — still the workhorse operation.
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Endoscopic carpal tunnel release
Camera through one or two tiny incisions. Faster return to heavy grip work, similar long-term outcomes to open release.
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Cubital tunnel decompression
In-situ decompression of the ulnar nerve at the elbow. Anterior transposition (subcutaneous or submuscular) reserved for unstable or revision cases.
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Guyon’s canal release
Wrist-level release of the ulnar nerve, usually with removal of a ganglion or lipoma if that is the cause.
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Tarsal tunnel release
Release of the flexor retinaculum at the ankle to decompress the posterior tibial nerve and its branches.
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Common peroneal decompression
Release of the nerve at the fibular neck. Best done before dense foot drop and wasting set in.
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External vs internal neurolysis
External: freeing scar from around the nerve. Internal: opening the epineurium to release intraneural scarring — reserved for chronic or revision cases.
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Nerve wrap for revision surgery
A collagen or vein wrap around a scarred nerve after re-do decompression to reduce re-scarring.
Our vetted London network
A small panel of nerve surgeons, we picked them.
Consultant hand, plastic, orthopaedic and neurosurgical specialists across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every peripheral nerve surgeon in our network.
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Hand, plastic, orthopaedic and neurosurgeons who focus on peripheral nerve work
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Access to nerve conduction studies, EMG and high-resolution nerve ultrasound
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MR neurography (MRN) available for atypical, revision or suspected mass cases
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Hand therapy and physio pathways for post-op rehab already in place
Safety, complications and recovery
What to expect afterwards — honestly.
Nerve decompression is generally a very safe day-case operation. The things worth planning are your anaesthetic, your rehab, and knowing what is normal — and what is not.
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Local, regional or GA
Most wrist-level releases are done under LA. Elbow, ankle, thigh and revision work usually needs regional block or GA — with an anaesthetist, in a proper theatre.
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Sensory recovery is quick, motor is slow
Tingling and night pain often improve within days. Strength, dexterity and any muscle wasting recover over months — sometimes not fully if you waited too long.
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Scar tenderness for a few months
Palm, elbow and ankle scars can be tender for two to three months (pillar pain in carpal tunnel). Massage and desensitisation help.
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Incomplete relief is possible
A minority of patients — particularly with severe pre-op NCS changes or diabetes — get partial rather than complete relief.
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Recurrence and revision
True recurrence is uncommon but real. Persistent symptoms are worked up with repeat NCS and MRN before considering revision surgery.
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Nerve injury is rare — and taken seriously
Iatrogenic injury to the nerve being decompressed, or a nearby branch, is uncommon in specialist hands but a real risk we consent for.
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Complex regional pain syndrome (CRPS)
A rare but recognised complication with disproportionate pain, swelling and colour change — early recognition and pain-team input matter.
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Rehab is not optional
Early gentle movement, nerve gliding and — where relevant — a hand therapist make the difference between a good and an excellent result.
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Red flags
Progressive weakness, spreading numbness, disproportionate burning pain, fever or wound breakdown after surgery — call the team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever nerve and technique, the note the surgeon sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and nerve treated
Which nerve, at which site, and what the pre-op NCS/EMG and imaging showed — the objective reason for surgery.
- 02 Technique
Anaesthetic and surgical technique
LA, regional or GA. Open or endoscopic. External or internal neurolysis. Any transposition, ganglion removal or nerve wrap used.
- 03 Findings
Intra-operative findings
What the surgeon actually saw — the degree of compression, any ganglion, lipoma, scar or anatomical variant, and the appearance of the nerve.
- 04 Impression
Recovery, rehab and expected timeline
Read this first: dressings, splint or not, when to move, hand therapy or physio, and realistic timelines for sensation, strength and any wasting.
Recognised by major UK insurers
Nerve decompression is generally covered by major UK insurers where medically indicated. We confirm cover — including whether NCS/EMG is included — before booking.
Frequently asked
Everything we get asked about nerve decompression.
Quick answers on diagnosis, alternatives to surgery, recovery timelines and what to do if the first operation did not work.
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How do I know which nerve is the problem?
Clinical examination — including Tinel’s tap and Phalen’s test for carpal tunnel — narrows it down. Nerve conduction studies (NCS) and EMG confirm which nerve is compressed, where and how badly. High-resolution nerve ultrasound and MR neurography (MRN) help in atypical, revision or suspected mass cases.
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Do I need surgery, or will splinting or injection be enough?
Mild or intermittent carpal tunnel often improves with a night splint or a steroid injection. Cubital tunnel can settle with elbow-extension splinting. Progressive symptoms, muscle wasting or severe NCS changes need surgery — waiting risks incomplete recovery.
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Open or endoscopic carpal tunnel release?
Long-term outcomes are similar. Endoscopic release usually means less palm tenderness and a slightly quicker return to heavy grip. Open release is quick, reliable and cheap. Your surgeon will recommend based on your anatomy and their experience.
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How long is recovery after nerve decompression?
Numbness and night pain often ease within days. Full return to heavy manual work takes four to six weeks after carpal tunnel, longer for cubital, tarsal or peroneal releases. Strength and any muscle wasting recover over three to twelve months.
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What if the surgery does not fully work?
Partial relief is possible, particularly with severe pre-op NCS changes, diabetes or long-standing symptoms. Persistent or recurrent symptoms are worked up with repeat NCS and MRN before considering revision — often with a nerve wrap.
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When should I see a doctor urgently?
Visible muscle wasting (for example thenar wasting in advanced carpal tunnel), foot drop, rapidly progressive weakness, or disproportionate burning pain and swelling after surgery (possible CRPS) all need urgent review — not a routine appointment.
Related tests and procedures
Looking for something else?
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Cubital tunnel syndrome treatment
Ulnar nerve at the elbow — decompression and transposition.
Learn more -
Nerve conduction studies
The objective test behind every nerve decompression plan.
Learn more -
Musculoskeletal MRI
Imaging for atypical, revision or suspected-mass cases.
Learn more -
All tests
Every test and procedure we arrange.
Learn more