Warning signs of nerve damage after surgery

Nerve damage (peripheral neuropathy) develops when the nerves in the body are compressed, stretched or subject to direct trauma. Between the financial years of 2009/10 and 2020/21, there were 3,534 clinical claims received where the primary injury was nerve damage.

Nerve damage can sometimes occur due to medical errors in surgery. This can have a significant effect on a patient’s life, potentially even permanently. In this article, we will highlight the warning signs of nerve damage after surgery, as well as how it is diagnosed and treated.

How does nerve damage occur during surgery?

While surgeons take various precautions to minimise the risk of nerve damage during surgery, it can still occur. Here are some reasons why:

• Surgical positioning – certain surgical positions may cause a nerve to be stretched or compressed, causing damage.
• Surgical bandages – tight bandages are sometimes used to reduce bleeding during surgery, causing pressure on the nerve.
• Surgical equipment – pressure can also be put on nerves through the use of some surgical equipment. For example, a retractor is used to hold structures in the body out of the way, allowing the surgeon to have a clear view.
• Direct injury – although rare, a surgeon may damage a nerve directly during surgery.
• Pre-existing conditions – you may be more likely to suffer from nerve damage during surgery if you have a pre-existing condition which compromises your nerves, such as diabetes, kidney and liver disorders or thyroid dysfunctions.
• Cannulas – nerve damage can sometimes stem from a cannula needle being placed into a vein or artery.

Signs and symptoms of nerve damage after surgery

The intensity and duration of nerve damage following surgery can vary depending on its location and severity. Here are some common signs and symptoms:

• Numbness – the positioning of a patient during an operation can cause nerves to become stretched or compressed, often leading to numbness after surgery, particularly in the hands and feet.
• Tingling – nerve damage can also cause a patient to experience pins and needles after surgery, causing a tingling sensation.
• Loss of balance and coordination – patients can sometimes struggle with instability due to nerve damage after an operation. This particularly relates to those who have undergone surgery near the spine or ear.
• Muscle weakness – the stretching or compression of nerves can cause muscle weakness after surgery. This weakness is most common in the hands and feet.

Most patients who have been subject to nerve damage after an operation experience these symptoms constantly. However, some patients may find that their symptoms come and go while they recover from their surgery. It is important to get in touch with your healthcare provider if you experience any or all of these symptoms following an operation, so they can assist you in finding some relief and treatment.

Diagnosis of nerve damage after surgery

If a patient suspects they have sustained nerve damage after surgery, there are multiple tests that can be carried out to confirm the diagnosis. Here are some examples:

• Clinical examination – first, a doctor will evaluate the symptoms, focusing on any tingling sensations felt by the patient when tapping over a nerve.
• Nerve conduction test (NCS) – during this test, small metal wires are placed on the patient’s skin before tiny electric shocks are released, in order to stimulate the nerves. A measurement is then taken to assess the speed and strength of the patient’s nerve signal.
• Electromyography (EMG) – this test involves a small needle being placed through the patient’s skin and into their muscle. The muscle’s electrical activity is then measured, both at rest and during contraction.
• MRI and ultrasound – these types of imaging studies can be used to discover the compression, swelling or structural damage of a patient’s nerves.
• MR neurography – the exact location of nerve damage can be discovered during this highly specialised version of an MRI scan.

Relieving nerve pain after surgery

Unfortunately, the pain caused by nerve damage after surgery is unlikely to be relieved through the use of regular painkillers, such as paracetamol and ibuprofen. However, there are more advanced medications that can help to ease the pain. Here are some examples:

• Nerve pain medications – amitriptyline, duloxetine, pregabalin and gabapentin are some of the medications recommended by the NHS specifically for nerve pain. These medications should be started at a minimal dose and gradually increased to reduce the risk of unwanted side effects.
• Capsaicin – this treatment comes in the form of a cream or a wearable patch. It relieves nerve pain after surgery by stopping the nerves from sending pain messages to the brain. Capsaicin should not be used on broken or inflamed skin.
• Tramadol – this painkiller is used when other medications are failing to treat the nerve pain successfully. However, it should only be used for short periods as it is an opioid and can become addictive if taken for a long time.

Some lifestyle changes may also be recommended alongside medication to create a combined treatment plan for nerve pain after an operation. Here are some examples:

• Physical therapy – if a patient’s nerve pain is causing muscle weakness and instability, they may be offered physical therapy to help relieve it. These specific stretches and exercises help to improve mobility and stiffness.
• Rest – one of the most effective yet simple treatments for nerve pain after surgery is rest. Repetitive use of the area affected by nerve damage is likely to worsen the pain, so it is best to avoid any activities that may cause this.
• Walking aids – if a patient is experiencing ankle weakness due to their nerve pain, they may be asked to wear a splint or use a walking aid. This helps to keep the limbs in their proper position and improve their functionality.

What should be done to prevent nerve damage during surgery?

During a procedure, the surgical team takes multiple precautions to minimise the chance of any nerve damage. Prior to the operation, the team should be made aware of the patient’s medical history and any pre-existing conditions they have that may make them more prone to nerve damage. Here are some examples of the precautions taken by the surgical team:

• Positioning and padding – the patient’s body should be properly aligned when moved into the required surgical position. Any vulnerable areas, such as the knees and elbows, should be protected with padding to prevent the stretching or compression of nerves.
• Surgical bandage management – although bandages are useful for reducing bleeding during surgery, they can also prevent blood flow to the nerves. For this reason, the duration and pressure of the bandages should be limited and monitored.
• Surgical equipment management – certain surgical tools, such as retractors and laser devices, should be kept away from nerve pathways, where possible.

It is important to be aware that nerve damage can still sometimes occur during surgery, despite the necessary precautions being taken. However, if the surgical team failed to take the required steps, this could be seen as negligent medical care.

Compensation claims for nerve damage after surgery

If you have experienced nerve damage after surgery and it is due to medical negligence, you may be entitled to compensation. At Patient Claim Line, our experts work on a no win, no fee basis and will be able to assess whether or not you can make a claim for your nerve damage. Some key aspects to consider for your claim are:

• Eligibility – to be eligible for a compensation claim for nerve damage after surgery, you must be able to prove that the damage was caused by another party due to a lack of care.
• Time limits – generally speaking, all medical negligence claims should be made within three years of the surgery being completed or from when you realised that the damage was caused by a lack of care from a medical professional. However, there are exceptions to these time limits for those who are under the age of 18 or have a reduced mental capacity.
• Essential evidence – to fully support your claim to the best of your ability, you should gather as much evidence of the damage caused as possible. For example, you should request access to your full medical records so that you have a detailed timeline of your appointments. It is also a good idea to gather witness statements from any individuals who can confirm the impact that the nerve damage has had on your life and well-being.

If you feel as though you have suffered nerve damage due to medical negligence, please get in touch, and one of our medical negligence experts will be able to guide you through your claims process.