Peripheral Nerve
Procedure
A peripheral nerve procedure is a treatment used to diagnose or relieve pain, numbness, tingling, or weakness caused by irritated, compressed, or damaged nerves outside the brain and spinal cord. These procedures can help restore nerve function, reduce discomfort, and improve movement and daily activities. Depending on your condition, treatment may involve nerve injections, nerve blocks, or other minimally invasive techniques to target the affected nerve and provide lasting relief.
Board Certified
Neurosurgeon
15+ Years
Experience
5000+
Procedures Performed
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What Is a Peripheral Nerve Procedure?
Your peripheral nervous system is a vast network of nerves that branches from your spinal cord out to your hands, arms, and legs. These nerves carry signals that control movement and sensation. When one of them gets compressed or squeezed by surrounding tendons, ligaments, or bone, things go wrong in ways that are hard to ignore.
Peripheral nerve procedures are a category of targeted surgical interventions designed to relieve that pressure. Rather than treating a single condition, these procedures address various compression problems, each targeting a specific nerve at a specific anatomical location.
At Capital Spine & Pain Institute, these procedures are performed by Dr. Avery L. Buchholz, a board-certified neurosurgeon with fellowship training and over 15 years of experience. The approach is always minimally invasive where possible, outpatient, and focused on getting you back to normal life as quickly as possible.
Insurance Accepted
3 Core Procedures
Patient-Focused Care
Cash Pay Accepted
What This Procedure Treats
Nerve compression doesn't always announce itself loudly. For some patients, it starts as mild tingling, easy to dismiss. For others, it's a burning pain that wakes them at 3 a.m. These are the symptoms and problems peripheral nerve procedures are built to address:
Persistent Numbness & Tingling
Constant or recurring sensory changes in the fingers, hand, or forearm, especially when they don't resolve after shaking the hand out.
Burning or Shooting Nerve Pain
Pain that travels along the nerve's path, often worse with specific positions or at night. Different from muscle soreness, sharper and more electric.
Grip Weakness
Difficulty holding objects, turning keys, or unscrewing lids. Dropping things unexpectedly is a common warning sign of nerve involvement.
Loss of Fine Motor Control
Trouble with precise tasks like buttoning clothes, typing, or writing is often the first sign patients notice affecting their job or daily routine.
Night Symptoms
Waking with a numb or tingling hand is a hallmark of carpal tunnel syndrome. The wrist position during sleep increases pressure on the median nerve.
Progressive Muscle Wasting
In advanced or long-standing cases, the muscles of the hand can visibly shrink. This signals serious nerve damage that warrants prompt evaluation.
When Patients Become Candidates
We don't jump to surgery. Most patients try splinting, physical therapy, and injections first. Surgery comes into the picture when those stop working or when waiting starts causing real damage.
Months of symptoms with no real improvement
Conservative care had a fair shot, and the numbness, tingling, or pain is still there or getting worse.
EMG or nerve study confirms compression
The test shows the nerve signal is slow or blocked. That's objective evidence, not just symptoms, that something needs to be done.
Grip or fine motor control is slipping
Dropping things, struggling to button a shirt, and not being able to open jars anymore, when function is going, the nerve is telling you it needs help.
Pain or numbness is breaking your sleep
Waking up at 2 a.m. to shake out your hand every night isn't something you just live with. That's a sign the compression is significant.
Muscle wasting is starting
When the pad at the base of the thumb visibly shrinks, the nerve has been compressed long enough that waiting any longer risks permanent loss.
Work or daily life is genuinely affected
A carpenter who can't grip a tool, a surgeon whose hand goes numb mid-procedure, at that point, surgery isn't elective anymore.
Why Choose Capital Spine & Pain Institute
Board-certified neurosurgeon
Dr. Buchholz brings deep subspecialty expertise in nerve and spine surgery. Peripheral nerve procedures are a core part of his practice, not an occasional add-on.
Conservative, First Philosophy
We don't jump to surgery. If your condition can be managed without it, we'll tell you that and help you get there. Surgery is recommended only when it's clearly the right next step.
Minimally Invasive When Possible
Where anatomy allows, we use the least invasive approach that still achieves a full, durable nerve release. Smaller incisions mean less disruption and faster healing.
Personalized
Care
From the diagnostic evaluation through recovery, your plan is built around your symptoms, your goals, and your schedule, not a one-size-fits-all protocol.
Outpatient
Convenience
Most procedures are same-day outpatient procedures. You arrive in the morning and go home the same afternoon, with no prolonged hospital stays.
Benefits and Outcomes
Peripheral nerve decompression has one of the strongest track records in nerve surgery when patients are appropriately selected and the diagnosis is accurate.
Relief from numbness and tingling
Many patients notice meaningful sensory improvement within the first few weeks following surgery, often before strength fully returns.
Nerve pain has reduced, including at night
The burning, aching discomfort that disrupts sleep is typically one of the first things to ease after the nerve is decompressed.
Improved grip strength and hand control
As the nerve heals, the muscles it supplies regain their ability to fire properly, restoring the grip and dexterity compression had taken away.
Outpatient, home the same day
No overnight hospital stay. You arrive, have the procedure, and go home the same afternoon once cleared by your care team.
The Procedure
While details vary by nerve and location, the general flow of a peripheral nerve decompression procedure looks like this:
01
Pre-procedure preparation
You check in at the outpatient center, meet the anesthesia team, and the arm is prepped. Most procedures use local anesthesia with light sedation; some use general anesthesia.
02
Incision placement
A small, precisely placed incision is made over the compression site, at the wrist, inner elbow, or elsewhere. Size is kept as small as clinically appropriate.
03
Identifying the nerve
Using magnification and specialized instruments, Dr. Buchholz locates the affected nerve and identifies the exact structure causing the compression.
04
Releasing the compression
The compressing structure is carefully divided or removed. The nerve is inspected to confirm it's free and has adequate room to move without tension.
05
Closure & discharge
The incision is closed with sutures, a sterile dressing is applied, and in some cases, a light splint is placed. Most patients go home within a few hours.
Ready to Find Relief? Let's Talk.
Don't ignore persistent pain, numbness, or weakness. Talk to a nerve specialist and find the right next step.
Expert Spine Surgeon
Dr. Avery L. Buchholz is a board-certified neurosurgeon with fellowship training in complex spine surgery. With over 15 years of experience and 5,000+ procedures performed, he specializes in both minimally invasive and complex surgical techniques.
His expertise spans the full spectrum of spine care, from non-surgical interventions to advanced reconstructive procedures, always prioritizing patient safety and optimal outcomes.
Frequently Asked Questions
How do I know if I need a peripheral nerve procedure?
Your hand goes numb at night, you keep dropping things, and the brace your doctor gave you stopped helping months ago. That's usually the point where surgery makes sense.
Is the procedure painful?
During? No. After, your wrist feels bruised for a few days. Tylenol works well for most people.
How long will it take to feel normal again?
Numbness clears up faster than strength does. Realistically, give it 3 months before judging the result.
Will I need physical therapy after the procedure?
Probably not for a basic release. If your hand was already weak before surgery, a few OT sessions speed things up.
When can I return to work?
Desk job, about a week. Construction, mechanics, and anything hands-on are closer to 6 to 8 weeks.
Is this covered by insurance?
Yes, once your EMG shows compression and your chart shows you tried conservative care first. We sort the insurance side out before your surgery date is set.
What's the difference between peripheral nerve and spine surgery?
Spine surgery is for nerve problems inside your back. This surgery is for the same nerve getting pinched again at your wrist or elbow, two different spots, two different operations.
Do I need a referral?
Depends on your insurance plan. Call us first, and we'll tell you in 2 minutes whether you need one or not.
Our Locations
Serving patients across VA and the DC area
Falls Church, VA
6400 Arlington Blvd, Suite 710
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Alexandria, VA
6244A Little River Turnpike
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Richmond, VA
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Charlottesville, VA
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Washington, DC
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Get In Touch
Contact us today to schedule your consultation and take the first step toward relief.
Address
6244 Little River Turnpike, Suite 101
Alexandria, VA 22312
Phone
FAX
Office Hours
Monday - Friday: 9:00 AM - 6:00 PM
Saturday: 9:00 AM - 6:00 PM
Sunday: Closed
This form is intended for scheduling purposes only and is not a HIPAA-compliant form. Please avoid sharing any sensitive medical information.
By submitting, you consent to being contacted using the information provided.
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