Nerve repair
An operation to reconnect or reconstruct a nerve that has been cut or damaged, aiming to recover feeling and movement in the area the nerve supplies.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Nerve repair reconnects or reconstructs a damaged nerve to try to bring back feeling and movement — it does not work instantly.
- Nerves regrow very slowly (about 1 mm a day), so recovery takes many months to years and you may not regain fully normal function.
- Incomplete recovery, altered sensation and cold intolerance are common, and a numb area needs protecting from burns and injury.
- Hand-therapy and sensory re-education are an important part of recovery; this is usually urgent NHS trauma care.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Gives the nerve the best chance to regrow and restore feeling and movement
If a long segment of nerve is destroyed or the injury is very high up, direct repair may not be possible and a graft or transfer is needed instead.
The limb is often splinted to protect the repair. Keep the hand elevated to reduce swelling, keep the wound clean, and start protecting the numb area from...
Early hand-therapy referral with protection of the numb area and joint exercises.
The limb is often splinted to protect the repair. Keep the hand elevated to reduce swelling, keep the wound clean...
The repair heals and the splint is gradually reduced under guidance. Hand therapy keeps joints supple. The nerve...
Early signs of regrowth may appear, such as tingling or pins and needles that can be tapped along the nerve (a...
Feeling and, for motor nerves, movement gradually return as fibres reach their targets. Sensory re-education with...
What is nerve repair?
Nerves are the body's wiring. They carry signals for feeling (touch, temperature, pain) and for movement (telling muscles to work). When a nerve is cut or badly damaged — often by a deep cut, glass, a crush injury or a fracture — the area it supplies can go numb, weak or paralysed. Nerve repair is surgery to reconnect or reconstruct the nerve so those signals can, in time, travel again.
Unlike stitching a tendon, repairing a nerve does not restore function straight away. The surgeon lines the nerve ends up precisely, but the nerve fibres then have to regrow from the repair down to the skin or muscle they supply — and they grow slowly, at roughly a millimetre a day. This is why recovery is measured in months and sometimes years.
It is important to understand that nerve recovery is often incomplete. Many people regain useful feeling and movement, but fewer than half regain fully normal function after a significant nerve repair, and results are poorer the higher up and more severe the injury. Cold intolerance, altered sensation and some lasting weakness are common. A good surgeon is honest about this from the start.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Options at a glance
These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.
Direct repair (neurorrhaphy)
When the two nerve ends can be brought together without tension, they are stitched directly under a microscope. This is the usual approach for clean cuts seen early and gives...
Nerve graft
When a length of nerve is missing or the ends cannot meet, a piece of nerve is borrowed from elsewhere (often a sensory nerve in the leg) to bridge the gap. The donor area is...
Nerve conduit or wrap
For short gaps in small nerves, a tube or wrap may be used to guide regrowth and avoid taking a graft. Best suited to small defects rather than large ones.
Nerve transfer
A nearby working nerve branch is rerouted to power an important muscle or restore feeling, especially for injuries high up where waiting for regrowth would take too long...
Preparing for your surgery
- Nerve injuries are often treated urgently, and the sooner a clean cut is repaired (often within days), the better the outcome tends to be.
- Tell your surgeon about diabetes, smoking and any condition affecting nerves or healing.
- Mention your dominant hand, your job and hobbies, as these shape the goals of treatment.
- Stopping smoking or nicotine supports nerve and wound healing.
- Ask whether a nerve graft may be needed and where it would be taken from, as this leaves a numb patch at the donor site.
- Arrange help at home and a lift, as you may have a splint and a numb, vulnerable hand.
- Ask who will provide hand therapy and sensory re-education, and when it will begin.
What happens
The operation is usually done under a regional block (numbing the whole arm), local anaesthetic, or general anaesthetic. Using a microscope or magnifying loupes, the surgeon finds the damaged nerve ends, trims them back to healthy tissue, and lines them up so the internal bundles match as closely as possible. Very fine stitches hold the ends together without tension.
If a segment of nerve is missing, the surgeon bridges the gap with a graft, conduit or a nerve transfer. Any injured tendons or blood vessels found at the same time are usually repaired too. The wound is closed and the limb is often splinted to protect the repair while the early healing settles.
Most people go home the same day. You will normally be referred to a hand therapist, who protects the area, teaches you how to look after a numb hand, and later guides 'sensory re-education' — retraining your brain to interpret the new, initially strange signals as the nerve regrows.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- If a long segment of nerve is destroyed or the injury is very high up, direct repair may not be possible and a graft or transfer is needed instead.
- Very delayed presentation reduces the chance of useful recovery, as the target muscles may waste before fibres reach them.
- Heavily contaminated or infected wounds need treating before nerve reconstruction.
- Where the muscle has been denervated too long to recover, a tendon transfer may be more useful than nerve repair.
Delay surgery if…
- There is active infection in the wound or limb.
- The wound is heavily contaminated and needs cleaning or settling first.
- Significant swelling or associated injuries need managing before nerve reconstruction.
- A planned graft or transfer is better timed once tissues have healed.
Alternatives to discuss
- Nerve graft, conduit or transfer when direct repair is not possible.
- Tendon transfer to restore movement when the nerve will not recover in time.
- Hand therapy and protective measures alone for some partial injuries.
- Accepting the deficit and adapting, where surgery is unlikely to help.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Gives the nerve the best chance to regrow and restore feeling and movement
- Can protect against the dangers of a permanently numb area, such as burns and unnoticed wounds
- May restore enough sensation for fine tasks like fastening buttons or picking up small objects
- Nerve transfers can restore important muscle function when waiting for regrowth would take too long
- Allows other damaged structures, such as tendons and vessels, to be repaired at the same time
Risks & complications
- Incomplete return of feeling or movement
- Altered or strange sensation as the nerve regrows (tingling, hypersensitivity)
- Cold intolerance — an exaggerated, sometimes painful reaction to cold
- A numb patch at the donor site if a graft was taken
- A firm or tender scar
- A painful nerve lump (neuroma) at the repair site
- Wound infection
- Persistent weakness in the muscles the nerve supplies
- Need for further surgery if recovery stalls
- Stiffness in nearby joints from protecting the hand
- Complex regional pain syndrome (persistent pain, swelling and stiffness)
- No meaningful recovery despite surgery
- Damage to nearby structures during the operation
The most important thing to understand is that nerve recovery is slow and often incomplete — surgery sets up the conditions for regrowth but cannot guarantee normal feeling or strength, especially for injuries higher up the arm or in older people. While the area is numb, you lose the warning of pain and may sweat less, so burns and unnoticed cuts are a real danger. Ask your surgeon what level of recovery is realistic for your specific injury, and how to protect the numb hand in the meantime.
Published figures to discuss
How well a nerve recovers depends heavily on the type and level of injury, the time to surgery, the patient's age and whether a graft or transfer was needed. Published figures vary and are best read as general guidance. In particular, the proportion of people regaining 'normal' function is lower than many expect, and cold intolerance is common.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Regaining fully normal function | Fewer than half of people regain good-to-excellent motor or sensory function after a significant nerve repair in published series | Better for clean, distal cuts in younger patients repaired early; worse for high, severe injuries. | The role of current techniques in peripheral nerve repair — PMCpmc.ncbi.nlm.nih.govSource-linked context |
| Cold intolerance after digital nerve injury | Severe or extremely severe cold intolerance reported in roughly a quarter of patients in one study (about 26%) | Can significantly affect work and hobbies and may be long-lasting. | The role of current techniques in peripheral nerve repair — PMCpmc.ncbi.nlm.nih.govPublished figure |
| Rate of nerve regrowth | Approximately 1 mm per day in humans | Explains why recovery takes months to years and why higher injuries recover less well. | The role of current techniques in peripheral nerve repair — PMCpmc.ncbi.nlm.nih.govSource-linked context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery after nerve repair is a long process. The first weeks protect the repair; then comes the slow phase of waiting for the nerve to regrow, supported by hand therapy and sensory re-education. Progress is gradual and varies a lot between people.
- A numb area that only very slowly starts to regain feeling
- Tingling, pins and needles or electric-shock sensations as the nerve regrows
- Hypersensitivity or strange sensation before normal feeling settles
- Cold intolerance that can persist for a long time
- Slow, incomplete progress rather than a sudden return to normal
Aftercare
- Protect the numb area from heat, sharp objects and pressure — you will not feel burns or cuts normally, so check the skin regularly.
- Wear your splint as instructed and keep the hand elevated early on to reduce swelling.
- Keep the wound clean and dry and follow advice on dressings and stitches.
- Do your hand-therapy exercises to keep joints moving while the nerve recovers.
- Begin sensory re-education when your therapist advises, to help your brain relearn touch.
- Stop smoking, as it impairs nerve and wound healing.
- Keep the hand warm and protected, as cold intolerance is common.
- Attend all follow-up and therapy appointments, as recovery is monitored over many months.
- Hand-therapy and sensory re-education appointments arranged
- Written advice on protecting a numb hand from burns and injury
- Splint care instructions understood
- Gloves or warm coverings for cold-intolerant skin
- Help at home for one-handed tasks
- Clinic's contact number for problems saved
- Realistic recovery timeline discussed and noted
Scars and how they heal
There will be a scar over the repaired nerve, and a second scar at the donor site if a graft was taken (often on the leg), which leaves its own patch of numbness. Scars are firm and sometimes tender at first and usually soften over months. A scar directly over a nerve can occasionally be sensitive; tell your therapist, as desensitisation techniques can help.
⚠ Get urgent help if…
- A burn, blister or wound on the numb area that you did not feel happening
- Spreading redness, heat, swelling or discharge from the wound (signs of infection)
- Severe, burning or escalating pain, or extreme hypersensitivity to light touch
- A painful lump at the repair site that worsens (possible neuroma)
- A fever or feeling generally unwell after surgery
- The hand or fingers becoming pale, blue or very cold
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means useful feeling returns — enough to protect the hand and ideally to handle small objects — and, for motor nerves, that important muscles work again. This is rebuilt very slowly over months to years, not seen straight after surgery. Recovery is frequently partial: many people are left with some altered sensation, cold intolerance or weakness, and a minority regain little despite a technically good repair. Outcomes are generally better for clean cuts, lower-down injuries, younger patients and early surgery. Your surgeon should set realistic expectations for your particular injury.
Whatever recovery a nerve achieves usually becomes the long-term result, since most regrowth happens in the first couple of years. Some sensation and strength can keep improving slowly beyond that, but gains tend to plateau. Cold intolerance and altered sensation may persist long-term. Keeping the area protected and continuing any prescribed therapy helps you make the most of the recovery you have.
Combining with other procedures
Nerve injuries often happen alongside cut tendons, blood vessels or fractures, which may all be repaired in the same operation; this affects both the recovery timeline and the rehabilitation plan. Where a nerve cannot regrow in time, a nerve or tendon transfer may be planned to restore key movements. Your team will explain what was found and how it shapes your recovery.
Follow-up & long-term care
You will be seen by the surgical team for wound checks and by a hand therapist over an extended period, as nerve recovery is tracked across many months. Reviews look for signs of regrowth (such as an advancing Tinel's sign), guide sensory re-education, and decide whether any further surgery is needed if recovery stalls.
- Keep protecting numb skin from burns and injury until protective sensation returns
- Continue sensory re-education and joint exercises as advised
- Keep the hand warm to manage cold intolerance
- Attend long-term reviews so a stalled recovery can be acted on
Revision and secondary surgery reality
- If recovery stalls, further surgery such as a nerve transfer or, later, a tendon transfer may be considered.
- A painful neuroma at the repair site sometimes needs additional treatment or surgery.
- Some loss of feeling, strength or cold tolerance commonly remains even after revision.
- The final outcome often only becomes clear after a year or more of monitored recovery.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- Early hand-therapy referral with protection of the numb area and joint exercises.
- A clear sensory re-education programme as the nerve regrows.
- Written advice on avoiding burns and injury to insensate skin, with a named contact.
- Long-term monitoring of recovery with a plan if it stalls.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The surgeon's fee and how complex the injury is (which nerve, how high up, associated tendon or vessel damage)
- Whether a direct repair, nerve graft, conduit or nerve transfer is needed
- Anaesthetic or regional block and the theatre or facility fee
- Microsurgical equipment and theatre time
- The many hand-therapy and sensory re-education sessions needed over months
- Follow-up appointments and treatment of any complications such as a painful neuroma
- The surgeon's fee and the facility/theatre fee
- Anaesthetic or regional block fee
- Whether a graft, conduit or transfer is included and any added cost
- How many hand-therapy and sensory re-education sessions are included
- Follow-up appointments over the long recovery period
- What happens, and who pays, if recovery stalls and further surgery is needed
- The cancellation policy and what is covered if a complication occurs
On the NHS? Cut and damaged nerves are normally repaired on the NHS as urgent trauma care, because early repair gives better results; private care is mainly chosen for speed or a particular surgeon.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being led to expect a return to 'normal' feeling and movement rather than honest, often partial, recovery.
- Not being warned about the slow timescale (months to years) of nerve regrowth.
- No discussion of cold intolerance, altered sensation or the donor-site numbness from a graft.
- No clear advice on protecting a numb hand from burns and injury while it recovers.
Marketing red flags
- Promises of 'full' or 'restored' sensation and movement after nerve repair.
- Glossing over the months-to-years timescale and the chance of incomplete recovery.
- No mention of cold intolerance, neuroma or donor-site effects.
- Surgery offered without a clear hand-therapy and sensory re-education plan.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- What level of feeling and movement is realistic for my specific injury?
- Will I need a nerve graft, and where would it be taken from?
- How long might recovery take, and how will you monitor it?
- How should I protect the numb area from burns and injury in the meantime?
- Who will provide my hand therapy and sensory re-education?
- What are the options if the nerve does not recover well, such as a transfer?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will I get all my feeling and movement back?
Why does recovery take so long?
Why is my hand numb but my nerve was repaired?
What is cold intolerance?
How do I protect a numb hand?
Can this be done on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Peripheral neuropathy (nerve damage) overview The role of current techniques in peripheral nerve repair — PMC Peripheral nerve reconstruction after injury: clinical and experimental review — Wiley/PMC Cold sensitivity and disability after repaired digital nerve injury — Scientific Reports
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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