Editing Peripheral neuropathy (section)

===Surgery===
{{Main article|Nerve decompression}}
Peripheral neuropathy due to [[Nerve compression syndrome|nerve compression]] is treatable with a [[nerve decompression]].<ref name=":13">{{cite journal |vauthors=Kay J, de Sa D, Morrison L, Fejtek E, Simunovic N, Martin HD, Ayeni OR |date=December 2017 |title=Surgical Management of Deep Gluteal Syndrome Causing Sciatic Nerve Entrapment: A Systematic Review |url= |journal=Arthroscopy |volume=33 |issue=12 |pages=2263–2278.e1 |doi=10.1016/j.arthro.2017.06.041 |pmid=28866346}}</ref><ref name=":14">{{cite journal |vauthors=ElHawary H, Barone N, Baradaran A, Janis JE |date=February 2022 |title=Efficacy and Safety of Migraine Surgery: A Systematic Review and Meta-analysis of Outcomes and Complication Rates |url= |journal=Ann Surg |volume=275 |issue=2 |pages=e315–e323 |doi=10.1097/SLA.0000000000005057 |pmid=35007230}}</ref><ref>{{cite journal |vauthors=Giulioni C, Pirola GM, Maggi M, Pitoni L, Fuligni D, Beltrami M, Palantrani V, De Stefano V, Maurizi V, Castellani D, Galosi AB |date=March 2024 |title=Pudendal Nerve Neurolysis in Patients Afflicted With Pudendal Nerve Entrapment: A Systematic Review of Surgical Techniques and Their Efficacy |url= |journal=Int Neurourol J |volume=28 |issue=1 |pages=11–21 |doi=10.5213/inj.2448010.005 |pmc=10990758 |pmid=38569616}}</ref><ref>{{cite journal |vauthors=Lu VM, Burks SS, Heath RN, Wolde T, Spinner RJ, Levi AD |date=January 2021 |title=Meralgia paresthetica treated by injection, decompression, and neurectomy: a systematic review and meta-analysis of pain and operative outcomes |url= |journal=J Neurosurg |volume=135 |issue=3 |pages=912–922 |doi=10.3171/2020.7.JNS202191 |pmid=33450741}}</ref> When a nerve is subject to localized pressure or stretching, the vascular supply is interrupted leading to a [[Pathophysiology of nerve entrapment|cascade of physiological changes]] that causes [[nerve injury]].<ref>{{cite journal |vauthors=Lundborg G, Dahlin LB |date=May 1996 |title=Anatomy, function, and pathophysiology of peripheral nerves and nerve compression |url= |journal=Hand Clin |volume=12 |issue=2 |pages=185–93 |doi= |pmid=8724572}}</ref> In a nerve decompression, a surgeon explores the entrapment site and removes tissue around the nerve to relieve pressure. Common sites of entrapment are spaces of anatomic narrowing such as osteofibrous tunnels (e.g. [[carpal tunnel]] in [[carpal tunnel syndrome]]).<ref>{{cite journal |vauthors=Schmid AB, Fundaun J, Tampin B |date=2020 |title=Entrapment neuropathies: a contemporary approach to pathophysiology, clinical assessment, and management |url= |journal=Pain Rep |volume=5 |issue=4 |pages=e829 |doi=10.1097/PR9.0000000000000829 |pmc=7382548 |pmid=32766466}}</ref> In many cases the potential for nerve recovery (full or partial) after decompression is excellent, as chronic nerve compression is associated with low-grade nerve injury ([[Nerve injury classification|Sunderland classification]] I-III) rather than high-grade nerve injury (Sunderland classification IV-V).<ref>{{cite journal |vauthors=Mackinnon SE |date=May 2002 |title=Pathophysiology of nerve compression |url= |journal=Hand Clin |volume=18 |issue=2 |pages=231–41 |doi=10.1016/s0749-0712(01)00012-9 |pmid=12371026}}</ref> Nerve decompressions for properly selected patients are associated with a significant reduction in pain, in some cases the complete elimination of pain.<ref>{{cite journal |vauthors=Louie D, Earp B, Blazar P |date=September 2012 |title=Long-term outcomes of carpal tunnel release: a critical review of the literature |url= |journal=Hand (N Y) |volume=7 |issue=3 |pages=242–6 |doi=10.1007/s11552-012-9429-x |pmc=3418353 |pmid=23997725}}</ref><ref name=":13" /><ref name=":14" />

In people with [[Diabetic neuropathy|diabetic peripheral neuropathy]], two reviews make a case for nerve decompression surgery as an effective means of pain relief and support claims for protection from foot ulceration.<ref name="Nickerson2017">{{cite journal |vauthors=Nickerson DS |title=Nerve decompression and neuropathy complications in diabetes: Are attitudes discordant with evidence? |journal=Diabet Foot Ankle |volume=8 |issue=1 |pages=1367209 |date=2017 |pmid=28959382 |pmc=5613909 |doi=10.1080/2000625X.2017.1367209 |url=}}</ref><ref name="Tu2017">{{cite journal |vauthors=Tu Y, Lineaweaver WC, Chen Z, Hu J, Mullins F, Zhang F |title=Surgical Decompression in the Treatment of Diabetic Peripheral Neuropathy: A Systematic Review and Meta-analysis |journal=J Reconstr Microsurg |volume=33 |issue=3 |pages=151–57 |date=March 2017 |pmid=27894152 |doi=10.1055/s-0036-1594300 |s2cid=22825614 |url=}}</ref> There is less evidence for efficacy of surgery for non-diabetic peripheral neuropathy of the legs and feet. One uncontrolled study that did before/after comparisons with a minimum of one-year follow-up reported improvements in pain relief, impaired balance, and numbness. "There was no difference in outcomes between patients with diabetic versus idiopathic neuropathy in response to nerve decompression."<ref name="Valdivia2013" /> There are no placebo-controlled trials for idiopathic peripheral neuropathy in the published scientific literature.