Surgical Decompression in the Management of Lower Extremity Diabetic Peripheral Neuropathy: A Narrative Review

Diabetic peripheral neuropathy commonly develops in patients with diabetes mellitus. Standard medical treatments help a minority of patients with the amelioration of pain, but do not modify the course of the illness. Treatment of diabetic peripheral neuropathy with surgical decompression of lower extremity nerves is controversial. However, the surgery has the potential to ameliorate pain and to improve quality of life in patients suffering with painful neuropathy; it also has the potential to modify the course of the disease, improving protective sensation of the skin of the foot, decreasing the probability of ulcer formation and subsequent amputation. This review will briefly look at the etiology of diabetic peripheral neuropathy and the rationale for nerve decompression surgery as a treatment option. Surgery for upper extremity nerves, and diagnostic criteria will be followed by an examination of the evidence published to date on the validity of nerve decompression surgery in the treatment of diabetic neuropathy.