Sensory Nerve Injury: Symptoms, Consequences, and Repair

A severed sensory nerve causes complete sensory loss in its distribution: numbness, absent pain/temperature/light touch, loss of proprioception (joint position sense). Motor function is spared unless mixed nerve.

Sequelae

• Neuropathic pain: Neuroma formation, central sensitization → burning, lancinating, allodynia.
• Functional impairment: Unrecognized injury, burns, ulceration (especially feet/hands).
• Motor consequences: Loss of proprioceptive feedback → incoordination, gait instability.

Management

• Microsurgical repair: Epineurial or fascicular coaptation within 72 hours (ideal) or delayed (months).
• Nerve grafts/conduits: For gaps >2 cm.
• Rehabilitation: Sensory re-education, desensitization, protective strategies.
• Pain control: Gabapentinoids, SNRIs, TCAs, topical agents; neuroma excision if refractory.

Recovery: ~1 mm/day axonal regeneration; sensory return may be incomplete. Early referral to peripheral nerve surgeon optimizes outcomes.