Peripheral Nerve Decompression for Diabetic Neuropathy: The Dellon Procedure

In This Guide

March 2026 |

A Surgical Option for Painful Diabetic Neuropathy

Reviewed by Dr. Tom Biernacki, DPM, FACFAS

Board-certified foot & ankle surgeon · 3,000+ surgeries · @MichiganFootDoctors (950K+ subscribers)

Last reviewed May 11, 2026 · (810) 206-1402

Diabetic peripheral neuropathy is typically considered a medical condition managed with blood sugar control and medications, but a subset of patients with painful neuropathy may benefit from surgical nerve decompression — a procedure associated with Dr. A. Lee Dellon — that addresses areas of nerve compression superimposed on the underlying neuropathy. The anatomical basis for this approach is the observation that peripheral nerves in diabetic patients are more susceptible to compression injury at fixed anatomical tunnels due to the metabolic changes of diabetes that swell the nerve within its fibrous sheath. Releasing these compression points may reduce pain and, in some cases, improve sensation in carefully selected patients.

The Anatomical Basis

tarsal tunnel tibial nerve compression diabetic neuropathy” class=”wp-image-57354″ width=”800″ height=”450″ loading=”lazy” decoding=”async”/>

The tibial nerve and its branches pass through several fibrous tunnels in the ankle and foot — most prominently the tarsal tunnel at the medial ankle, and the medial and lateral plantar nerve tunnels at the medial heel. The deep peroneal nerve passes beneath the inferior extensor retinaculum at the front of the ankle. Diabetic nerves have impaired axoplasmic transport and tend to accumulate within their sheaths when compressed, creating a vicious cycle where compression worsens neuropathic injury. Clinical signs of superimposed compression — positive Tinel sign at tunnel sites, relief of symptoms with local anesthetic injection at compression points — are used to identify patients most likely to benefit from decompression.

Surgical Procedure and Patient Selection

Diabetic neuropathy nerve decompression surgery recovery – podiatrist Michigan” class=”wp-image-57391″ width=”800″ height=”450″ loading=”lazy” decoding=”async”/>

Peripheral nerve decompression for diabetic neuropathy involves releasing the fibrous roofs of the nerve tunnels at the tarsal tunnel and plantar nerve channels under general or regional anesthesia. The procedure typically takes 1 to 2 hours per extremity and is performed as an outpatient. Appropriate patient selection is critical to achieving good outcomes — patients with an identifiable positive Tinel sign at the compression sites, a measurable nerve conduction deficit, and controlled blood glucose are better candidates than those with diffuse neuropathy without focal signs.

Published outcomes from experienced centers show significant reductions in neuropathic pain scores and measurable improvement in protective sensation in approximately 70 to 80 percent of appropriately selected patients. The evidence base, while growing, includes primarily retrospective studies and prospective case series rather than large randomized controlled trials, and the procedure is not universally endorsed. At Balance Foot & Ankle, we evaluate patients with painful diabetic neuropathy comprehensively and discuss all management options — including the potential role of nerve decompression — in a thorough and individualized way.

Recovery Support Products for Neuropathy Patients

Whether pursuing surgical decompression or managing diabetic neuropathy conservatively, these products support nerve health and protect insensate feet from injury.

PowerStep Pinnacle Arch Supports redistribute pressure across the plantar surface, reducing focal compression on damaged nerves. For neuropathy patients, proper biomechanical support protects the foot from the repetitive microtrauma that worsens nerve injury over time. Check price

Eucerin Advanced Repair Cream addresses the dry, cracked skin common in diabetic neuropathy patients. Maintaining skin integrity is critical when protective sensation is reduced — cracked skin is an entry point for infection that can lead to serious complications. Check price on Amazon

SB SOX Compression Socks promote circulation in the lower extremities — a key factor in nerve recovery after decompression surgery and in daily neuropathy management. Improved blood flow supports nerve healing and reduces the edema that contributes to nerve tunnel compression. Check price

Affiliate disclosure: We may earn a small commission on qualifying purchases at no cost to you. We only recommend products we use in our clinic.

More Podiatrist-Recommended Diabetic Essentials

Diabetic-Approved Walking Shoe

Orthofeet Sprint — seamless, extra-depth, designed for neuropathic feet.

Seamless Diabetic Sock

View on Amazon →

OS1st FS4 — non-binding, moisture-wicking, protects fragile diabetic skin.

Recovery Slide for Indoor Wear

HOKA Ora 3 — protects diabetic feet from barefoot injury at home.

As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.

When to See a Podiatrist

One unnoticed blister on a neuropathic foot can become a limb-threatening ulcer in under 14 days. Medicare covers diabetic shoes (A5500) and comprehensive foot exams annually for most diabetic patients with neuropathy or circulation concerns. Balance Foot & Ankle runs a dedicated diabetic limb-preservation program — vascular screening, offloading, ulcer care, and shoe fitting — all in one visit. Schedule your annual diabetic foot exam today.

Call Balance Foot & Ankle: (810) 206-1402  ·  Book online  ·  Offices in Howell & Bloomfield Township

Frequently Asked Questions About Nerve Decompression

Does nerve decompression cure diabetic neuropathy?

Nerve decompression does not cure the underlying diabetic neuropathy — it addresses the mechanical compression component that worsens symptoms. By releasing the nerve at specific tunnel sites, the procedure can significantly reduce pain and restore protective sensation, but ongoing blood sugar management remains essential for long-term nerve health.

How long does recovery take after nerve decompression surgery?

Most patients are weight-bearing in a protective shoe within 1 to 2 weeks and return to regular footwear at 3 to 4 weeks. Nerve recovery is gradual — sensation improvement typically begins within weeks to months and can continue for up to 12 to 18 months as the decompressed nerves regenerate.

Who is a good candidate for the Dellon procedure?

The best candidates have painful diabetic neuropathy with a positive Tinel’s sign at one or more nerve tunnel sites, documented nerve conduction abnormalities, and reasonably controlled blood sugar. Patients with completely absent sensation and advanced peripheral vascular disease are generally not candidates because nerve regeneration capacity is too compromised.

The Bottom Line

Peripheral nerve decompression offers a meaningful surgical option for patients with painful diabetic neuropathy who have identifiable nerve compression at anatomical tunnel sites. The procedure does not replace medical management but can significantly improve quality of life when conservative treatments have failed. If you experience burning, tingling, or progressive numbness in your feet and live in Howell or Bloomfield Township, Michigan, an evaluation for nerve compression can determine whether the Dellon procedure may help restore sensation and reduce pain.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your neuropathy, our podiatry team at Balance Foot & Ankle can help with expert evaluations and advanced in-office care.

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.