If you've lost sensation in a hand or foot due to nerve injury, you'll notice that most of the information available focuses on muscle. Muscle wasting, muscle strengthening, preventing atrophy, stimulating a weak limb. Page after page of content. Then you look for something about the numbness, the part that actually bothers you most, and there is very little content available.

I want to address that gap, because there is real evidence that electrical stimulation improves sensory recovery. There is also, as far as I am aware, no evidence that any device you can buy and use at home will bring feeling back to a numb hand. Those two statements sit together and seem to be opposing; the difference between them is worth understanding before anyone sells you anything.

We see many people with foot drop, but the cause can vary a great deal and the treatment approach consequently will need to be personalised to the situation. One person has broken a leg; another has dislocated a knee or is recovering from a hip replacement or lumbar spine surgery, and now the foot on that side will not lift. They are catching their toe on every kerb. They have discovered foot drop stimulators online, watched the videos of people walking along a corridor without a brace, and they want to know how to get one.

The videos are genuine. The devices do what they appear to do. But almost every person in those videos has had a stroke, and that difference is not a minor detail. It decides whether that type of device can work for you at all.

I want to explain what a foot drop stimulator is actually doing, why it may do nothing whatsoever for a peroneal nerve injury, and what does matter in the first few months after that kind of injury.

Someone has damaged a nerve. Perhaps because of a fracture, perhaps a fall, perhaps a complication of surgery they were told would be routine. They have read that electrical stimulation can help prevent muscle wasting. They have bought a device, often an inexpensive TENS unit, sometimes a consumer muscle stimulator. They have put the pads on, turned the intensity up as far as it will go, and nothing has happened. No contraction. No twitch. Nothing at all.

Then, usually near the end of the call, comes the question, and it is nearly always some version of this:

Could I have made it worse?

If you have a nerve injury, whether at the spine or further out in a limb, at some point, someone may send you for a nerve conduction study. You will lie on a couch while a neurophysiologist delivers small electrical pulses to your skin and, a little later, puts a fine needle into one or two muscles. A few weeks after that, a report lands with your consultant. It is dense, full of numbers and abbreviations, and it is written for one clinician to read to another. Almost nobody explains it to the person whose nerve it describes. Just this morning, I read a note from a client who said, "I had a nerve conduction test, which indicated severe injury to the nerves." You might wonder, like me, what severe means, and what do I do about it?

It is quite common for us to meet clients who have tried electrical stimulation on a limb and found that nothing happened. No matter how high the intensity was set, the muscle simply would not contract. They arrive frustrated, sometimes having been told that nothing more can be done. When we then use the RISE Stimulator, a specialist device capable of producing the long-impulse-duration waveforms that denervated muscle actually requires, they are often surprised and relieved to see a contraction for the first time.

That moment of surprise reveals an important gap in understanding. The muscle did not fail to respond because it was beyond help. It failed because the wrong electrical 'language' was being spoken. A denervated muscle is not simply a weak muscle. It is, in a very real sense, a different tissue with altered structure, electrical properties, and activation rules. Understanding these differences is the foundation for making sense of any treatment approach.

Nerve repair surgery—whether nerve grafting, nerve transfer, or direct repair—offers hope for people with peripheral nerve injuries, including brachial plexus injuries. However, surgery is just the beginning of the recovery journey. After the surgeon has reconnected or rerouted nerves, there's a waiting period while regenerating nerve fibres grow toward their target muscles. This process is slow, measured in months rather than weeks.

During this waiting period, a critical question arises: what happens to the muscles? Without nerve signals, they begin to atrophy and deteriorate. If the muscle degenerates too severely before reinnervation occurs, even successful nerve regeneration may not restore function—the nerve reconnects, but finds a muscle no longer capable of responding.

This is where electrical stimulation plays a crucial role. By keeping muscles viable during the reinnervation window, stimulation can significantly improve the chances of functional recovery. In this article, I'll explain how nerve regeneration works, when to consider electrical stimulation, and what to expect throughout the process.