TMR Nerve does not provide specific medical or legal advice but provides patients with information to better understand their health and healthcare issues surrounding amputation. Always consult your physician for your specific healthcare needs.

Abutment

Abutment

The piece of metal for osseointegration that sticks out of the stump skin and that attaches to the prosthesis.

AKA

AKA

Above knee amputation

Amputee Coalition

Amputee Coalition

A 501(c)3 nonprofit organization whose mission is “to reach out to and empower people affected by limb loss to achieve their full potential through education, support and advocacy, and to promote limb loss prevention.”

American Association of Orthotists and Prosthetists (AAOP)

American Association of Orthotists and Prosthetists (AAOP)

Founded in 1970, AAOP is the professional organization representing certified practitioners, state-licensed practitioners, assistants, technicians, fitters, and others affiliated with the profession of orthotics and prosthetics.

BKA

BKA

Below knee amputation

Chronic

Chronic

Long lasting

CRPS (Complex regional pain syndrome)

CRPS (Complex regional pain syndrome)

An unusual nerve and tissue response after injuries and surgery, typically with generalized swelling, burning pain, color changes in the skin, increased hair growth, and poor function.

Diagnostic nerve block

Diagnostic nerve block

The injection of local numbing medicine to see if the pain of a neuroma can go away temporarily. A positive nerve block means that the patient feels less pain for 2-4 hours after the injection,and is a sign that surgery can help relieve pain more permanently.

Dysesthesia

Dysesthesia

Uncomfortable or creepy feeling in skin that has lost its innervation. The feelings can be elicited to light touch or stroking of the skin, and this is not the pain of deep palpation that causes neuromas to be painful. Dysesthesias tend to become better with time and to be a smaller area over time.

Dysvascular amputation

Dysvascular amputation

Lower limb amputation is a common occurrence with advanced peripheral vascular disease.

Epidural blocks

Epidural blocks

An anesthetic or pain medication injected just outside the spinal cord but inside the spinal canal.

Evoked pain

Evoked pain

Pain brought on by normally non-painful stimuli such as cold, gentle brushing against the skin, pressure, etc.

Innervate

Innervate

Literally, to “put the nerves into” something. When nerves go into muscle fiber, they innervate the muscle fiber.

Liner

Liner

A cylindrical fabric or material that comes between the skin and the firm part of a prosthesis.

Musculoskeletal

Musculoskeletal

Bones, muscles, tendons, ligaments and soft tissues that work together to support your body's weight and help you move.

Myoelectric

Myoelectric

Electric properties of muscles. A myoelectric-controlled prosthesis is an externally powered artificial limb that you control with the electrical signals generated naturally by your own muscles.

Nerve blocks

Nerve blocks

An anesthetic or pain medication is injected near a nerve. Nerve blocks are typically started during a procedure and can be continued for several days afterward.

Nerve transfer

Nerve transfer

Moving the end of the nerve from one muscle to another muscle, so that the innervation of that muscle changes. TMR surgery involves one or more nerve transfers.

Neuroma

Neuroma

The end of a divided nerve. Divided nerves are a part of every amputation. In a patient with intact arms and legs, any injured nerve can form a local swelling that can be a neuroma. Not all neuromas cause symptoms—there are painful neuromas and quiet neuromas. A symptomatic neuroma is painful to palpation, and typically causes “zingers” in the direction that the nerve used to travel.

Neuropathic pain

Neuropathic pain

Nerve pain caused by damaged nerve fibers sending the wrong signals to pain centers.

Neuropathy

Neuropathy

A disturbance of function or a change in one or several nerves.

Osseointegration

Osseointegration

A direct connection between human bone and an artificial implant. Osseointegration for amputees involves implanting a metal anchor directly to the bone of an amputated limb that extends out of the residual limb. A prosthesis is then attached to the metal extension (abutment).

Palpation

Palpation

Feeling with the fingers or hands as part of a diagnostic examination.

Peripheral nerves

Peripheral nerves

The nerves that are spread throughout the body to places like organs, arms, legs, fingers and toes.

Perioperative

Perioperative

The period of time that starts when you go to the hospital for surgery and ends when at discharge. From a pain management perspective, the plan of how your pain will be treated after surgery begins before surgery.

Phantom limb pain

Phantom limb pain

Ongoing painful sensations that seem to be coming from the part of the limb that is no longer there. The limb is gone, but the pain is real. The onset of this pain most often occurs soon after surgery. Sometimes referred to as PLP.

Prosthesis

Prosthesis

An artificial body part, such as a limb.

Prosthetist

Prosthetist

A person specifically trained to work with prostheses, such as artificial limbs and other body parts. Some orthotists and prosthetists construct devices for their patients. Others supervise the construction of the orthotic or prosthetic devices by medical appliance technicians.

Residual limb

Residual limb

The part of the limb that’s left following amputation.

Residual limb pain

Residual limb pain

A broad term that refers to pain in the remaining part of the amputated limb, also known as the stump.

Shrinker

Shrinker

A cylindrical bandage that is “rolled” onto a limb after surgery to get out swelling.

Stimuli

Stimuli

A thing or event that provokes a specific functional reaction in an organ or tissue.

Therapeutic nerve block

Therapeutic nerve block

The injection of steroids and/or numbing medicine around a nerve to decrease its pain permanently.

Targeted Muscle Reinnervation

Targeted Muscle Reinnervation

Also referred to as TMR, a procedure where surgeons reroute amputated nerves by attaching them to other nerves in nearby muscles.

Traumatic amputation

Traumatic amputation

An injury to an extremity that results in immediate separation of the limb or will result in loss of the limb as a result of accident or injury.
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Targeted Muscle Reinnervation (TMR) is a surgical treatment that is gaining acceptance for nerve pain associated with amputation. 

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TMR is not a treatment option for patients with spinal cord injuries, brachial plexus injuries, or who are generally not healthy enough for surgery. The procedure does present typical risks of surgery. Patients may experience a temporary increase in pain as part of the nerve healing process. Your physician will help you determine whether TMR is right for you.

Gregory Dumanian, MD, is medical director of TMRnerve.com. He is a paid consultant of Checkpoint Surgical, Inc.

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