Written by TMRnerve.com Staff
Following an amputation, pain can come from a variety of sources: nerves, tissue or bone healing or from an ill-fitting prosthesis.
According to experts, amputation can be one of the most painful experiences thanks to the number of sites involved with the procedure that produces pain. If you’re experiencing pain following an amputation, it can be difficult to determine whether that pain is a result of your bones and tissues or if it’s nerve-related.
Post-amputation nerve pain happens after the nerves have been severed during the amputation procedure. When injured, nerves regenerate, but in an amputation, nerves have nowhere to regenerate to. This results in the formation of neuromas, which can cause pain. Neuroma pain can vary, but can possibly feel like sharp, stinging, burning or shooting pain.
According to Dr. Gregory Dumanian, MD, a plastic and reconstructive surgeon with Northwestern University, your doctor can determine if your pain is nerve related by using the following methods.
“It is amazing that in this day and age, there are no additional tests to help determine whether the pain is related to the nerve divided by the amputation,” commented Dr. Dumanian.
Orthopedic pain originates in the musculoskeletal system, which means it can be felt in the muscles, joints or bones of your body or around the area of amputation. A normal amount of post-amputation orthopedic pain occurs immediately after the amputation surgery. Pain associated with surgical healing usually decreases over the first few weeks post-surgery, according to the Amputee Coalition. If your pain is lasting longer than you think it should, has become unmanageable or you have questions, you should contact your care team.
Post-amputation orthopedic pain that persists weeks to months after an amputation can be a sign of the need for further treatment. Post-amputation orthopedic pain tends to be generalized over a wide area, rather than localized like nerve pain. It can occur due to poor padding of at the end of the amputated bone, bone overgrowth (called heterotopic ossification), wounds, joint stiffness, and sometime due to not enough blood reaching the end of the residual limb.
While post-amputation orthopedic and nerve pain may seem similar, a simple way to differentiate between them is the Tinel’s sign. A positive Tinel’s sign usually indicates pain is coming from a nerve, as Dr. Dumanian mentioned above. If you’ve got nerve pain, you will have pain in addition to the sensation of tingling or “pins and needles” along the path where the nerve went before the amputation.
Treatment options for orthopedic pain can include:
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. Your physician will help you determine whether TMR is right for you.
Written by TMRnerve.com Staff
Targeted Muscle Reinnervation (TMR) is a surgical treatment that is gaining acceptance for nerve pain associated with amputation.