Written by TMRnerve.com Staff
According to Cleveland Clinic, “An estimated 8 out of 10 people who lose a limb experience some degree of phantom pain.”
There are a number of therapies to manage post-amputation pain. Targeted Muscle Reinnervation (TMR) is a surgical treatment quickly gaining broad acceptance for nerve pain associated with amputation. In TMR, painful conditions may improve when amputated nerves are reconnected to nearby nerves and eventually muscle targets. If you think about nerves as electrical wiring, TMR helps to complete the “circuit” by reconnecting the “live wire.”
There are two instances where TMR surgery might be conducted.
The prevalence of post-amputation pain is high, with 74% of patients experiencing painful neuromas and 80% experiencing phantom limb pain following surgery. Some research suggests that TMR is most effective when performed preemptively before nerve pain begins. If you and your physician are planning an amputation, you may want to discuss TMR as an option.
TMR is also performed to address pain that has developed from a prior amputation. TMR can be effective even in patients with established nerve pain – as long as 10 years following the initial amputation.
As you are learning more about TMR surgery as an option, it’s helpful to have a checklist with you for your first visit. To ensure you start with a clear and open conversation with your surgeon, you should be ready to share as much detail as possible. For example:
If the doctor is unfamiliar with your case, you should be prepared to describe the circumstances of your amputation: When did it occur? Why was the amputation performed?
If you are exploring TMR for pain relief, you should be prepared to describe your pain in detail: Is it phantom pain or residual limb (stump) pain? How severe is the pain? How often does it occur?
You should be prepared to talk about all medications and treatments you’ve tried and how effective they were in alleviating your pain. Your doctor will want to understand the impact your pain has had on your life. Is your pain limiting the use of your prosthetic? Is it impacting your relationships, your physical activity or your ability to work?
Your doctor will want to understand your personal goals for considering TMR for pain. Would you like to be able to use your prosthetic? Get off medications? Resume an active lifestyle?
The questions you have for your doctor will depend on your physical condition. But these are common questions to think about:
Starting the process of researching TMR nerve surgery should be a positive experience. The trauma of limb loss is the worst hurdle, and one that likely you are addressing through a network of providers, support systems and family. This next step of choosing a potentially life-altering surgery is a matter of investigation and preparation.
For a list of surgeons who perform TMR nerve surgery, view our physicians list.
Written by TMRnerve.com Staff
Targeted Muscle Reinnervation (TMR) is a surgical treatment that is gaining acceptance for nerve pain associated with amputation.
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.