Neuroma and phantom limb pain following leg or foot amputation is quite common. These types of pain are commonly referred to as neuropathic (nerve) pain, by healthcare professionals. The severed nerves no longer have a connection to muscles and skin and are the source of pain symptoms. Different from bone and muscle pain, known as somatic pain, nerve pain is less responsive to pain medication. As a result, nerve pain is more likely to become chronic (long lasting) and interfere with a patient’s happiness and daily living.
Phantom sensations are perceived to occur in the leg or foot that is no longer attached. Lower limb amputees report a variety of feelings, including burning, shooting, stabbing, tingling, twisting, throbbing and crushing. The missing leg is imagined to be held in an ice bath. While not all phantoms are painful, studies show the majority of lower limb amputees with phantom symptoms do experience pain.
Phantoms are usually a lifelong condition. In general, phantom pain is usually most intense closer to the time of amputation and gradually lessens over decades.
Experts agree that phantoms are the result of altered signals sent from injured peripheral nerves to the brain following limb loss. Amputation removes a source of sensory input to the brain, and the absent signal from the limb tells the brain something is wrong. In turn, the brain fills the sensory void by creating a phantom, which is interpreted as painful.
A variety of therapies can help you manage the pain and discomfort from phantoms in the lower extremity, including a new surgical technique called Targeted Muscle Reinnervation (TMR).
When nerves in the leg or foot are cut, they undergo the natural phenomenon of trying to heal. But without a destination to connect to, nerve endings grow in a disorganized tangle of nerve tissue, known as a neuroma. About half of amputees experience pain from neuromas that are sensitive to pressure, touch or impact. Often when the area is bumped, the result is shooting or shocking pain in the path the nerve traveled prior to the injury.
A variety of therapies can help you manage post-amputation neuroma pain in the lower extremity, including a new surgical technique called Targeted Muscle Reinnervation (TMR).
Residual limb pain is a broad term that refers to pain in the remaining part of the amputated limb, also known as the stump. Pain in the residual arm or hand may be neuropathic (nerve-related) or musculoskeletal (soft tissue or bone) in origin.
A variety of therapies can help you manage residual limb pain in the lower extremity, including a new surgical technique called Targeted Muscle Reinnervation (TMR).
In addition to nerve-related (phantom or neuroma) pain, lower limb amputees may also experience musculoskeletal (soft tissue or bone-related) pain. Musculoskeletal pain may have a variety of causes, including pressure from their prosthetic, bone spurs caused by overgrowth of bone (called heterotopic ossification), wounds, internal pressure sores called "bursas", poorly fitting prosthetics, and more infrequently, inadequate blood supply to the stump. Ischemia, or not enough blood going to the stump, is an important consideration in patients who have lost their limb due to hardening of the arteries. Lower back pain affects more than half of lower limb amputees and is believed to be related to the body’s adaptation to the missing limb. An abnormal gait pattern or unbalanced stance places more stress on the back, hips, and knees, and these factors may lead to pain.
It's important to understand whether the source of your lower extremity pain is related to nerves or something else. If your post-amputation pain is nerve-related, then a new surgical technique called Targeted Muscle Reinnervation (TMR) may help.