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All About Neuromas

What are they, where do they come from, and how are they managed?

Healthy peripheral nerve cell illustrated above. When the axon portion is severed (i.e. due to amputation), the axon sprouting occurs to reinnervate denervated muscle fibers Image adapted from Shutterstock.

What are they?

Neuroma is a collection of nerve endings that form under the skin of residual limbs (the part of the limb that remains attached to the body upon amputation). According to the Amputee Coalition, you can think of it like tangled hair. They can be extremely sensitive and painful to the touch.


Where do they come from?

Neuromas may form in different types of nervous tissue and for different reasons. Traumatic neuroma usually occurs after surgery, including amputation surgeries, and is considered a postoperative complication. It involves nerve swelling and tumor-like thickening due to abnormal regeneration of sprouting axons. The science behind this abnormality is not well-understood.


In one analysis of 75 consecutive lower limb amputees who developed painful neuroma, symptoms that would suggest a neuroma appeared after 9-10 months of prosthetic use. Neuromas are often asymptomatic until they interact with their surroundings. Prosthetic use is the leading trigger since abrasive pressure is applied to the neuroma site during use. Symptoms may also arise if the neuroma grows, scar tissue contracts, and ischemia (blood vessel constriction) occurs among other potential triggers.


The incidence rate of symptomatic neuroma was ~4% in a study of 96 patients who underwent lower limb amputation.


What are the symptoms?

While neuromas are often asymptomatic, crushing pain is associated with frequent stimulation of the damaged nerve site. Unfortunately, this likely the case for patients with limb loss who aim to wear prostheses as much as possible. The prostheses socket may persistently contact, rub against, and transfer forces to the neuroma. The neuroma may be chronically irritated in this way.


Pain Management

Unfortunately, neuromas often reform upon surgical removal. While the pain behind neuroma is not well-understood, several options have been studied and implemented to help people manage this pain. For example, the Amputee Coalition lists the following:

If you think you may be suffering from post-amputation neuroma, consult your healthcare providers to understand the nature of your pain and discuss these options. One or a combination of therapies may effectively manage pain and improve your quality of life.

 

About Writer: Pranita Muralidhar


Pranita Muralidhar is passionate about health sciences, entrepreneurship, and connecting people with products that benefit them the most. By contributing to the blog, Pranita hopes to help raise broad exposure and awareness of TheraV ELIX. 


Learn more about Pranita at pranitamuralidhar.com

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