A neuroma is a disorganized growth of nerve cells at the site of a nerve injury. A neuroma occurs after a nerve is partially or completely damaged by an injury — either due to a cut, a crush, or an excessive stretch. The neuroma is a ball-shaped mass at the site of the injury, which can be painful or cause a tingling sensation if tapped or if pressure is applied. Although not always the case, a neuroma can be extremely painful and can cause significant loss of function for the patient by limiting motion and contact with the affected area.
Neuromas can occur after trauma and even after surgery in any region in the body since most areas have nerve fibers providing feeling. Painful neuromas are common after cuts to the fingers, hand, wrist, or arm, and in amputations of the fingers, hand, and upper extremity (arm) and in the lower extremity (leg). They are also seen following hernia repair in the groin, or after knee or ankle surgery.
The peripheral nervous system is defined as the nerves outside the spinal canal. When nerves are injured, cut, or pinched, the brain interprets that as pain. Carpal tunnel is one example of a pinching of a peripheral nerve. Neuromas are the result of injury to a peripheral nerve. The nerve tries to heal, but instead develops disorganized nerve and scar tissue. For amputees, the loss of the limb creates many cut or damaged nerves in the amputated stump. Like a live electrical wire, the neuromas that form can cause severe pain in some patients. In amputees, the loss of connectedness of the end of the nerve can also cause unpleasant phantom limb pain.
A procedure called Targeted Muscle Reinnervation, or TMR, gives the injured nerve somewhere to go and something to do. TMR involves rerouting severed or injured nerves to new muscle targets using microsurgical techniques to provide the nerve endings with a new muscle to innervate. The new muscle target encourages the nerve to regenerate in an organized fashion, with improvements in both neuroma pain and phantom limb pain.
In addition to treating nerves in amputated limbs, Dr. Spiess employs Targeted Muscle Reinnervation (TMR) when treating a number of other conditions, including:
Dr. Spiess can evaluate your nerve tumor, discuss if an MRI should be done, and let you know what the chances are for a loss of function from the removal of the tumor.
1/20 people will experience chronic groin pain after the treatment of an inguinal hernia. Dr. Spiess performs neuroma excision and targeted muscle reinnervation procedure to treat chronic localized pain after inguinal hernia repair. In the office, Dr. Spiess will often inject local anesthesia to numb the area as a test to see if you are a good candidate for surgery.
Alexander Spiess, MD is a specialist in Targeted Muscle Reinnervation, and he has the expertise to determine whether TMR will help you find relief from pain due to nerve damage. When you have your first consultation with Dr. Spiess, he will review your medical history, your condition, and your unique needs and goals in order to help you decide whether or not to pursue TMR.