Rerouting Nerves During Amputation May Reduce Phantom Limb Pain

Soon amputees may not have to fear a haunting phantom limb.

Begone Ghost

If you've never had to feel pain in a limb you no longer have, consider yourself lucky.

"Phantom limb pain" is a sensation of pain and muscle tension in a limb which isn't actually attached to the body anymore. Roughly 60% to 80% of amputees feel some sort of phantom limb pain after their procedure. The effects, beyond being painful, can be outright debilitating for some people.

Now, doctors from the Ohio State University Wexner Medical Center have discovered that a procedure originally meant to help with advanced prosthetic devices may also reduce or prevent phantom limb pain entirely.

Un-Nerving

Primary targeted muscle reinnervation or TMR, the process of rerouting nerves cut by amputation into surrounding muscle, was originally developed to help patients have better control of upper-limb prosthetics. Normally the procedure is performed month or even years after an initial amputation. By performing TMR at the time of amputation, however, doctors can tie up loose ends (so to speak) helping to prevent pain.

Over the course of three years, surgeons performed 22 TMR surgeries on below-the-knee amputees. None of the patients have developed neuromas, or pinched nerves, and six months later only 13 percent of patients reported having pain.

Attaching severed nerves "allows the body to re-establish its neural circuitry. This alleviates phantom and residual limb pain by giving those severed nerves somewhere to go and something to do," said Dr. Ian Valerio, division chief of Burn, Wound and Trauma in Ohio State's Department of Plastic and Reconstructive Surgery.

Sweet Relief

By making TMR surgery a normal part of amputation procedures, doctors may be able to prevent a lifetime of pain for patients and later enable them to have more precise control over prosthetic limbs. In the United States alone there are approximately 185,000 amputations annually, according the Amputee Coalition. Developments, like those made by Valerio and team, will go a long way toward helping new amputees and those who use advanced prosthetic devices.

READ MORE: Rerouting nerves during amputation reduces phantom limb pain before it starts [EurekAlert]

More on Advanced Prosthetics: Electronic Skin Lets Amputees Feel Pain Through Their Prosthetics