Re: NEUROMA DERIVING FROM AMPUTATION

Posted By CCF Neuro MD on May 30, 1997 at 11:27:11:

In Reply to: NEUROMA DERIVING FROM AMPUTATION posted by Nicanor Aparicio on May 22, 1997 at 11:57:22:







: NEUROMA DERIVING FROM AMPUTATION
Several years ago I had a severe fall and my left ankle
was lesioned in the tendinous region of the anterior
fibula. Since my recovery was not complete, I underwent
an operation 4 years ago. In that intervention,the left
anterior peroneal tendon was cleaned up and two small
pieces of anomalous conective tissue were removed.
After the surgery, the tendon pain remitted but an
pea-sized amputation neuroma developed on a superficial
branch of the left fibial nerve at the level of the
exterior malleolus. Since it was painful,
the neurosurgeon recommended that it should be removed.
In this second operation the neuroma was removed but
the original continuation of the nerve could not be
found such that it remaind severed. Unfortunately,
10 mounths have elapsed since that operation and the
pain in the region continues and is even worse.
The neurosurgeon has offered me two possibilities:
a) treatement to palliate the pain in the area with
ultrasond, laser thechniques, ionophoresis.... (I have
already been to several sessions but have noted no
improvement), and b) a new operation to re-sheath the
nerve (2-3cm) with a closed tube of biocompatible
material, thus attempting to reduce the sensitivity
of the zone. I am a man of 45 years old.
I look forward to receiving your views on this
and take this opportunity to thank you in advance
for any consideration you might care to give the matter.
Sincerely, Nicanor.






Hell Nicanor,
Causalgia is the term used to refer to pain brought on by damage to a nerve.  In some instances medications such as amitryptilline, tegretol, pamelor, or neurotin can be helpful in alleviating the pain.  Another medication that can be tried is capsaicin cream applied over the painful area 3 to 4 times a day.  Capsaicin has a disadvantage of initially making the pain worse however the pain gradually improves over several days.  Many people are unable to tolerate capsaicin because they could not stand the initial worsening of pain.  These medications, however, have the added advantage of being a noninvasive mode of therapy and shuold be considered before pursuing further more invasive therapies.  I hope you have sucess in getting your pain under control.  This information is meant for educational purposes only.  For specific medical questions pertaining to your medical condition, I suggest you consult your physicain.