Nerve pain in my knee after surgery, it was called a neuroma

[Mingo3434]

I recently had knee surgery to repair my ACL in my left knee (for the 2nd time). The Doctor too the Petella graft from my right knee. The surgery was done in March 07.  Shortly after the surgery during my Physical Therapy I started having pain in my right knee. The Doctor went back in on July 5th 07 to try and find a Neuroma. The Doctor said after the surgery that she didn't find anything, but I still had very sharp pains shooting through my knee. The pains are very sharp and can last from 1-2 seconds up to 30 seconds and going on all day long. Some days are worse then others and sometimes the pain is not so bad and other times it hurts so bad that I can't really move or do much of anything else all day but lay on the couch and medicate myself. What I'm looking for is help trying to find out if there is anything else I can do to stop the pain. I am currently taking Neurontin (gabapentin), and have had an epideral, a sympathetic nerve block, Methedone,Elavil (amitryptiline), and none of them have really worked. The Neurontin has helped in cutting down the frequency of the spikes but that is all. Please HELP me find out a way to make this better, I have a 4 month old daughter that I would like to get on the floor and play with. I take about 8-10 Vicoden right now and they basicly have now effect anymore. I guess what I'm looking for is some kind of relief from the pain in my knee. I really want not be taking any pills to do this but have been told that this neuroma is going to be a life long thing and is going to be very painful to deal with, without medication.

[jcverive]

Traumatic neuromas result when nerves are cut. When nerves are operating properly, the constant electrical and chemical activity prevents the release of a substance known as nerve growth factor (NGF).  If these normal activities stop, NGF is released, causing nerve endings in the vicinity to grow "fingers" called dendrites. Dendrites grow slowly, around 1 mm per year for peripheral nerves. Until the dendrites reconnect, they continue to sprawl out, often attaching to nearby tissues (muscle, scar, bone, etc.), and anything that compresses or pulls on these new nerve endings has the potential to send out pain signals.  This is believed to be a major cause of "phantom pains" that often occur after a limb (arm, leg) or extremity (finger, toe) is amputated.

This nerve pain (neuralgia) is usually sharp and shooting, and does not respond well to pain killers, including narcotics. Neurontin, Elavil, nerve blocks, and the like often work for a while, but just as often don't last long.  Lyrica and Keppra are possible candidate drugs worth investigating. Lyrica helps to desensitize overly sensitive nerves (common in chronic pain patients), and Keppra interferes with pain neurotransmission by preventing synaptic gaps from closing enough to allow neurotransmitter release.  Combinations of Neurontin, Lyrica, and/or Keppra have been effective for many chronic neuralgia patients (myself included).  I recommend you ask your pain doctor to consider this information.

Other surgical interventions include intrathecal pumps, spinal cord stimulation, motor cortex stimulation, or deep brain (thalamus) stimulation, all with varying degrees of risk.

I am not a doctor, but as a chronic pain patient for the past 30 years, I have spent hundreds of hours researching pain treatments. I offer no guarantees other than to state that my free advice is worth every penny you pay for it.

Best of luck!

Jeff