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!
I too have this neuroma of the let knee. Like the previous writer, I have had to ACL reconstructions. After the second one, my rehab was very slow. Its been 2 years post-op and the knee pain is constant. I have been told my future holds a double knee replacement but because of my age they refuse to do it. I'm told I also have neuroma. Apparently there is a surgury for this, but once again I was told I am not a candidate. Every second of everyday is painful. At times I say to myself, I wish they would just cut the leg off. I know this is an absurd way of thinking, but after 2yrs. with no relief I am at ly wits end.I have tried several shots of cortisone and synvisc but nothing. I feel for anyone with this condition
I fell in November 2009 with an impact to my left knee. after initial doctor consultation i was referred to physio who then promptly referred me to orthapeodics who then referred me to plastic surgery department who then referred me to pain department who have now said i have to go back to pain consultant with the possibility of injections and then surgery by plastic surgeon. i'm on gabepentin amitriptilyne dyclofenac and lidocain 5% anesthetic patches for 12 hours a day. believe me i sympathise with all the above. one consolation is that they are still passing me around which means someone is investigating.
i refuse to give up until someone resolves it. i've been told they think i may have a neuroma now so we're getting somewhere now. don't give up. keep pestering them until someone listens and says they can and will help
How old are you? While waiting at my surgeon's office I talked with a man who was 87 and was recovering from knee replacement surgery. I am a mere 74 myself, and I have had chronic pain for almost 1000 days. The surgeon gave up on me, not even considering that I might have a neuroma. I mean, when you cut nerves, isn't that one of the things you should think of? Anyway, my pain at long last has been diagnosed by an anestheologist using a special ultrasound machine who found the little 5x5mm jewel. Tomorrow I go in for a steroid injection to see whether that works. If not, there are other options ... I know surgery is one but cryogenics might be another. Wish me luck!
Going on two years ago (February 2010) I tore my right ACL in a varsity softball game, I had it repaired and went through therapy for a long amount of time. In January of this year I found I wasnt getting any relief and was having a hard time getting full flexion back. They went back in and found a inflammed Plica band wrapped around my knee, which they removed, afterwards I continued with therapy. Since then I have still seemed to not get any relief, but the pain now is very specific. Its a sharp shooting pain near one of my ACL surgery scars. The doctors thought it may the screw which has not softenened yet. They also thought it may be a nerve problem or a problem with the fluid, so I underwent Euflexxa injections, then had a Lumbar Sympathetic Nerve Block, and was taking Lyrica for several months. The condition still persisted and now I have finally gone back to my Orthopaedic surgeon to get another diagnosis. They still believe it may be the screw, but recently they have suggested it is a neuroma. Because they harvested my hamstring for my ACL it would make sense to be a problem with the nerves and the doctor checked it out and thinks so too. Today I got another Cortisone shot directly into the pain site in hopes it would help, but so far I have had no relief. Im only 17 so this process is not because of my wear and tear on my knees over the years. Im confused though, how does the Neuroma surgery work? Will it have a long recovery time and require therapy? Will I be on crutches again? If anyone can answer these questions please tell me! Thank you!
Hi, I fell on my right knee - hard - 2.5 mos ago, and the doc recently concluded I had a neuroma. The pain is intense and Ive taken tramadol but that does nothing and I don't want stronger drugs. im starting acupuncture next week. I am also working with a naturuopath. I'm afraid of the surgery - that it won't work and I will have limited mobility, but I have limited mobility now, and lots of pain. I'm 52, and was very active. Advice is welcome, and I hope your pain has lessened since you wrote.
Just FYI but this is a really old thread...You will get more responses by posting a new thread on your own.
But to quickly answer your question...I had surgery in my left foot for a Morton's Neuroma. It is a very easy surgery (doesn't matter whether it's knee or foot as it's the same issue) where they use local anesthesia and I went in for surgery in the am and was out back home by the afternoon.
It's really just cutting out the neuroma that has formed. So, I'm not sure why you are being so pessimistic about it not working. They are very successful surgeries.
If one or two cortisone treatments/injections haven't worked...then I don't see many Drs. wanted to continue to treat you medicinally as there is such an easy answer with surgery to remove the neuroma and get on with your life:)
Hi. I'm 36 and discovered a neuroma near my left knee. I have no idea how I got it due to zero injuries. However, the pain started after pregnancy. For years it would throb when I would get cold or get nervous. I received the steroid injection and the pain got worse. I am now taking gabapentin to manage the pain. It is working. Meeting with the doctor in two weeks to determine whether or not to remove the neuroma. I decided that the pain is too much and I need to make a change.
It took five years to find a doctor who could figure this out. Thanks to a neurologist. And an orthopedic surgeon working together, I finally have some answers.
I had a full seizure and am now on keppra. I had simple partials up till now. I don't remember anything from this big one. I'm so scared this med. is going to make me worse. More depersonalization. I have been living in fear for far too long. Any advise?
There are 2 places in the US that are doing some trials with knee neuroma, they identify the specific pain points around the knee, then inject numbing agents (lidocain and another). if the pain goes away in a little bit they know they are treating the correct issue. They do 3 total treatments. About 17% of patients are good after the 3 treatments, other 83% have a surgery to remove the neuroma and place the nerve into a muscle. Froedtert Hospital in Milwaukee, WI is one place that they do this. In their Orthopedic area. Baltimore has another one. They just started doing this in the last year (2015/2016).
My favorite procedure is called ‘Radiofrequency Ablation for Neuromas’. I have been doing this amazing procedure for a few years and I have close to one hundred percent success with it. This involves inserting a radiofrequency probe into the foot right at the inflamed nerve. Once it is in the perfect spot, I heat up the tip of the probe to ninety degrees Celsius, just below the boiling point of water. I repeat this process at three areas of the neuroma, all through one entry point through the skin. This pin point spot of heat denatures the proteins off the nerve and stops the transmission of the pain fibers.