Targeted Muscle Reinnervation (TMR)

Did you know about 2 million people in America have lost a limb? And every year, nearly 185,000 more people undergo amputation. For about 70% of these amputees, phantom limb pain or chronic pain results. 

At Anthony Echo, M.D., with two offices in Houston, Texas, board-certified surgeon Anthony Echo, MD, FACS, understands the aggravation and discomfort phantom limb pain causes — especially when it continues long after your healing from surgery is complete. 

To help patients struggling with ongoing pain after amputation, Dr. Echo performs targeted muscle reinnervation (TMR). His expertise in microsurgery and peripheral nerve surgery draws patients from around the country to seek his help in alleviating phantom limb pain.

If you’re suffering from lasting pain or discomfort after amputation, read on to learn more about phantom limb pain and how targeted muscle reinnervation can help.  

Why do I have phantom limb pain?

Your body sends information about sensation to your brain through the nervous system. When you experience pain, it’s a signal that something is wrong and needs attention. 

Phantom limb pain occurs when the severed nerves from the amputated limb continue to send sensory signals to your brain. This pain may also present as itching, warmth or cold, pins and needles, or a sensation of pressure. 

Sometimes amputees develop neuromas, a hypersensitive collection of scar and nerve tissue, at the end of these nerves that cause chronic pain. When the extremely sensitive neuroma is touched or presses on something, it can trigger phantom limb pain or uncomfortable sensations.    

What are the symptoms of phantom limb pain?

While the majority of amputees suffer from phantom limb pain at some point after their amputation, only about 5-10% seek medical help. This may be due, in part, to the varying ways phantom limb pain can present. 

While your limb may be gone, phantom limb pain is very real. Some of the symptoms that indicate phantom limb pain include:

• Phantom pain that develops after amputation (immediately after an injury or weeks, months, and even years later)
• Stabbing or shooting pain in the phantom limb
• Cramping, pressure, or throbbing in the phantom limb
• Sensation of pins and needles in the phantom limb
• Itching or burning in the phantom limb
• Feeling like the phantom limb is being crushed or twisted

The phantom pain may be continuous, or it may come and go. Fatigue, stress, anxiety, or fear can often make phantom limb pain worse. 

How can TMR help phantom limb pain?

Targeted muscle reinnervation works by surgically re-routing the severed nerves to create a new neural circuit. By reassigning these nerves to other motor nerves, Dr. Echo can use TMR to reduce or eliminate your phantom pain. 

Dr. Echo first assesses your phantom limb pain and conducts diagnostic testing to identify which nerves and neuromas are the root cause of your pain. After surgery, any pain signals sent from the affected nerves are redirected into your muscles. 

While TMR is highly successful, it takes time for the nerves to heal and the new neural circuit to become established. Most patients experience improving results over the months after TMR surgery with maximum results at about six months. 

TMR works best when used in conjunction with other treatments. Dr. Echo collaborates with your entire medical team to ensure you get the care you need. 

If you’re suffering from phantom limb pain and want to know if TMR can help you, call the Houston office of Anthony Echo, MD, most convenient to you or request an appointment online now.