Research Summary

Targeted Muscle Reinnervation Reduces Pain, Improves Quality of Life for Patients With Symptomatic Neuromas

Anthony Calabro, MA

Key Highlights

  • Targeted muscle reinnervation (TMR) reduced resting pain in 72.5% of patients with symptomatic neuromas.
  • Mean visual analog scale pain scores decreased from 6.6 preoperatively to 3.7 at 12 months.
  • Improvements in quality of life were observed postoperatively.
  • Longer time between nerve injury and TMR correlated with higher pain scores at 12 months.

Targeted muscle reinnervation (TMR) resulted in significant reductions in resting pain and improved quality of life in patients with symptomatic neuromas of the upper and lower extremities, according to results from a prospective study. At the 12-month follow-up, more than 70% of participants reported reduced pain.

Peripheral neuromas, often arising from nerve injuries, are a common and challenging source of pain. Traditional surgical treatments vary in effectiveness, prompting exploration of newer techniques like TMR. This method, originally developed to enhance myoelectric prosthetic control, has more recently been employed to address symptomatic neuromas by rerouting transected nerves to motor targets, thereby reducing aberrant nerve signaling that causes pain.

In this study, 40 patients undergoing TMR for upper or lower extremity neuromas were prospectively followed. Pain and quality-of-life outcomes were measured preoperatively and at 3 and 12 months postoperatively. The primary endpoint was resting pain as measured by the Visual Analog Scale (VAS, 0–10), with secondary endpoints including activity-related pain, proportion of patients achieving a VAS ≤3, and health-related quality of life using the EQ-index.

At 12 months, 29 out of 40 patients (72.5%) demonstrated improvement in VAS scores at rest. The mean VAS pain score decreased from 6.6±2.2 at baseline to 4.3±2.7 at 3 months and 3.7±2.8 at 12 months (P < .001). A statistically significant correlation was found between a longer duration from injury to TMR and higher 12-month pain scores (Pearson correlation coefficient = 0.35, P = .026), suggesting earlier intervention may lead to better outcomes. Quality of life also improved significantly, with mean EQ-index scores rising from 0.43±0.26 to 0.55±0.30 (P = .016) over the same period.

“TMR reduces limb pain in over 70% of patients with symptomatic neuromas and is associated with an improvement in quality of life,” the authors concluded. “Further research is needed to identify prognostic factors for the success of TMR as well as establish its’ effectiveness in comparison to other surgical treatments.”

Reference
Langeveld M, Hundepool CA, Luijsterburg AJM, Power D, Duraku LS, Zuidam JM. Targeted Muscle Reinnervation for the treatment of painful neuromas: a prospective cohort study. Plast Reconstr Surg. Published online April 9, 2025. doi:10.1097/PRS.0000000000012152