Overview and Treatment of Neuroma

A neuroma is an abnormal growth of nerve tissue. Neuromas are usually benign growths, but they do involve thickening of the nerve tissues. This thickening, which can occur anywhere in the body, often causes severe nerve pain. Neuroma can also mess with the way that you interpret touch and thus result in allodynia, dysesthesia, and hypersensitivity, all of which can be painful and uncomfortable.

A lacerated nerve located anywhere in the body will form a neuroma. In other words, anywhere in your body where a nerve is cut is prone to forming a painful neuroma. Please note that not all neuromas are painful but the ones that are go recognized.

A neuroma is a ball of scar tissue and axon sprouts. These axon sprouts represent the nerve's attempt to regenerate.

Neuromas can occur after certain surgeries, such as a mastectomy or limb amputation, causing pain to persist long after the expected surgical healing time. This can lead to chronic postoperative pain.

The initial treatment of a neuroma is nonsurgical. (A general principle of medicine is to reserve surgery for conditions that can't be treated with medication or other noninvasive means.) Depending on the location of the neuroma, some initial nonsurgical treatments of neuroma include the following:

• tricyclic antidepressants
• anticonvulsants
• desensitization
• electrical stimulation
• ultrasound
• corticosteroid injections

Now let's look at some specific examples of neuromas.

The superficial radial nerve in the hand is particularly prone to developing neuromas. The superficial radial nerve enables sensation in the back of the hand. Neuromas that affect the superficial radial nerve can be detected using the Tinel's test, where a physician taps the area over the nerve to elicit a "pins and needles" sensation.

When nonsurgical treatments for superficial radial nerve neuroma fail, the neuroma can be resected or cut off. However, a new neuroma will sprout up to take its place. A better treatment for this type of neuroma is to bury it in a muscle or bone thus moving the neuroma away from the surface of the skin where it can be impacted and irritated. In other words, by hiding the neuroma, it's less likely to be irritated and result in pain.

During knee arthroplasty or knee replacement, the infrapatellar branch of the saphenous nerve can be severed thus resulting in neuroma. The infrapatellar branch of the saphenous nerve innervates the skin overlying the patella or kneecap.