Targeted Muscle Reinnervation Surgery for Phantom Limb Pain

Understanding Post-Amputation Pain

Over two million people in the U.S. live with limb loss, and many experience ongoing pain afterward. This pain may come in different forms:

  • Neuroma pain: Sharp pain caused by nerve clusters that form when cut nerves try to regrow but have nowhere to go.
  • Phantom limb pain: A burning, aching, or electric-like pain that feels like it’s coming from the missing limb.
  • Residual limb (stump) pain: Discomfort in the remaining part of the limb, often caused by prosthetic fit, skin irritation, or neuromas.

Phantom limb pain often begins soon after surgery. While it may fade for some, it becomes a long-term challenge for many. Poor pain control around the time of surgery may increase the risk of chronic symptoms.

A Closer Look at TMR Surgery

TMR is an advanced surgical procedure designed to help relieve chronic nerve-related pain after amputation. During the procedure, surgeons re-route severed nerves into nearby healthy muscles.

This helps:
  • Improve how the brain processes nerve signals from the amputated limb
  • Prevent the formation of painful nerve clusters
  • Reduce or eliminate phantom limb and neuroma pain

Redirecting the nerves gives them a new purpose, essentially “closing the loop” to prevent misfiring pain signals. This not only decreases pain but may also improve your ability to use a prosthetic comfortably. TMR has shown promising results in helping amputees return to daily life with less pain and better function.

A Comprehensive Approach to Care

The Center for Hand and Upper Extremity Surgery specializes in treating nerve pain that persists after amputation. Our surgeons are highly experienced in TMR and other advanced techniques. We take a personalized approach, combining surgical expertise with pain management strategies tailored to your needs. Our mission is to help you move forward with greater comfort, confidence, and quality of life.

Our
Approach

We Treat Phantom Limb Pain
at 29 Locations Across New Jersey, New York, and Pennsylvania

Red Bank
Red Bank
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331 Newman Springs Rd. 
Building 2 - First Floor, STE 200
Red Bank, New Jersey 07701
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Phone: 855-980-6981
East Brunswick
East Brunswick
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192 Summer Hill Rd
Suite 201
East Brunswick, New Jersey 08816
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Phone: 855-980-6981
Hopewell
Hopewell
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1 Capital Way
Suite 390
Pennington, New Jersey 08534
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Phone: 855-980-6981
Rockland County
Rockland County
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257 Lafayette Ave
Suite 200
Suffern, New York 10901
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Phone: 855-980-6981

About
The Institute for
Advanced Reconstruction

The Center for Hand and Upper Extremity Surgery is uniquely positioned as the ‘go-to’ center for revolutionary hand and upper extremity procedures, as well as world-class reconstructive treatments.

These include cutting-edge procedures such as nerve transplantation that may restore a significant degree of function for those who have suffered from stroke and other forms of paralysis. Patients who at one time believed they had exhausted their paralysis treatment options come from around the country and the globe to our practice in New York City and Red Bank, New Jersey.

Frequently
Asked
Questions

What happens to nerves after amputation?
When a limb is amputated, one end of the nerves connecting that limb to the brain and central nervous system will be severed as well. In this process, damaged nerve fibers may metastasize into a mass which we call a Neuroma. This mass will send confused signals to the brain and can cause mild to extreme pain.
How common is phantom limb pain?

Phantom limb pain is quite common, affecting 60-85% of all amputees. Most patients who suffer from phantom limb pain will experience relief through treatments that mirror other neuropathic pain treatments: rehabilitation and, ultimately, surgery.

What is Targeted Muscle Reinnervation (TMR)?

Targeted Muscle Reinnervation (TMR) surgery involves transferring nerves that once controlled the amputated limb to reinnervate (restore function to) remaining muscles. Following surgery, nerves grow back into the new muscles, decreasing and potentially preventing misdirected nerve growth, which can contribute to pain within the residual limb. TMR has the potential to treat pain from neuromas while enabling amputee patients to return to their activities of daily living and improve prosthetic use and tolerance.

What does a TMR surgery include?

Targeted Muscle Reinnervation (TMR) surgery requires grafting nerves from one area of the body to reinstate healthy (and less painful) nerve function inside the limb remains, partial limb, stump, or other connective tissue.

How effective is TMR surgery?
Patients who experience chronic nerve pain often exhaust all other options before choosing surgery. However, once surgery is “on the table” as an option for patients, we answer every question and ensure complete confidence before we begin this course of treatment.
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