TMR & RPNI
A solution for chronic painful neuromas and amputations.
Targeted Muscle Reinnervation (TMR) is a well established surgical procedure. Originally developed for the use of myomechanical prosthetic integration (think of a terminator arm), but it has gained popularity due to its potential in treating chronic painful peripheral nerve neuromas. Neuromas are abnormal growths of nerve tissue that can occur after a nerve is injured. Neuromas often cause chronic pain and discomfort, or in the case of an amputation it may cause phantom limb syndrome. Historic treatments include medication, nerve blocks, or surgery. These are often done today but with limited effectiveness, leaving patients with few options for relief.
What is TMR?
TMR RPNI Peripheral Nerve Surgeon Dr. Oren Michaeli New York New Jersey
How is a TMR done?
TMR for pain involves rewiring the sensory nerves responsible for feeling pain to nearby motor nerves. By doing so, the sensory nerve fibers that would generate pain signals are instead redirected to the muscles, providing a more natural and pain-free sensation. This is done by surgically identifying the affected sensory (feeling) nerve and attaching it to a nearby healthy nerve (muscle).
Dr. oren michaeli amputation prosthestics tmr rpni
Numerous studies have shown promising results for the use of TMR in the treatment of painful peripheral nerve neuromas, and phantom limb pain. One study conducted in 2015 found that TMR resulted in a significant reduction in pain for patients with chronic neuromas, with 73% of patients reporting improvement in their pain levels. Another study published in 2019 reported similar findings, with over 70% of patients experiencing significant pain relief.
How effective is TMR?
Why choose TMR for pain control?
TMR and RPNI are far superior to traditional treatments for peripheral nerve neuromas. Unlike addictive medications or nerve blocks, which need to be repeated. TMR is done only once. It is a low-risk surgical procedure, which usually requires minimal or no nights spent in the hospital. It also allows for more precise targeting of the affected nerves, reducing the risk of damaging surrounding tissues.
TMR can also provide functional benefits for amputees. By redirecting the severed nerves to nearby muscles, patients may be able to use these muscles to control a prosthetic limb. This can lead to improved mobility and independence, as well as a better overall quality of life.
What are the other utilities of TMR?
Why you might not not have heard of TMR?
A natural question might be; “why haven’t I heard of this before?”. TMR is a relatively new technique. As research continues, and young doctors are taught about TMR, it is likely that TMR will become an increasingly viable option for patients suffering from chronic pain, and more importantly it is likely that they will be done prophylactically to prevent pain when doing amputations. If you are experiencing chronic pain from a peripheral nerve neuroma, it may be worth discussing TMR with your healthcare provider or Dr. Oren Michaeli to determine if it is a suitable treatment option for you.