As many as 75 percent of the two million amputees in the U.S. experience debilitating pain, numbness and phantom limb pain. It often makes the use of a prosthetic limb intolerable and requires medication to manage the pain.

However, doctors at The Ohio State University Wexner Medical Center have found that a surgery to reroute amputated nerves, called targeted muscle reinnervation, or TMR, can reduce or prevent phantom and residual limb pain from ever occurring in those who receive the procedure at the time of amputation. The procedure can also help amputees who have lived with pain for years.



“Their pain is caused by disorganized nerve endings in the residual limb that used to connect to muscle, but now have nowhere to go,” said Dr. Ian Valerio, division chief of Burn, Wound and Trauma in the Department of Plastic Surgery. “Attaching those nerve endings to active nerves in a nearby muscle allows the body to rebuild circuits and alleviates phantom and residual limb pain by giving those severed nerves something to do.”

Only 13 percent of patients who received TMR at the same time as their amputation surgery reported having pain six months later, while reports of phantom limb pain were cut in half in amputees who received TMR months or years after their amputation. Valerio says patients are able to significantly reduce or completely discontinue the use of narcotics and greatly improve their quality of life.

“Patients who have been living with this constant pain feel relief almost immediately,” Valerio said. “Within the first couple of weeks after surgery, they’ll say that they feel much better and that the pain is greatly reduced or gone completely. This allows them to finally get back to their daily lives and effectively adjust to life without a limb.”