Neuroma

When there is damage to a nerve, the damaged nerve may form what is known as a neuroma, which is a disorganized growth of the nerve. This often forms a ball-shaped growth that can be very painful and irritable. This can occur after injuries or surgery, including mastectomy.

A neuroma typically is diagnosed with a history and physical examination. This is often associated with a painful burning or tingling sensation known as “neuropathic pain”, and there may be a focal area of exquisite pain that when tapped causes shooting electrical sensations known as a “Tinel’s sign”. Often, a nerve block is performed with an injection of local anesthetic near the neuroma. If this leads to significant relief of pain, then this typically is diagnostic of a neuroma and suggests that surgical treatment would be beneficial. Of note, a local anesthetic injection provides only temporary relief and will not cure pain from a neuroma; it is intended only to assist with diagnosis and treatment planning.

If a neuroma is diagnosed, the treatment typically is surgical. The neuroma is surgically excised. The nerve end can be repaired to the other cut end of the nerve if it can be identified. If not, then there are various treatment options including burying the nerve deeper within the tissue so that it is not as frequently irritated, TMR, or RPNI. There are medications that can be used to decrease some of the pain associated with neuromas, but these medications will not cure the neuroma.

Recovery from the surgery is usually relatively quick. In most cases, the neuroma pain should improve quickly. In some cases, the surgery may result in temporary increase in nerve-related pain before it improves. Surgery may also successfully treat the neuroma but result in “unmasking” of pain from other nearby neuromas.

Be sure to see an experienced surgeon to treat this condition. Our fellowship-trained specialists at The Buncke Clinic in San Francisco treat patients with neuromas from across the Bay Area and Northern California. Contact us to schedule a consultation.