Ultrasound Guided Neuroma Injection

Author

Shankar Hariharan, M.D.
Associate Professor
Department of Anesthesiology
Medical College of Wisconsin and Zablocki VA Medical Center
Milwaukee, Wisconsin

Commentary

Bernhard Moriggl, M.D.
Professor
University of Innsbruck
Innsbruck, Austria

Introduction - TOP

Neuromas occur following varying degrees of nerve injury anywhere in the body. They are part of the reparative process and the appearance is dictated by the availability of a distal tract or Schwann cell. Sometimes the site of the neuroma can be a source of pain. With residual limb pain, the cause of pain may be due to scar tissue producing traction on the nerve and neuroma, from compression by the adjacent tissues or vessels or from ischemia due to decrease in blood supply.1,2 Managing pain arising from the neuroma is challenging. The treatment options include injection of local anesthetic, steroid and neurolytic agents, cryo-ablation, radiofrequency ablations and surgical revision.3,4,5,6,7 Unfortunately modifying the surgical technique to prevent neuroma formation has not always been successful.8

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