residual limb neuroma
/ nyoo-ROH-muh /
When a nerve is cut during amputation, it does not simply stop. A nerve is built to grow and repair, so the cut end keeps trying to regrow — but with nowhere to go, the sprouting fibres tangle into a small, disorganised knot called a neuroma. Every cut nerve forms one; the trouble starts only when that knot ends up somewhere it gets pressed, pinched, or knocked.
A neuroma is therefore a tiny ball of mixed-up nerve tissue at the end of a severed nerve. Most are silent and cause no problem. A symptomatic neuroma, though, is exquisitely tender: tapping over it sends an electric, shooting pain down the line of the old nerve (a Tinel's sign), and when such a neuroma sits right where the socket presses, the person feels a sharp, zinging pain at the same spot every time they put weight on the limb. It often feels like a precise, reproducible point of pain rather than the diffuse, hard-to-localise quality of phantom pain.
Distinguishing a neuroma from other residual-limb pain matters because the fixes differ. A neuroma's pain is mechanical and local: the first and best step is often to relieve the pressure on it by adjusting or relieving the socket so it no longer bears down on that spot. Other measures include desensitization, injections, and, for stubborn cases, surgery to move the nerve end into muscle or bone where it is cushioned. Modern surgical techniques done at amputation — targeted muscle reinnervation and regenerative peripheral nerve interface — aim to prevent painful neuromas in the first place by giving the cut nerve a proper place to grow into.
An amputee reports a sharp, electric jab at exactly one spot on his limb whenever he stands; tapping that spot reproduces the zing. The team recognises a neuroma sitting under a pressure point, relieves the socket over it, and the stabbing pain on standing settles.
A neuroma gives sharp, pinpoint pain at one reproducible spot — often where the socket presses on it.
Every cut nerve forms a neuroma, but most never hurt; a neuroma only becomes a problem when it sits where it is repeatedly pressed, so relieving the socket over it is often more effective than reaching first for surgery.