Painful Neuroma

Neuropathic pain is pain that results from disturbances in the nervous system. This kind of pain can progress to the point that it is chronic and unremitting. Not infrequently, such pain is caused by the development of a benign tumor called a neuroma, made of cells from nervous tissue – a tumor that presses on the tissue of the nerve itself. Such a situation will at times necessitate microsurgical intervention, during which the tumor will be removed and the injured nerve repaired.

What is a Neuroma?

A neuroma, as mentioned above, is a benign tumor (i.e. not cancerous) that develops from neural tissue cells. Neuromas tend to develop the following injury to nerve tissue and adjacent to it, and can, therefore, appear in different regions of the body. Any nerve injury – laceration, stabbing, gunshot, etc. – anything that causes the nerve to be either partially or completely severed can stimulate the growth of the tumor adjacent to the area of the injury.

There are several types of a neuroma, including:

• Acoustic neuroma: One of the most common types of a neuroma, that develops close to the auditory nerve deep inside the skull, and can impair the patient’s hearing
• Morton’s neuroma: Exerts pressure on a main nerve in the foot causing chronic pain in the toes
• Verneuil’s neuroma: A tumor that develops from skin tissue
• Amputation neuroma
• Traumatic neuroma

The development of a neuroma can have many implications: its very growth on the nerve can lead to the exertion of pressure on it and disrupt the nerve’s ability to transmit electrical signals – an ability that was probably already impaired previously due to the external injury. This kind of impairment often causes severe pain in the area of the injury because of damage to the nerve, which can no longer transmit normal electrical signals to the brain, and instead sends constant and unabating pain signals for which there is no real reason. This pain may spread and radiate to nearby organs, above or below the point at which the injured nerve is located.

Painful Neuroma – a condition that requires treatment

The situation caused by the development of the tumor can become intolerable: the chronic and incessant pain appears without any ‘real’ direct reason, though it is so severe that it can even disrupt a person’s daily routine. This condition is known in medical jargon as a painful neuroma because the direct cause of chronic pain is the tumor itself.

Treatment for such a condition must focus on the nerve itself and on attempting to restore its normal function so far as possible. While an injured nerve cannot usually be completely rehabilitated, neurosurgical and microsurgical techniques that have been developed over the years, in which Prof. Rochkind specializes, can offer optimal rehabilitation of the nerve, and no less importantly – neutralize the source of pain.

Surgery will thus be the recommended treatment for painful neuroma, with the objective of immediately stopping the pain. In the first stage of the procedure, the surgeon releases the nerve from the scars that were caused by external injury. The release of the nerve is achieved by doing just that – dissecting it from the various tissues pressing on it and separating it from this tissue as completely as possible.

After the injured nerve is released, the neuroma itself is removed. Removal of the tumor ensures that the pressure of the nerve will not recur and that the entire region will be more ‘free’. Following its removal, the neuroma is, of course, sent for pathological testing, in order to assess its nature and characteristics.

During the final stage, the proximal end of the nerve (the end that is closest to the center of the body and to the center of the nervous system) is buried in an adjacent muscle. Such a procedure will restore its ability to function, at least partially, and will enable its rehabilitation. Furthermore, rehabilitation of the nerve will prevent future recurrence of the neuroma.

The operation takes several hours, due to the delicacy and precision required. The process of recovery from the operation will take several months, mainly because of the slow rate of growth of neural tissue. However, the relief of pain and of the frequency of its occurrence is likely to be relatively rapid, due to the removal of the tumor that exerted direct pressure on the nerve.

The surgical procedure for the treatment of painful neuromas is considered to be particularly delicate and complex and requires the surgeon to be highly skilled – which is why it is so important to select the right surgeon for this procedure.

Prof. Shimon Rochkind, who is considered to be a world-renowned expert in all aspects of the treatment of the peripheral nervous system, has performed numerous operations for the treatment of painful neuromas, with particularly high success rates. Prof. Rochkind and the team that works closely with him offer consultations to patients at the Neurosurgical Center for Excellence at the Herzliya Medical Center regarding the most appropriate treatment for their condition and perform microsurgical procedures for the treatment of painful neuromas, even in exceptionally complex cases.

Furthermore, the chance of suffering external infections at Herzliya Medical Center Hospital – one of the biggest risks in hospitals in Israel – is minuscule, enabling rapid and optimal recovery, with no health side effects.

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