A man in his mid-40s had lost his hand years earlier, after an injury caused by a compressive splint that cut off circulation to the limb. About eight months after the amputation, he began feeling severe pain at the slightest touch to the site — pain sharp enough that he could no longer tolerate wearing his prosthetic hand.
An ultrasound examination revealed two neuromas at the ends of the nerves that had been cut during the amputation — non-cancerous clusters of nerve fibers that can form when a severed nerve tries to regenerate without finding a clear path to reconnect to.
Given how severe the pain was and its direct impact on prosthetic use, and because the imaging pointed to a clear, surgically treatable cause, surgery was the most suitable option. During the operation, an additional cause of the pain became apparent: the exposed nerve endings had become directly attached to the skin, which explained the intense sensitivity to even the lightest touch. Not every case of post-amputation pain needs surgery, but two clearly identified neuromas with skin attachment made surgery the right call here.
Both neuromas were removed, the attachments between the nerves and the skin were released, and the nerve endings were then buried within the muscles of the residual limb after being wrapped in a layer of the patient's own fat to protect them and prevent them from reattaching to the skin.
The pain improved noticeably right after surgery, and he left the hospital the following day. He gradually regained the ability to tolerate touch at the site and to use his prosthetic hand again, with regular follow-up to monitor his longer-term recovery.
Experiencing Similar Symptoms?
If touching your amputation site is painful or you're struggling to wear a prosthetic, you can read more about the causes and treatment of severe pain after amputation, learn about peripheral nerve surgery with Dr. Mazen Agour, and book a consultation through the contact page.