Journal of Pain & Relief
Open Access

Abstract

Background: Formation of stump neuroma plays an important role in generation of pain in the amputee. However, these symptoms often do not respond conservative therapy, so management remains difficult. Even if surgical removal is performed, it is known that the probability of regrowth is not low. ESWT has been used to treat various musculoskeletal disorders and is known to have side effects that can cause nerve destruction. So in the patient of painful stump neuroma, we applied ESWT for the neurodestructive effect. Case: A 74-year-old patient for chronic stump pain. He presented with a history of Rt. transfemoral amputation secondary to a gunshot injury and had been able to gait independently with prosthesis. He complained of parasthetic and shooting pain emanating from posterior mid-thigh to the most caudal point of the stump. These pains interfered with the use of his prosthetic device. We used the ultrasound for scanning of stump site, and detected the 1.7cm x 3.0cm x 3.6cm - sized mass in the sciatic nerve pathway. We identified the location and depth of the stalk of neuroma using the ultrasound. ESWTs were applied once a week, five times in total, targeting the stalk of neuroma. Pstprocedure results showed that immediate pain relief and reduction of neuroma size at 6-months follow-up. Conclusions: We report the case that relieved symptoms and decreased size of painful stump neuroma after application of ESWT under sonographic guidance.

Biography

Jin Seok Seo  has completed his MD at the age of 26 years from Kyunghee University School of Medicine. He is a physical medicine and rehabilitation doctor of Veterans Health Service Medical Center, Seoul, Korea.