If you’re living with chronic pain, muscle weakness, or phantom limb sensations after an amputation or nerve injury, targeted muscle reinnervation may help. At Sharma Hand & Nerve in Boise, Dr. Ketan Sharma offers this advanced surgical procedure to restore nerve function and improve long-term pain and mobility outcomes.
What is Targeted Muscle Reinnervation?
Targeted muscle reinnervation (TMR) is a specialized procedure that redirects severed or damaged nerves to new muscle targets. This redirection enables the nerve to reestablish a connection with the muscle tissue, helping to restore function and alleviate pain. Originally developed for amputees, TMR can also benefit patients with nerve injuries or chronic pain syndromes. By rerouting nerves to muscles that have lost their original nerve supply, TMR provides the nervous system with a new pathway, promoting healing, improving prosthetic control, and minimizing painful nerve signals.
What Are the Signs and Symptoms Indicating You May Need Targeted Muscle Reinnervation?
If you’re struggling with ongoing nerve pain or functional issues after a trauma, surgery, or amputation, targeted muscle reinnervation may be an option. This procedure is often considered when traditional treatments no longer provide relief. Common signs and symptoms include:
- Ongoing sharp or burning pain at the site of a prior amputation or injury
- Persistent phantom limb sensations or discomfort
- Painful nerve masses (neuromas) that worsen with touch or pressure
- Loss of muscle control in a limb following nerve injury
- Failed relief from previous nerve repair or pain management procedures
What Does Targeted Muscle Reinnervation Treat?
Targeted muscle reinnervation (TMR) helps individuals suffering from nerve-related pain and dysfunction, particularly following trauma, amputation, or surgery. It is especially beneficial for patients who experience neuroma pain, phantom limb pain, or limited muscle control due to lost or injured nerves.
By rerouting nerves to new muscle targets, TMR can significantly reduce chronic pain and restore more natural nerve function.
What Happens During Targeted Muscle Reinnervation?
During TMR surgery, Dr. Sharma begins by exposing the site of nerve injury, often in the upper or lower limb. Using microsurgical techniques, he identifies the problematic sensory or mixed motor nerves, often those that have formed painful neuromas or are no longer connected to their original muscle targets. Once these nerves are isolated, Dr. Sharma prepares their ends for transfer by trimming scar tissue or neuroma growth. He then locates nearby, denervated motor nerves leading to small, expendable muscles in the region.
Dr. Sharma coapts (joins) the injured nerves to these motor nerve branches using ultra-fine sutures under a microscope. This provides the severed nerve fibers a destination, allowing them to grow into the target muscle instead of forming painful neuromas. In upper limb amputees, for example, this reinnervation can also create new myoelectric signals that enhance prosthetic control. The surgery typically takes 2 to 4 hours, depending on the complexity, and patients often go home the same day or after an overnight stay.
What is Recovery Like After Targeted Muscle Reinnervation?
After targeted muscle reinnervation, you can expect some initial soreness, swelling, and limited movement near the surgical site. Most patients experience significant pain relief within a few weeks, but full nerve regeneration may take months. Physical therapy may be recommended to help retrain muscle activation or optimize prosthetic control. While downtime varies based on the complexity of your surgery and overall health, many patients can return to light activities within 2–3 weeks and resume full function within a few months.
To support your recovery, you may be advised to:
- Limit physical activity in the affected area for several weeks
- Keep the surgical site clean and dry
- Take prescribed medications for pain or inflammation
- Attend scheduled physical therapy appointments
- Avoid putting pressure on the surgical area
- Follow up regularly with Dr. Sharma for progress assessments
Why Choose Dr. Sharma for Targeted Muscle Reinnervation?
Dr. Ketan Sharma is a board-certified hand and nerve surgeon with extensive expertise in complex nerve reconstruction and chronic pain relief. He performs over 600 advanced nerve procedures annually and is nationally recognized for his expertise in TMR. With training from institutions like Johns Hopkins and Washington University in St. Louis, Dr. Sharma brings world-class surgical precision to each case. His personalized approach focuses on restoring both function and quality of life for patients with nerve damage or post-amputation pain.
Patients trust Dr. Sharma because he:
- Performs high volumes of complex nerve and pain surgeries
- Specializes in treating chronic pain through surgical intervention
- Emphasizes detailed physical exams to pinpoint the true source of symptoms
- Offers proven outcomes for pain relief and improved limb control
- Provides compassionate, one-on-one care from consultation through recovery
To explore whether targeted muscle reinnervation is right for you, schedule a consultation with Dr. Sharma today.
