Has anyone had a problem with developing a neuroma in the TMJ post surgery? I started to have pain again 6 months post artificial joint replacement. We've tried steroids, back to a liquid diet (again!) and finally tried a nerve/joint block on both sides. That did the trick! Unfortunately blocks only last for about 3 hours - but it did get me pain-free for a while, which indicates it's the joints. I'm having surgery again in March (the artificial joints themselves are fine via CT scan) where we're going to clean out all scar tissue, then place a fat pad in the joints to prevent scar tissue formation within the joint itself.
Anyone had a procedure like this before, and if yes, what was the outcome?
Pam, I'm sorry to hear you are going through another surgery! I'm post-op TMJR, 7 months, and have had significant pain and unable to chew since the surgery (and before). My dr says I probably have a neuroma too, and started me on Neurontin which has helped the nerve pin significantly. Of course there is still pain from the muscles too. How did your dr confirm that it is a neuroma for sure?
The following user gives a hug of support to navymid: pamo810 (02-18-2012)
We don't know for sure that it's a neuroma - we are going to go in, clean out all of the scar tissue, and send it out for histopathology, which will tell us whether a neuroma was involved in the scar tissue or not. We did a joint block/nerve block last week and the pain disappeared - totally. I had a level 8 pain on the left and 6 on the right side. After the block, the pain was literally a 0. As for muscle pain, I do massage on the trigger points, get trigger point injections from my pain management specialist at Hopkins, and use Lidoderm patches to cover the areas that hurt the most. If I need it, I have Percocet.
We didn't do an MRI to check for Neuroma, because there would be too many artifacts due to the replacements. We did do a CT scan to look at the hardware - it's fine and stable. The block seemed to definitively proof the pain was coming from the joints themselves. Dr. Warburton offered to send me up to Philadelphia to consult with an oral surgeon who has dealt with a lot of neuroma cases. I didn't really see the need after the blocks because the reduction in pain spoke volumes.
Get a CT scan and then have the blocks done to see if it's either the hardware or scar tissue. Evidently these neuromas show up around 6 months post-op, so it may be that you have one or excess scar tissue. Don't do surgery unless these two tests have been done.
Thanks Pam. We did a CT scan last month and all the hardware looked good. I need to ask my dr about the nerve block. He and I have talked about neuromas several times, and he even sent me an article from that dr in Philly about them. It seems like a lot of people have a significant reduction in pain after getting them removed, or getting scar tissue removed. My nerologist and surgeon seem to believe it is a neuroma(s), but my surgeon does not want to do surgery. He said he does not want to open up the joint again because it could cause infection or cause the pain to be worst. Although I really don't know how it could be worse! I can't chew and am on strong meds (fentanyl patch). I hate being on this much medication.
I do hope that your surgery goes well and you are able to benefit from the results!
The Following User Says Thank You to navymid For This Useful Post: pamo810 (02-19-2012)
I actually had surgery last week for both TMJs. Turns out there was a lot of scar tissue around and in each joint- that was removed and had a fat pad from my belly placed in each joint to prevent scar tissue from reforming in the joint. Pain has decreased significantly, although I still can't eat solids (should be able to in a week or two!) Range of motion is already better than it was pre-op. Keep your fingers crossed about the use of the fat pads - it's a new technique reported on from Philadelphia. I'm still waiting on the histopathology report to find out if and how many neuromas were in the joint.
Did you get your joint block? Did it reduce or eliminate the pain? What does your doctor ay in how to proceed forward? Hoping that you get some improvement in your pain levels and functionality of the joints.
I'm glad you are doing better! I never pursued the nerve block... Instead I started physical therapy and will see if that will work. The therapist I am working with is great, so I have a lot of hope that he will help. He found that a tendon is actually causing most of my pain! I've never done therapy before, so I definitely want to try this first before surgery of any kind.
Did you ever get the report back on if there were neuromas in the scar tissue? How is your pain and function now?
I am having terrible pain again.... I was taking Neurontin for nerve pain for many months, and recently got off it. I'm wondering if it was helping the pain that much. I am going back to the idea of there being a neuroma(s) in the joint, and am going to persue a nerve block.
Please let me know how you are doing!!