Neuromas and Burning Sensation

Clinical Presentation of Neuromas

Burning sensation is a hallmark symptom of neuromas, particularly in peripheral neuropathic pain, according to the American Academy of Ophthalmology 1, 2
Additional symptoms include allodynia (pain from normally non-painful stimuli), hyperalgesia (increased pain sensitivity), and cold intolerance, as reported by the American Society of Clinical Oncology 2
Paresthesias (abnormal sensations like tingling or pins and needles) commonly accompany the burning pain, as noted by the American Society of Clinical Oncology 2
Dysesthesias (unpleasant abnormal sensations) are frequently reported, according to the American Academy of Ophthalmology 1

Hyperexcitability develops in the trigeminal pathway, causing spontaneous firing of damaged nerves that manifests as burning pain, as explained by the American Academy of Ophthalmology 1
Small fiber involvement is particularly associated with burning sensations in the affected area, as reported by the American Society of Clinical Oncology and the European Hematology Association 2, 3

Clinical history focusing on nerve injury and characteristic burning pain is essential for diagnosis, as recommended by the American Academy of Ophthalmology 1
Physical examination including Tinel's test (tapping over the suspected neuroma elicits pain) can aid in diagnosis, as noted by the British Journal of Anaesthesia 4
Diagnostic nerve blocks can confirm the diagnosis by temporarily relieving the burning pain, as reported by the British Journal of Anaesthesia 4
Assessment of sensory changes in the distribution of the affected nerve is crucial for diagnosis, as recommended by the American Society of Clinical Oncology and the American Academy of Ophthalmology 1, 2

Medications like pregabalin or duloxetine are first-line pharmacologic treatments for neuropathic pain components, as recommended by the American Diabetes Association and the American Academy of Ophthalmology 1, 5
Topical nerve regenerative therapies may help with peripheral neuropathic pain, as reported by the American Academy of Ophthalmology 1, 6

Neuromas affecting the trigeminal nerve can cause facial burning pain that mimics other conditions, as noted by the British Journal of Anaesthesia and the American Academy of Ophthalmology 1, 4
Chemotherapy-induced peripheral neuropathy can present with similar burning sensations but has different underlying mechanisms, as reported by the European Hematology Association and the American Society of Clinical Oncology 3, 7

Neuroma pain typically presents as burning, stabbing, or electric shock-like sensations that can occur spontaneously without triggers, according to the British Journal of Anaesthesia 8
Unlike trigeminal neuralgia, neuroma pain can occur spontaneously without any trigger, as noted by the British Journal of Anaesthesia 8, 9
Neuroma pain can occur suddenly at any time, including during periods of rest, which differentiates it from diabetic neuropathy pain that may worsen at night, as reported in Diabetes/Metabolism Research and Reviews 10, 11

Neuroma pain can follow different patterns, including paroxysmal attacks that occur suddenly and last seconds to minutes, as described by the British Journal of Anaesthesia 8, 9