TMR reroutes a cut nerve into a nearby motor nerve, giving it a meaningful new job — delivering durable relief from neuroma and phantom pain and enabling intuitive prosthetic control.
To motor nerve
Pain relief
Prosthetic control
In TMR, the end of an injured or amputated nerve is transferred into a small motor nerve that drives a nearby muscle. The injured nerve now has a real destination, so it stops generating the chaotic signals that cause neuroma and phantom pain.
As a bonus, when that muscle contracts it produces an amplified signal that advanced prostheses can read — allowing more natural, intuitive control. TMR is a cornerstone of modern amputation and neuroma care.
Fig: Targeted Muscle Reinnervation: a cut nerve is rerouted into a nearby motor nerve so it gains a functional target.
Performed during amputation to prevent neuroma and phantom pain.
Treats existing neuroma and phantom pain, even years later.
Creates intuitive control sites for advanced myoelectric prostheses.
A nearby expendable motor nerve is selected as the recipient.
The injured/amputated nerve end is prepared under magnification.
The nerve is coapted into the motor nerve, tension-free.
The muscle is reinnervated, providing pain relief and a control signal.
Peripheral nerve surgery is its own discipline. Dr. Michaeli has dedicated his practice to the nerves, with fellowship-level training and thousands of nerve procedures.
Nerve work is measured in millimeters. Every repair is performed under high-magnification with microsurgical instruments and the latest reconstructive techniques.
Many patients arrive having been told nothing more can be done. A dedicated nerve evaluation often reveals options that general specialists do not offer.
The transfer heals; the surgical site settles.
The target muscle begins to respond; pain signals decline.
Durable pain relief develops; prosthetic signal use can advance.
Peripheral Nerve & Brachial Plexus Surgeon · New Jersey & New York
Dr. Michaeli is among the most experienced and trusted peripheral nerve specialists on the East Coast, combining board-certified hand surgery expertise with dedicated peripheral nerve training. He has helped patients across the region regain function when they were told nothing more could be done.
Most peripheral nerve procedures are medically necessary and covered by insurance. Our team will help you understand your benefits and assemble the documentation your plan requires.
How rerouting a nerve into muscle relieves pain and powers intuitive prosthetic control.
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“After years of being told my pain was something I’d have to live with, Dr. Michaeli found the nerve causing it and fixed it.”
Neuroma surgery
“I had given up hope of using my hand again. The nerve transfer gave me back movement the other doctors said was gone.”
Nerve transfer
“The carpal tunnel release was quick and the night pain was gone immediately. I only wish I’d done it sooner.”
Carpal tunnel release
Schedule a consultation with Dr. Michaeli to understand your options and build a plan that fits your life.
