Botulinum Toxin A for the Treatment of Residual Limb Neuropathic Pain Due to Hyperhidrosis: A Case Report

Postamputation pain is a common condition affecting veterans with amputations. Recognition and treatment of skin conditions play a significant role in treating residual limb pain. Hyperhidrosis or excessive sweating is the most common skin problem reported by amputees and can cause infections, act as triggers for other pain generators such as neuromas, and impede the proper use of a prosthetic.

We discuss a case of a 38-year-old man with a left transtibial amputation who presented with refractory neuropathic pain aggravated by persistent hyperhidrosis. Botulinum toxin A was injected both into suspected neuroma sites and areas of hyperhidrosis with a significant decrease in pain and sweating.

Botulinum toxin A can be successfully used in the treatment of neuropathic residual limb pain exacerbated by hyperhidrosis.