Painful stump neuroma （PSN） is a non-neoplastic pathological condition resulting from disorganized axonal

regeneration following limb amputation and constitutes a major cause of chronic neuropathic pain. The underlying mechanisms of pain are complex and extend beyond simple structural nerve proliferation， involving aberrant regulation of neurotrophic factor gradients， ion-channel remodeling with consequent ectopic neuronal discharges， scar-related fibrosis， disruption of the local microenvironment， and central sensitization. Accurate diagnosis relies on a comprehensive evaluation that integrates neuropathic pain characteristics， targeted physical examination， imaging modalities， and electrophysiological studies， and requires careful differentiation from residual limb pain， phantom limb pain， and peripheral nerve entrapment syndromes. Management of PSN follows a stepwise therapeutic paradigm， beginning with pharmacological treatment and physical therapies， progressing to surgical options such as neuroma excision and nerve stump implantation， and ultimately advancing toward functional reconstructive procedures that re-establish physiological neural targets. These include targeted muscle reinnervation （TMR） and regenerative peripheral nerve interface （RPNI）， both of which have demonstrated efficacy in pain relief and reduction of PSN recurrence. More recently， innovative interventions， including cryoablation， radiofrequency ablation， biodegradable nerve conduits， tissue-engineered scaffolds， and emerging therapies involving stem cells and exosomes， have shown promising development， providing novel strategies for the prevention and treatment of PSN.

Painful stump neuroma, Amputation stumps, Neuropathic pain, Targeted muscle reinnervation,

Regenerative peripheral nerve interface, Tissue engineering