Phantom limb pain


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As many as 80% of amputees experience some kind of “phantom” sensation in their amputated limbs. However, up to half of those who have them do not receive any treatment for or relief from their pain. This makes phantom pain a chronic pain condition.

What is Phantom Limb Pain?

After a limb is removed, you may continue to feel it, as though it were still there. Phantom limb pain is not the same thing as stump pain, which is felt in and around the incision following surgery. Stump pain is localized to the amputation site, while phantom pain is felt in some part of the leg that is no longer attached.

Many people describe burning sensations in their toes though they may be missing their entire leg below the knee. This can be a confusing and even scary sensation, leading some people to believe that they are losing their minds. How can you feel pain in a limb that no longer exists?

Symptoms

Phantom pain can be a debilitating condition. Pain is often described as burning, stabbing and throbbing -- typical descriptor words for neuropathic pain. Phantom pain may happen in a continuous cycle, or it may be brought on by outside factors such as temperature change, stress or stump irritation.

Most people describe their phantom pain as if it were coming from the distal parts of the amputated limb, such as feet, toes or hands. Phantom sensations are more common in the first few months after surgery than they are several months down the road, but they can happen at any time after an amputation.

Treatment

Like most chronic pain conditions, no single treatment approach works for everybody. A number of medications complementary and alternative treatments out there work for phantom pain. Here are some of the most common approaches.

  • Medication:  Because it is considered a neuropathic disorder, antidepressants and anticonvulsants are often prescribed for phantom pain. NSAIDSs, opioids and muscle relaxants are also on the list of medications. As with other chronic pain conditions, finding the right medication can take time and patience. Sometimes successful phantom pain relief takes a combination of these medications.
  • Mirror therapy:  Many therapists use mirrors in their treatments to show the brain into a healthy limb in place of a stump. This usually involves placing both limbs in a mirror box, which makes the amputated limb appear intact. The individual is then asked to perform exercises with “both” limbs. This tricks the brain, and effectively reduces phantom pain for some people.
  • Stump stimulation:  Using TENS, applying pain-relief patches or rubbing the stump can relieve phantom pain in some people. Using hot packs and cold packs can work for some people. Providing an alternate sensation from the stump can interrupt pain signals.
  • Cognitive therapies:  Some people find relief from their phantom pain through hypnosis, relaxation or guided imagery. These approaches can change the way the brain interprets phantom sensations, including phantom pain.

Usually more than one treatment approach is used to get phantom pain under control. Some people, however, may require more invasive forms of treatment. These include additional surgery to untangle nerve bundles at the amputation site, stimulation of the spinal cord or the brain to change the way pain is interpreted and implantation of pain pumps that deliver medications directly to the spinal cord.