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Phantom Limb Pain

Phantom limb pain is a condition in which a patient that has undergone amputation still feels the sensation of pain in the non-existent limb. Phantom limb pain is caused by the severed nerve trunk terminal end at the site of the amputation sending pain signals to the brain.

What is phantom limb pain?

The nerves that had once extended into the limb continue to send pain signals to the brain as if the limb were still present, and the brain interprets these signals as pain in the amputated limb. Often the sensations of pain will cease after a period of about six months; however, occasionally sensations may continue for longer periods (or even indefinitely in some cases).
Persons that have had limbs amputated, either surgically due to illness or injury, or that have lost the limb due to an accident often experience phantom limb pain for a brief period of time until the body’s nervous system becomes adjusted to the loss of the limb. Typically this condition will only last for a few months but occasionally it can last longer. In even more rare cases, it persists indefinitely. The condition is usually expected to subside within six months; however, patients who continue to experience the condition after six months usually will not experience improvement.
Symptoms of phantom limb pain include, but are not limited to, sensations of pain from the now amputated limb. The patient may experience other sensations. These could include sensations of heat, cold, tingling, numbness, cramping, stiffness, soreness, the sensation that the extremity is asleep, or any other sensations that could have been felt in the limb prior to amputation.
Treatment for phantom limb pain can be quite difficult due to the nature of the condition. There are several methods of treatment that do typically meet with some success. One method is the use of prescription pain relievers and other medications such as anticonvulsants, neuroleptics, beta-blockers, antidepressants, and sodium channel blockers. Your physician may also utilize neurostimulation by means of spinal cord stimulation or deep brain stimulation to help alleviate the symptoms.
The physician may also perform surgery to remove scar tissue from the area surrounding the nerves. This may be causing pressure on the nerve and cause the sensations that the brain interprets as pain. TENS (transcutaneous electrical nerve stimulation) of the stump is often used to help alleviate the pain sensations, but there are also less invasive methods of treatment.
Often the patient will respond positively to simple massage of the area near the amputation and often post amputation physical therapy can help to alleviate the condition. Methods the patient may use at home include the application of heat and cold compresses to the area of amputation and relaxation techniques that the patient can learn to do themselves at home that may help control the pain.
Some of these methods may work better than others, and each method may not work for everyone. The best thing to do is speak with your physician and begin some form of treatment until you find one that works best for you. It is likely that your physician will recommend that you start with the simpler, non-invasive forms of treatment such as massage, exercise, and hot/cold therapy.
If you do not experience pain relief from these methods you will probably then be given other treatments such as the TENS unit and physical therapy. Treatment with drugs or a surgical solution will be the last resort if all other methods fail to provide relief.