Phantom Limb Pain
What Is Phantom Limb Pain?
Phantom limb pain is a sensation that a person has when a body part or limb has been amputated, but still feels as if it is attached. Many amputees have phantom sensations that are not painful. It is estimated that 85% of people experience phantom limb sensations in the first several weeks following amputation; however, a smaller population of people will continue to feel these sensations for prolonged periods of time. It is reported that 60% of people will continue to experience sensations one year after surgery.
What Are The Symptoms?
These phantom limb sensations can be severely painful and debilitating. Some patients may feel tingling, numbness, hot or cold, cramping, stabbing, and burning. The most common sensation that patients continue to feel is pain in the missing limb. These painful sensations can diminish over time, but some people suffer from long-term pain that can be difficult to treat.
What Are The Causes?
There are several risk factors for the development of phantom limb pain, including phantom sensations, pain in the stump, pain in the limb prior to amputation, use of a prosthetic limb, and the number of years since the original amputation surgery. The most significant risk factors include amputation of bilateral limbs and lower extremity amputation.
What Are The Treatments?
Some treatments for phantom limb pain include:
Medications – Studies have shown that tricyclic antidepressants, sodium channel blockers, and anticonvulsant medications can be effective.
Physical therapy – Desensitization therapies and sympathetic nerve blocks may help patients who have sympathetically mediated pain. Additionally, finding the proper fit for any prosthetic is also key to decreasing pain.
Mirror therapy – This involves using a mirrored box with two openings: one for the amputated limb and one for the other limb. The patient then performs isometric exercises with the non-amputated limb, so it appears as though the amputated limb is also moving.
Interventional injections – Injection therapy uses nerve blocks to treat upper and lower extremities. Nerve blocks are often combined with physical therapy.
Spinal cord stimulation – Spinal cord stimulation (SCS) is often described as a “pacemaker for pain” and uses an electrical current into the epidural space near the source of chronic pain impulses.