What is Phantom Limb Pain?
Phantom limb pain explained by Denver, Golden, Aurora, Boulder, Broomfield, Jefferson, and Littleton Colorado’s top pain doctors
Phantom limb pain occurs after an amputation and is characterized as a neuropathic pain condition. In the past, it was believed that the symptoms related to this condition were the result of psychological factors, but it is now understood that this condition is quite complex. Evidence-based studies have even shown that the spinal cord and brain are responsible for phantom limb pain.
The first sign of symptoms related to phantom limb pain typically develop during the first few days after an individual has undergone an amputation. Furthermore, the symptoms are usually the most severe immediately after the procedure, although they tend to decrease as time passes and completely disappear in most cases. The prognosis of experiencing complete pain relief is generally poor if phantom limb pain persists for longer than six months following an amputation.
The amount and type of pain that is experienced as a result of this condition may be different for each individual who suffers from it. Furthermore, the pain may vary from dull and throbbing to sharp, stabbing pains. Some patients have even reported feeling as if the amputated limb is being maneuvered in an awkward manner. Factors such as the weather can even influence pain sensations and increased emotional stress can also cause the symptoms to worsen.
Although this condition is generally observed in individuals who have undergone an amputation, the phantom limb pain description is a misnomer. Patients have actually reported experiencing pain sensations from various areas where portions of the body may have been removed through a surgical procedure. For example, phantom limb pain has been reported after eye, tongue, and breast surgery.
Causes of Phantom Limb Pain
For many individuals, the amputation of a body part causes sensations that create the feeling that the body part is still there and the experience is usually painless. These sensations are referred to as phantom limb sensations. However, some patients report that they have discomfort and pain that originates from the area of the body part that was removed. This condition is known as phantom limb pain.
An exact cause for phantom limb pain has not been determined, but it is understood that the phantom sensations are the result of signals being transferred from the spinal cord and brain. Furthermore, imaging research has demonstrated neurological activity in parts of the brain that transfer signals to the nerves that were located in the area of amputated body part. It is often believed that the sensations of phantom limb pain develop as a result of losing nerve input following the amputation. This means that the brain and spinal cord continue to transmit pain signals even after sensory input has been disrupted due to an amputation.
Undergoing an amputation does not always result in the development of phantom pain. Instead, it has been reported that different factors such as scar tissue and damaged nerves as well as memories of pain in the affected body part prior to amputation may be related to the occurrence of phantom limb pain after surgery.
Treatments for Phantom Limb Pain
A cure for phantom limb pain has not been found, but several treatments have been established that help relieve the painful symptoms this condition causes.
Pharmacotherapy treatments are usually the first method of choice and although there are no approved medications for phantom limb pain, certain medications appear to provide some pain relief. For example, anticonvulsants such as gabapentin have been shown to be effective in reducing the pain that accompanies nerve damage after surgery. Furthermore, there are several medications that were originally developed to treat depressive symptoms that have also demonstrated the ability to effectively reduce neuropathic pain. When an individual has severe pain that does not improve after treatment with over-the-counter medication, a physician may discuss the possibility of managing the pain with opioid medications.
In addition, patients who have severe and chronic neuropathic phantom limb pain may receive TENS units. These are devices that administer mild electrical stimulation to the stump of an amputated limb or other body part and this method is showing promise in terms of providing effective pain relief. Spinal cord stimulation is another method that has provided some patients with a significant decrease in pain. During this procedure, a device is implanted near the spinal column in order to transmit electrical impulses from spinal nerves that regulate pain signal transmission to different parts of the body. Similarly, intrathecal pump implants, which administer medication directly to the region that encompasses the spinal cord, provides dramatic pain relief for some patients.
Biofeedback training is an alternative treatment approach that provides phantom limb pain relief by teaching patients relaxation strategies and coping techniques that assist them with managing their pain symptoms as well as emotional stressors that may exacerbate the pain. Additional forms of therapy such as acupuncture have also shown promise for patients with phantom limb pain especially when this therapy is combined with additional treatment methods.
Phantom limb pain occurs after a body part has been amputated and is described as a neuropathic pain condition. Currently, the exact cause of this condition is not completely understood, but it has been suggested that mixed neural signals and nerve damage are more than likely responsible for these sensations.
A cure for the phantom limb pain is not available, but the pain tends to completely subside over time in most cases. If phantom limb pain does not resolve within six months of the amputation, then the prognosis for complete pain relief is poor. There are several treatment methods that have been shown to be effective at improving the symptoms of phantom limb pain. Therefore, patients are encouraged to discuss different forms of intervention with their physician in order to decide which type treatment may work best.
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