Jonathan Aarons M.D.

Tired of Chronic Pain?

Phantom Limb Pain

 

Phantom limb pain is a painful sensation that occurs after a body part has been amputated.  This is different from phantom limb sensation.  After amputation, many people experience the sensation of that body part still being attached.  This may occur after traumatic or surgical amputations of an arm or leg, but can apply to any body part that has been removed such as a breast.  Over time the sensation tends to diminish or alter.  A limb may undergo what is called telescoping, where it feels like the hand or foot is actually attached closer to the body.

Patients with phantom limb pain experience painful sensations.  The body part may feel as if it is in an abnormal position.  The pain can be constant and may be described as shooting, stabbing, boring or squeezing.  Occasionally, the patient may experience a burning pain similar to RSD or CRPS.  This may come from a sympathetically mediated component of the pain.  There is some evidence that the appearance of phantom limb pain is linked to the severity of pain prior to amputation.  Changes in the  pain may be linked to changes in weather or emotional triggers.  Sometimes phantom limb pain may be due to a neuroma, an abnormal collection of nerves, in the stump of the amputated body part.  This can also be worsened by poor fitting prosthesis.

Treatment of phantom limb pain is challenging.  Many medications have been tried including antidepressants, neuroleptics, anticonvulsants and narcotics.  An adequate trial of several of these may be necessary before a medication that provides relief may be found.  Other methods of treatment have also been used including TENS, Spinal chord stimulation, accupuncture and deep brain stimulation.  No one treatment has been found to be more effective and multiple modalities may need to be tried before effective therapy is found.

 

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