Phantom Pain

Man sitting on steps with prosthetic leg.

Phantom limb pain is an unpleasant sensation coming from a body part that is no longer there. This pain typically occurs after limb amputation. It has been well described in studies of American servicemen and women who have lost limbs in combat. Additionally, many amputations performed in United States are the result of significant peripheral vascular disease brought on or worsened by smoking or diabetes.

Patients suffering with phantom limb pain report the pain occurring in the amputated limb. Although the body part is no longer there, the spinal cord and brain create signals that are responsible for the pain experience of the patient. This pain can be either constant or intermittent. It can be severe enough to impair function or limit sleep. Interestingly most patients who have undergone amputation will at some point experience phantom limb sensations, although most do not go on to have chronic phantom limb pain.

Medication Treatment

The treatment of phantom limb pain is taken on with the goal of improving quality of life by decreasing pain, improving functionality, and improving daily activities such as sleep. Neuropathic medications such as antidepressants (such as amitriptyline and duloxetine) and anticonvulsants (such as gabapentin and pregabalin) are often effective. The use of these non-opioid medications is encouraged in favor of opioid medications which have addictive risk and significant side effect potential.

Mirror Therapy

One of the more interesting treatments that has been shown to be beneficial in patients who suffer with phantom limb pain is called mirror therapy. In this exercise, patient’s cover the amputation site with a mirror which reflects the remaining limb on the other side of the patient’s body. It appears that visually seen what looks like a healthy limb provides a pain-relieving effect to the nervous system. This intervention is obviously a good one to use as it is low-cost without risk of serious side effects. Patient to undergo mirror therapy may do so once or twice per day for 15-20 minutes

Procedures for Long Term Relief

An injection known as a lumbar sympathetic block may be beneficial for patient to suffer with Phantom limb pain. Success with lumbar sympathetic blocks also predicts success with spinal cord stimulation. Spinal cord stimulation has been shown in multiple studies to be beneficial for long-term control of phantom limb pain. These procedures and the treatments listed above are therapeutic options we use at Cahaba Pain and Spine Care to treat phantom limb pain.