FAQs on Phantom Limb Pain Treatment in Nashville

Phantom limb pain is the severe discomfort that often occurs after amputation. For many patients, phantom limb sensations disappear with time, but for others, the pain persists six months or more. Chronic pain related to an amputation is a reality for many people.

What causes phantom limb pain?

Even though the limb is no longer there, the nerve endings at the site of the amputation transmit pain signals regardless. The signals are sent to the spinal cord and brain, which perceives that the limb is still present. The brain retains a memory of pain, which persists long after the limb is gone.

How common is phantom limb pain?

In a study involving 144 patients who experienced upper extremity amputations, the prevalence of phantom limb pain was around 43%, with more than one-third of patients describing pain on a daily basis. The pain was described as “discomforting,” affecting daily activities.

What symptoms occur along with the phantom limb pain?

The pain related with this condition is as if the limb is still there. Patients describe achy, sharp, and shooting pain, as well as cramping, tingling, heat, and cold sensations. In addition, patients often still feel the pain that was felt prior to the amputation.

Who is at risk for phantom limb pain?

Certain patients are at greater risk for phantom limb pain than others. Several factors increase the risk for this condition, such as:

  • Pain before the amputation – People who have pain in the limb before removal are at greater risk for long-term phantom limb pain. Scientists believe this is related to the brain’s memory of the pain sensation.
  • Poor-fitting prosthesis – When the artificial limb does not fit correctly, the patient often experiences residual pain.
  • Stump pain – The amputee who experiences stump pain right after the amputation procedure is more likely to have long-term phantom limb pain. Stump pain is related to damaged nerve endings and abnormal tissue growth.

How is phantom limb pain treated?

There are many treatment options for phantom limb pain. These include:

  • Medications – No one drug works for every patient with phantom limb pain. Commonly prescribed medicines include tricyclic antidepressants, which modify chemical messengers that detect pain. In addition, anticonvulsants quieten the damaged nerves to slow or prevent pain signal transmission. When patients fail on other treatments, opioids are used.
  • Transcutaneous electrical nerve stimulation (TENS) – Electrodes are positioned on the skin near the spine, and wires connect the electrodes to a small device. To interrupt pain signals, weak electrical current is transmitted. Many clinical studies show that TENS is effective for reducing phantom limb pain.
  • Stump injections – The doctor can inject the stump with a long-acting corticosteroid and/or an anesthetic. According to a 2009 clinical study, many patients reported a decrease in phantom limb pain after receiving bupivacaine stump injections.
  • Botox – For the last decade, Botox has been used to paralyze stump muscles. This substance has been found to be useful for pain reduction in clinical studies.
  • Acupuncture – This traditional Chinese therapy has been used for years to relieve pain by stimulating the central nervous system to release endorphins. With acupuncture, the practitioner inserts extremely small needles into the skin.

Resources

Davies A (2013). Acupuncture treatment of phantom limb pain and phantom limb sensation in a primary care setting. Acupunct Med, 31(1):101-4

Desmond, DM & Maclaclan, M (2010). Prevalence and characteristics of phantom limb pain and residual limb pain in the long term after upper limb amputation. Int Journal of Rehab Res, 33(3), 279-282.

Giuffrida, O, Simpson, L, & Halligan, PW (2010). Contralateral stimulation, using tens, of phantom limb pain: two confirmatory cases. Pain Medicine, 11(1), 133–141.

Kern, U, Martin, C, Scheicher, S, & Muller, H (2004). Long-term treatment of phantom- and stump pain with Botulinum toxin type A over 12 months. A first clinical observation. Nervenarzt, 75(4), 336-340.