Phantom limb pain is a complex phenomenon that refers to pain that feels like it’s coming rom a body part that’s no longer there. Approximately 60 – 80% of amputees experience phantom sensations and the majority of these feelings are some form of pain, ranging from mild to extreme.
Fortunately, phantom limb pain will typically decrease over time and eventually disappear. However, when phantom limb sensations persist for over 6 months, the prognosis for spontaneous improvement is somewhat poor. However, recent advances in psychological, pharmacologic and integrative therapies show promise for improved treatment modalities in the near future. Scientific research between the interdisciplinary fields of neuroscience, robotics, virtual reality and prosthetics has also shown significant promise for restoring the neural representation of the missing limb, and subsequently diminishing the intensity of phantom limb pain.
What Causes Phantom Limb Pain?
Exactly what causes phantom limb pain is not 100% clear to scientists. The brain is known to have a sensory “map” of the various different parts of the body. Research has suggested that phantom limb pain is the result of lasting representations of the amputated limb. Studies indicate that after an amputation, the brain may remap that region of the body’s sensory circuitry to another area of the body, referring sensory information elsewhere.
Damaged nerve endings are also thought to be a potential cause for phantom limb pain. Although the limb is no longer there, it is believed that injured nerve endings at the site of the amputation may continue to send pain impulses to the brain in a random fashion. In other cases, the cause may be nerve fibers that are trapped by other tissues such as muscle.
Treating Phantom Limb Pain
Finding the appropriate treatment to relieve specific phantom limb pain can be somewhat of a process. Physicians will typically begin with medication and may also complement this with other noninvasive therapies.
Although there are no drugs specifically designed to treat phantom limb pain, other medications (developed originally for other conditions) have proven effective in managing phantom limb pain. These include:
- Antidepressants
- Anticonvulsants
- Narcotics (codeine, morphine, etc…)
- NMDA receptor antagonists
As is the case with medications, treating phantom limb pain with noninvasive and minimally invasive therapies is also a process of trial and observation. The following techniques have shown to be effective in treating the symptoms of phantom limb pain:
- Nerve stimulation
- Mirror Box Therapy
- Acupuncture
- Injection
- Spinal cord stimulation
- Nerve blocks
If the patient’s symptoms have failed to improve after trying other more conservative approaches, surgical options may be considered to attain relief. Surgical procedures used in the treatment of phantom limb pain can include:
- Brain stimulation
- Stump revision or neurectomy
For more information of phantom limb pain therapies and treatment options, please contact our Austin pain management providers. Call (512) 981-7246 or click on the appointment request button below to schedule a visit with our providers.