Pain Management: Phantom Limb Pain

Phantom limb pain is mild to extreme pain felt in the area where a limb has been amputated.

Phantom limb sensations usually will disappear or decrease over time; but, when phantom limb pain continues for more than six months, the prognosis for improvement is poor.

What Causes Phantom Limb Pain?

Although the limb is no longer there, the nerve endings at the site of the amputation continue to send pain signals to the brain that make the brain think the limb is still there. Sometimes, the brain memory of pain is retained and is interpreted as pain regardless of signals from injured nerves.

What Are the Symptoms of Phantom Limb Pain?

In addition to pain in the phantom limb, some people experience other sensations such as tingling, cramping, heat, and cold in the portion of the limb that was removed. Any sensation that the limb could have experienced prior to the amputation may be experienced in the amputated phantom limb.

How Is Phantom Limb Pain Treated?

Successful treatment of phantom limb pain is difficult. Treatment is usually determined based on the person's level of pain, and multiple treatments may be combined. Some treatments include:

• Heat application
• Biofeedback to reduce muscle tension
• Relaxation techniques
• Massage of the amputation area
• Surgery to remove scar tissue entangling a nerve
• Physical therapy
• TENS (transcutaneous electrical nerve stimulation) of the stump
• Neurostimulation techniques such as spinal cord stimulation or deep brain stimulation
• Medications, including: pain-relievers, neuroleptics, anticonvulsants, antidepressants, beta-blockers, and sodium channel blockers.

Reviewed by the doctors at The Cleveland Clinic Pain Management Department.