Phantom Pain in Amputees
Phantom limb pain is the occurrence of sensations in amputees, characterized by pain, that feel like they are coming from the now missing body part. While phantom pain is reported in some who have had body parts like organs, teeth, or breasts removed, the sensory phenomenon is most common in those who experience limb loss.
For some amputees, phantom limb pain gets better with time, but for others, managing phantom limb pain can be a constant challenge and can lead to grief, lack of sleep, and other impediments to living a normal life. Nearly 80 percent of amputees experience phantom limb pain at some point in their lives.
Symptoms of Phantom Limb Pain
According to studies, the vast majority of patients experience phantom limb sensations immediately after amputation while a minority start to experience it a few weeks after the operation.
In general, amputees report many different sensations associated with the missing limb with varying degrees of pain. Phantom limb sensations, not to be confused with phantom limb pain necessarily, may include pressure, itchiness, tingling, coldness, warmth, and, of course, pain.
Symptoms of phantom pain, specifically, include a shooting, stabbing, throbbing, or burning feeling that often seems to be coming from the furthest part of the missing limb, meaning the foot, toes, hand, or fingers.
Causes of Phantom Pain
In the past, doctors and medical scientists believed phantom limb pain was a purely psychological problem, but over time, evidence proved that phantom sensations are the product of mixed signals from the brain and spinal chord to the missing limb.
Thanks to brain scans, when an amputee feels phantom pain, areas of the brain that were neurologically connected to the amputated limb show increased activity. More specifically, the brain is sending pain signals to the phantom limb.
As to why some amputees experience phantom pain and others don’t, there is still no definite reason. Despite not knowing this, however, it’s now believed by most experts in the medical field that some factors can increase the risk of phantom limb pain, including limb pain before amputation, stump pain due to damaged nerve endings, and a poor-fitting prosthetic limb.
Treating Phantom Limb Pain
The first thing any person suffering from phantom pain should do is to get in touch with a doctor to schedule an appointment. Also making detailed notes of your symptoms like when they occur, what triggers them, and how long they last can help your doctor more accurately create a treatment plan.
Although no specific medications exists for phantom limb pain, there are numerous other drugs out there that can be used to alleviate the pain, including anti-inflammatories, anti-depressants, anti-convulsants, beta-blockers, and muscle relaxers. Opioids may be prescribed but are not often effective and are highly addictive.
If medications alone don’t provide enough relief, other more invasive operations might do the trick. Popular treatments include injections, brain stimulation, stump revision, and spinal chord stimulation.
Another recent development being used to treat phantom pain is Vibrating Therapeutic Apparel created by Amira Idris, a graduate from University of Delaware. Put simply, the device works by placing a sleeve where the phantom pain is occurring. The vibrating nodes of the sleeve will then stimulate the area and reduce pain.
Managing Phantom Pain
While phantom limb pain is a reality of life for many amputees, taking steps to manage and prevent the pain can go a long way.
The best non-medical steps to manage phantom pain are to avoid phantom pain triggers and to make lifestyle adjustments.
Instead of solely going the medical route, it is important for those suffering from phantom pain to also try to incorporate alternative therapies that may help alleviate symptoms. Some options for this include acupuncture, massages, propping up the residual limb, electric nerve stimulation, and mirror box therapy.
Another great way to manage phantom limb pain is by making lifestyle changes like staying physically active, finding ways to relax, and by seeking out support from family, friends, and other amputees who have experienced phantom limb pain.
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POSI prosthetist and technicians are trained and certified by the following manufacturers for use of their products:
Ossur: Touch Bionics, I-Limb
Otto Bock: Bebionic, Michelangelo
Prosthetic Orthotic Solutions International (POSI) is an outcome based prosthetic fitting & prosthetic care practice in the New Jersey, Pennsylvania and Delaware areas. POSI specializes in; lower limb prosthetics, upper extremity prosthetics, silicone prosthetics, prosthetic arm, and prosthetic leg fittings.