Phantom Limb Pain and Chronic Pain

Topic Overview

Phantom limb pain is pain that is felt in the area where an arm or leg has been amputated. Although the limb is gone, 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. Phantom limb pain can be mild to agonizing and even disabling for some. And it may lead to a lifelong battle with chronic pain. Women who have had a breast removed because of breast cancer may also feel phantom pain.

Some people experience other sensations such as tingling, cramping, heat, cold, and squeezing along with pain. You can feel any sensation in the portion of the limb that was removed (your "phantom" limb) that the limb might have experienced before it was removed.

You may also have residual limb pain or "stump pain" at the actual site of the amputation. You may feel cramping, burning, aching, or sensations of heat or cold in the residual limb.

Successful treatment of phantom limb pain may be challenging. Treatment is usually based on the amount of pain you are feeling. Many treatments may be tried and can include applying heat, massaging the area of the amputation, and biofeedback to reduce muscle tension in the residual limb. Other treatments that can be tried are acupuncture, medicines (such as anticonvulsants and antidepressants), and sometimes surgery to remove scar tissue entangling a nerve. Usually, the best approach is to combine multiple treatments.

Other treatments may include transcutaneous electrical nerve stimulation (TENS) of the residual limb. Sometimes using TENS on the portion of the limb that is still present can help with phantom limb pain. You may benefit from physical therapy and use of an artificial limb (prosthesis).

One treatment that is becoming more popular is mirror therapy. For this therapy, you place a mirror so that the reflection of your intact limb looks like your missing, or phantom, limb. You then look at this "virtual" limb in the mirror. And when you move your intact limb, without pain, your brain "sees" painless movement in the phantom limb. Mirror therapy may help some people who have phantom limb pain. The studies done so far have been small, and the results have been mixed.^{footnote 1}

When other treatments have failed, electrical stimulation of the spine may be tried to relieve chronic phantom limb pain, though results have been mixed.