Phantom limb pain occurs after an individual has undergone limb amputation and still feels severe pain around where the limb used to be. 85% of individuals that undergo an amputation report feeling some kind of sensation in the missing area. This painful condition has often been misdiagnosed as psychological; however, it is now considered to originate from the brain and spine.
Research has shown that what partly causes phantom limb pain after an amputation is a mechanism known as a peripheral nerve hyperexcitability (PNH). During the process, neurons in the brain can still be stimulated from the area around the affected limb or body part. The neurons still fire off signals, even though the body part has been amputated, and these signals result in the sensation of pain for the individual.
Often, phantom limb pain is described as a burning, stabbing, or throbbing sensation that is caused by neuropathic post-amputation pain, however, the pain is usually described as pins and needles and typically begins after the first couple of days following the amputation. In most cases, the pain decreases over time, but in others, with cases of chronic limb pain, the prognosis can be generally poor.
There are no specific medications approved for the treatment of phantom limb pain, however, research has shown favorable outcomes regarding the use of the following agents: Anticonvulsants, Antidepressants and Opioids.
These medications can be taken orally or, in some cases, through the use of intrathecal pain pump implants. This device delivers pain-relieving medications into the intrathecal area between the spinal cord and its protective sheath.
Spinal cord stimulation is another option to help reduce pain if medication is not an option. This involves the implantation of a device near the spinal column that sends electrical impulses to help control pain signals that are sent from the nerves located in the spinal area.
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