Treatment of Phantom Pain
You know phantom pain when you feel it. It comes from where your limb used to be. The sensation starts as a discomfort. It is a real feeling coming from the missing limb. It might be a “charley horse” or a cramp in your hand or wrist. The pain gradually increases. It may start as simple “pins and needles,” or an itch you can't scratch.
In the United States, 30,000 to 40,000 amputations are performed each year. Ninety-five percent of patients report experiencing some amputation-related pain, with 79.9% reporting phantom pain. One theory to explain this is that the brain has developed a recorded image of the limb and when normal messages from the limb are lost due to amputation the brain attempts to reconstruct that image of the limb, and send messages; hence phantom sensation. The good news is that the brain has an amazing way to re-learn, and this is helped by increasing normal input, for example; moving, touching or best of all, using the residual limb (with the help of a prosthesis) to enable a ‘new image’ of the limb to be created in the brain.
Phantom pain starts in the weeks following amputation. It can not be ignored. It robs amputees from sleep. They can’t concentrate. It can be similar to a shooting or sharp pain, cramp, burning or feel like an intense electric shock. There are some treatments for Phantom pain. Phantom pain frequently returns when there are other stressors. Some amputees experience more pain due to a change in weather conditions and surrounding environments.
One of the successful ways to manage phantom pain is called diversion therapy. It takes its name from the fact that interfearing with concentrating on the pain helps reduce its effect. Diversion therapy is when you try to focus your attention on doing something different. Try moving if you have been sitting still for a while, or touching and massaging your residual limb. Some people listen to music, to a friend or play a game, to help take their mind off the pain. Although the pain does not stop it is felt less intensely. Other techniques are massage or stretching and mirror therapy. Heat and cold packs are also useful distractions. Transcutaneous Electrical Nerve Stimulation (TENS) machines generate electrical impulses through the skin surface that are transmitted to the spinal cord and brain. These different messages from your residual limb (stump) can create a diversion and therefore disrupt and reduce the pain. It is always recommended to speak with your healthcare team to discuss the use of other treatments for phantom pain to make sure you are using a method that is safe.
The use of electrical stimulation of the nerves is a new technique that has shown promise in the treatment of phantom pain.