FAQs on Phantom Limb Pain Treatment in Las Vegas

Phantom limb pain is any discomfort felt after a portion of an extremity has been amputated. This condition is often misdiagnosed and can be disabling. Often misunderstood and misdiagnosed, this pain originates from the brain and spinal cord.

Which body regions are most affected by phantom limb pain?

Phantom pain occurs following amputation of the arm, hand, leg, foot, or any portion of an extremity. In addition, the removal of any body part can lead to phantom limb pain, such as a breast, the tongue, an eye, the nose, or an ear.

Is phantom limb pain common?

According to statistics, 1.7 million people have had a body part amputated. Of these persons, 50-85% experience phantom limb pain, making it quite common.

How does phantom limb pain feel?

Phantom limb pain can be throbbing, stabbing, burning, as well as a sensation of electric shock. Because the pain has a neuropathic origin (nerve-like), it often feels like a sensation of pins and needles.

Who is at risk for phantom limb pain?

The risks for phantom limb pain include:

  • Damaged nerves
  • A traumatic injury prior to the amputation
  • Memories of pain prior to amputation
  • Scar tissue accumulation

What causes phantom limb pain?

Most experts believe the cause of phantom limb pain is peripheral nerve hyper-excitability. Once the limb or body part is removed, neurons (nerve components) in the brain continue to be stimulated, as if the painful limb is still present.

What can trigger (bring about) phantom limb pain?

Certain substances, conditions, and activities can trigger phantom limb pain. These include:

  • Sexual intercourse
  • Touch
  • Chest pain
  • Urination or defecation
  • Exposure to cold
  • Cigarette smoking
  • Herpes zoster
  • Changes in barometric pressure

How does the doctor treat phantom limb pain?

Because phantom limb pain is complex, the pain specialist will use a combination of therapies to treat this. These include:

  • Physical therapy – The therapist can use techniques to provide pain relief, such as electrical stimulation, ultrasound, massage, and heat/cold therapy.
  • Medications – Tricyclic antidepressants (amitriptyline and nortriptyline) reduce pain signals by affecting certain brain regions. Nerve pain is treated with anticonvulsants, such as Tegretol and Neurontin. When pain is severe, the specialist uses narcotic analgesics short-term.
  • Stump injections – The pain specialist can inject a corticosteroid and long-acting anesthetic into the stump. In a recent clinical study, these injections were found to decrease phantom sensations.
  • Acupuncture – The practitioner can insert tiny, fine needles into the stump or other parts of the body to decrease pain. This technique works by stimulating the brain to release endorphins and promote the body’s own healing abilities.
  • Botulinum toxin type A – This is a powerful paralyzing agent used to alleviate stump pain. According to a recent research report, Botox injections were proven successful for treating phantom limb pain.
  • Spinal cord stimulation (SCS) – The doctor can implant a small device into the lower abdomen or buttocks. Wires run from the device to electrodes, which are surgically placed along the spinal cord. Electrical current impulses will block pain signal transmission. SCS is used when other treatments fail. In a recent clinical study, this device was proven effective for the phantom limb pain.
  • Mirror therapy – This new treatment involves use of a mirrored box with two openings. The full-length limb goes in one opening, and the amputated limb goes in the other. The therapist has the patient perform isometric exercises using the healthy limb, which makes it appear as if the missing limb is moving. According to a randomized, controlled study, patients who used mirror therapy enjoyed significant pain reduction.

Resources

Chan B., Witt, R., Charrow, A., et al. (2007). Mirror therapy for phantom limb pain. New England Journal of Medicine, 357;21: 2206-2207.

Davies A (2013). Acupuncture treatment of phantom limb pain and phantom limb sensation in a primary care setting. Acupunct Med, 31(1):101-4

Kern, U, Martin, C, Scheicher, S, & Muller, H (2004). Long-term treatment of phantom- and stump pain with Botulinum toxin type A over 12 months. A first clinical observation. Nervenarzt, 75(4), 336-340.

Ulger O, Topuz S, Bayramlar K, Sener G, & Erbahçeci F (2009). Effectiveness of phantom exercises for phantom limb pain: a pilot study. J Rehabil Med, 41(7):582-4.

Viswanathan, A, Phan, PC, & Burton, AW (2010). Use of spinal cord stimulation in the treatment of phantom limb pain: case series and review of the literature. Pain Practice, 10(5), 479–484.