Phantom pain/post amputation pain

Phantom Limb Pain

Phantom limb pain was first observed in Civil War amputees. In an 1871 study, surgeon Silas Mitchell coined the term to describe the sensation or pain perceived by soldiers in a leg or arm that had been removed. [1] Nowadays the definition of phantom limb pain has broadened and can refer to sensation continuously felt in any part of the body that has been removed (organ, breast etc.), or even in limbs that have been paralyzed. Roughly 85% of amputees will experience phantom limb pain within the first three weeks of surgery. [2]

Patients can have non-painful and painful phantom sensations. Non-painful sensations include the perception the missing organ is still attached and functioning normally with the rest of the body as it did before. These patients can feel the movement of amputated arms or the extension of toes or fingers. In some cases, patients even report being able to feel the presence of an accessory they were accustomed to wearing on the phantom limb, such as a wristwatch or wedding ring. [3]

Painful phantom sensations can be initially mild: a feeling of heat or wetness, pressure, pins-and-needles, itching. In more severe cases patients will experience intolerable stabbing, cramping, burning, squeezing or throbbing pain in the missing body part. Intermittent tremors and painful muscle spasms have also been reported. [4]

Phantom limb pain is still not yet well understood and there is a need for more data from large controlled trials. The good news is that, in the meantime, patients have shown great responses to a combination of behavioral therapies, medications, and minimally invasive procedures. The doctors at the Ainsworth Institute of Pain Management are experts in state-of-the-art treatment combinations for phantom limb pain.

What is Phantom Limb Pain?

As mentioned above, phantom limb pain refers to pain felt in a missing (or paralyzed) body part. The pain might be triggered by certain bodily positions or movements. The pain can also be brought on or exacerbated by changes in the weather, or, in the case of amputation, pressure on the residual part of the limb. Psychological factors such as chronic stress and anxiety have been implicated in triggering pain as well. [5]

The phantom usually feels the same size and shape of the missing body part immediately after removal. [6] Over time the perception of the size of the phantom as opposed to it’s original size can become distorted. In cases of limb amputation, patients can sometimes feel as if the nonexistent hand or foot at the end of the removed limb has become twisted or sprained. Also, patients with amputated arms or legs have reported feeling the phantom grow smaller until the eventually only feel the digits of the hand or toes of the foot at the amputation site (stump). This phenomenon is called telescoping. [7]

The pain itself can also change quality over time. Studies have shown that patients who experienced a sharp stabbing pain immediately after surgery have had it change in presentation to a squeezing or burning after 6 months. [8] Pain usually decreased overall in the first 6 months as well. Phantom pain persisting longer than 6 months becomes increasingly difficult to treat. [9]

Phantom limb pain strikes males and females in similar numbers. It also seems to show no preference for age, reason for body part removal, or health status. [9] Pain in the body part previous to the amputation, however, seems to increase the likelihood of phantom pain after removal.

What are the Symptoms?

Phantom limb pain can have multiple non-painful and painful symptoms. Non-painful symptoms can still interfere with a patient’s quality of life.

Non-Painful Symptoms

  • Feeling of limb/body part still existing after it has been removed
  • Perception of movement or normal function in the removed limb/body part
  • Distorted representation of size or position in the removed limb/body part
  • Itching
  • Pins and needles
  • Feeling of pressure
  • Feeling of heat/cold/wetness

Painful Symptoms

  • Sharp knife-like or stabbing pain
  • Feeling something is sticking in the limb
  • Squeezing or burning in the furthest part of the original limb i.e. hand or foot
  • Electrical shock
  • Cramping
  • Burning
  • Feeling of tremor or muscle spasm in removed body part

Patient Testimonials

Read patient reviews from around the web

41 Total Reviews

We are ready to help you