Phantom limb pain, sometimes referred to as just phantom pain, is a form of chronic pain that feels as if it’s coming from a part of the body that is no longer there. Once believed to be simply a psychological phenomenon brought on after an amputation, but recent research proves that it is real pain originating from the brain and spinal cord.
Not to be confused with phantom limb sensation, which is simply when someone with a limb removed reports that it sometimes feels like the amputated limb is still there. Almost all people with an amputated limb are thought to experience at least occasional phantom limb sensation.
While some may find that their phantom limb pain gets better with time, others may have a much more difficult time managing their phantom pain. Fortunately, there are a lot of treatment options for those suffering.
What are the causes of Phantom Limb Pain?
While the exact cause is still not entirely clear, phantom pain is thought to be caused by mixed signals coming from the brain or spinal cord. The parts of the brain connected to the nerves of the amputated limb tend to show activity when the person is feeling phantom pain when tested in either a magnetic resonance imaging (MRI) or positron emission tomography (PET) scan.
Some research seems to indicate that after an amputation, the brain will try to remap the amputated part’s sensory circuitry to another part of the body, essentially moving the nerve information to a still-existing body part. When the still-existing body part is touched, the brain or spinal cord may interpret to an amputated body part as having been touched, which generally results in pain.
In addition, some activities or conditions are more likely to trigger phantom limb pain:
- Urination or defecation
- Sexual intercourse
- Cigarette smoking
- Changes in barometric pressure
- Exposure to cold temperatures
What are the symptoms?
Generally speaking, the symptoms will appear within the first week after amputation, but in some cases symptoms may be delayed by months or even longer.
Since phantom limb pain is a chronic pain condition, the most common symptoms include (but may not be limited to):
- Shooting Pain
- Stabbing Pain
- Crushing Pain
- “Pins and Needles” sensation
- Burning Pain
The treatment for phantom limb pain varies depending on severity of pain and the exact mechanisms playing a role, but these five techniques are some of the most effective:
- Mirror Box Therapy This is a type of physical therapy where the patient watches in a mirror in an effort to remap the brain’s neural pathways (essentially, remind the brain that the amputated body part is no longer there)
- Nerve Cuff Stimulation This is placing a nerve stimulator on the nerves connected to the amputated body part. This nerve stimulator sends a pleasant signal throughout the nerves to try to replace the phantom pain sensation.
- Local Injection Therapy Your physician will inject a pain-blocking agent at the site of the amputation. This can help the painful signals involved in phantom pain.
- Non-Opiate Analgesic A prescription pain medication can help slow or limit the phantom pain sensations.
- Deep Brain Stimulation A surgeon will place tiny electrodes onto the brain to use electrical impulses to help attenuate pain.
What new treatments can help Phantom Limb Pain?
- Ketamine Infusions – Ketamine, an NMDA-receptor antagonist, can help restore nerve passages and reset connections when infused at a low dose. Many patients are finding relief through the clinical use of Ketamine
How can Ketamine Infusions help treatment Phantom Limb Pain?
Ketamine was first approved by the FDA as an anesthetic, but has been used as a pain and depression treatment since 2006. Infused at a low dose from an IV into the bloodstream, Ketamine has been shown to improve pain and depression symptoms in 75-80% of patients. If you or a loved one is suffering from phantom limb pain and has questions about Ketamine treatment, we invite you to call us and schedule a phone consultation to decide if Ketamine infusion therapy is right for you.