Why is there phantom limb pain after amputation? Nine ways to reduce phantom limb pain.
What is phantom limb pain
When an arm or leg is amputated, many people continue to feel that the limb is still there. This vivid sensation was originally described by Mitchell (1872) as a "phantom limb" and is often accompanied by excruciating pain. Phantom limb pain is defined as pain felt in the missing part of an amputated limb.
Phantom pain syndrome is reported by 50-80% of amputee patients. Hallucinations have been described as: burning, cramping, crushing, stabbing, tingling, itching, pressure, electric shock-like sensations, heat or cold, throbbing, or numbness. It is sometimes called "ghost pain" because the limb is sometimes invisible but painful. Pain may be intermittent or constant and may continue for years after the amputation.
Causes of phantom limb pain
Researchers don't know exactly what causes phantom limb pain. One possible explanation: Nerves in parts of your spinal cord and brain become "rewired" when they lose signals from your arms or legs. As a result, they send pain signals, which is your body's typical response when it senses something is wrong. Another example of rewiring: When you touch a body part, your brain may feel it in the missing limb.
Here are nine ways to relieve phantom limb pain
1. Drug management
There are no medications that specifically treat phantom limb pain. However, medications for other conditions, from depression to epilepsy, may provide some relief. (It must be noted that each person’s physical condition and drug allergies are different, and any drug treatment must be carried out under the guidance of a physician)
Tricyclic antidepressants. Medications such as amitriptyline (Elavil), nortriptyline (Pamelor), and tramadol (Conzip, Ultram) can relieve nerve pain by changing the chemicals in the body that send pain signals. Anticonvulsants. These medications treat seizures but can also help relieve nerve pain. Examples include carbamazepine (Carbatrol, Tegretol), gabapentin (Gralise, Neurontin), and pregabalin (Lyrica). Opioids. Drugs such as codeine and morphine can reduce phantom limb pain in some people, but not everyone. Before taking one of these medications, tell your doctor if you have a history of drug abuse. Other pain relievers. Some other types may also help with phantom limb pain, including: NMDA receptor antagonists, such as ketamine and dextromethorphan. Over-the-Counter Medications. Injection of painkillers such as aspirin and acetaminophen at the amputation site2. Nerve stimulation.
You may already be aware of the TENS (transcutaneous electrical nerve stimulation) devices sold at pharmacies to relieve muscle pain. They send a weak electric current through sticky patches that stick to the skin. The idea is that it interrupts pain signals before they reach your brain.
3. Mirror box therapy.
Imagine a box without a lid. It has two holes, one for the stump and one for the sound limb, with a mirror in the middle. When you place the stump and good limb inside, you will see the reflection of the intact arm or leg in the mirror. When you do physical therapy exercises, it tricks your brain into thinking you have limbs. Research shows this can help reduce the pain of missing limbs.
4. Acupuncture.
A skilled practitioner inserts fine needles into the skin at specific locations. This prompts your body to release pain-relieving chemicals.
5. Living habits.
Don’t overlook the relief that lifestyle choices can bring.
Find distractions to take your mind off the pain
Stay physically active
Practice relaxation techniques, including meditation and recreation
6. Spinal cord stimulation.
Doctors place tiny electrodes in the body along the spinal cord and send a small amount of electricity through them. In some cases, this can help relieve pain.
7. Brain stimulation.
Similar to spinal cord stimulation, except the electrodes send electrical current to the brain. The surgeon will place the electrodes in the correct locations on the brain. Scientists are still figuring out how it works, but for some, the research is promising.
8. Wear shrink socks.
Maintaining constant pressure on the end of the limb may help reduce phantom pain.
9. Wear prosthetics.
Just like wearing compression socks, using a prosthesis provides steady pressure on the limb. This seems to reduce phantom pain in some people.
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