Phantom Limb Pain: Causes and Treatments
Phantom limb pain is the sensation of pain that feels like it is coming from a body part that is no longer there. Once believed to be a psychological problem, research shows that phantom limb pain is a real sensation. The sensation originates in the spinal cord and brain.
What is Phantom Limb Pain?
Phantom limb pain is pain in an area where there has been an amputation. The pain can be minor and go away on its own with the symptoms decreasing over time. However, phantom limb pain can be extremely debilitating and can lead to chronic pain. When the pain is consistent and continual for more than 6 months, the chances of phantom limb pain disappearing on its own is slim-to-none.
The pain is real and not just a psychological phenomenon. During MRI scans, areas of the brain that were previously connected to the nerves in the amputated limb show activity when the patient feels pain.
What Causes Phantom Limb Pain?
The underlying root cause of phantom limb pain is not clear, but it originates in the spinal cord and brain. This is believed to be caused by a mixed signal in the brain. After amputation occurs, areas of the spinal cord and brain miss input sensations from where the limb should be. The body takes time to adjust. However, this lack of input sensations triggers the body’s most basic message that something is wrong: PAIN.
There are studies that show how, after an amputation, the brain “rewires” that part of the body’s sensory nerves to another part of the body. Because that amputated area is unable to receive sensory information, the information is referrfed. This means instead of feeling pain in the now-amputated leg, you feel those senses in a still-present hand.
Damaged nerve endings and scar tissue at the amputation site contribute to phantom limb pain. Sometimes the physical memory of the limb can invoke pain, as that sensory information has been retained.
Treatment options vary depending on the severity of the pain sensations. Like many pain conditions, a combination of multiple treatment options is most effective in reducing pain. It can be difficult to treat phantom limb pain, but your doctor may begin with medication options and noninvasive treatments.
Some medications administered and prescribed to help phantom limb pain are as follows:
- Over-the-Counter Medications: Acetaminophen, Ibuprofen, or Naproxen may relieve phantom limb pain. These should be taken under the direction of your doctor.
- N-Methyl-D-Aspartate (NMDA) Receptor Antagonists: This type of anesthetics binds to the NMDA receptors on the brain and blocks activity of glutamate - a protein that plays a crucial role in relaying nerve signals.
- Antidepressants: Tricyclic antidepressants may relieve the pain caused by damaged nerves.
- Anticonvulsants: Typically used to treat epilepsy, this medication is also used to treat nerve pain.
Other medications may include beta-blockers, sodium channel blockers and even low-dose narcotics if the pain is severe. Many physicians do not recommend taking narcotics and find other methods of relieving pain.
Non-invasive therapies do not always work for everyone, and just like medication, the effectiveness is monitored and measured in order to find the most viable solution to treat pain. Treatment options may involve:
- Acupuncture: Acupuncture has been found to ease chronic pain symptoms. Long, fine, sterile needles are injected into pain points on the body, relieving tension and pain. It is an incredibly safe treatment option.
- Spinal Cord Stimulation: Tiny electrodes are placed along your spinal cord and an electrical current is delivered to the spinal cord and relieves pain.
- Heat Therapy
- Biofeedback: Training the body to effectively handle and manage pain by learning what the sensations feel like.
- Relaxation Techniques: Meditation, yoga, breathing techniques, and other methods of self-taught relaxation help you learn how to focus your energy away from the pain.
- Physical Therapy: Physical therapists design a treatment plan to incorporate cardio and strengthening exercises into your daily routine that help reduce pain and teach your body how to positively cope with pain.
If those options do not provide effective relief, surgery is available. If you suffer from phantom limb pain, talk to your doctor today about starting a treatment plan.