Phantom Limb Syndrome

Phantom Limb Syndrome

(Phantom Pain; Phantom Limb; Neuropathic Pain)

Definition

Phantom limb syndrome is the feeling of sensations in a limb that has been removed. The limb may feel as though it is still attached to the body. This is because the brain continues to get messages from nerves that used to "feel" for the missing limb.

Nervous System

CNS and PNS
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Causes

The exact cause is not known. It is thought that the feelings happen because the brain must rewire itself to adjust to the changes in the body.

Risk Factors

This problem is more common in adults. Other things that may raise the risk are:

  • Pre-amputation pain or infection
  • A blood clot in the amputated limb
  • Previous damage to the spinal cord or the peripheral nerves of the affected limb
  • Sudden amputation from trauma, such as an accident
  • The type of anesthesia used during the amputation

Symptoms

The symptoms are felt in a limb that is no longer there. Phantom limb syndrome may cause sensations of:

  • Shooting, stabbing, piercing, or burning pain
  • Pleasure, such as from a light touch
  • Pressure
  • The limb still being attached and working normally
  • Numbness, tickling, or cramping

Diagnosis

The doctor will ask about your symptoms and health history. You will also be asked questions about your amputation. This is often enough to diagnose phantom pain.

Treatment

Phantom limb syndrome is often brief. It can pass on its own over time. Some people may have lasting pain that is hard to manage. There is no one treatment plan that is best. Treatment will be chosen to help control specific symptoms. Options are:

Medicine

Medicine that may be given to manage symptoms include:

  • Pain medicine
  • Muscle relaxants
  • Antidepressants
  • Anti-seizure medicine
  • Antipsychotics

Electrical Nerve Stimulation

Electrical nerve stimulation may help calm nerve signals. Examples are:

  • Transcutaneous electrical nerve stimulation (TENS)—a tiny electric current is sent through the skin to nearby nerves
  • Transcranial magnetic stimulation—a strong magnetic pulse is sent through the scalp into the brain
  • Spinal cord stimulation—an electrode is inserted near the spinal cord to ease pain

Other Methods

Other methods that may help are:

  • Regional sympathectomy—surgery to interrupt selected nerves near the spinal cord
  • Biofeedback
  • Stress relaxation methods
  • Exercise

Prevention

There are no known methods to prevent this health problem.

RESOURCES:

Amputee Coalition of America
http://www.amputee-coalition.org
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

The War Amps of Canada
http://www.waramps.ca

References:

Richardson C, Kulkarni J. A review of the management of phantom limb pain: challenges and solutions. J Pain Res. 2017;10:1861-1870.
Lower extremity amputation. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/upper-extremity-amputation-15. Accessed September 15, 2021.
Upper extremity amputation. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/upper-extremity-amputation-15. Accessed September 15, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Mary-Beth Seymour, RN
Last Updated: 9/15/2021

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