What Is The Cure For Phantom Limb Pain?

Phantom limb pain is the sensation felt in the amputated limb which is no longer there. In most cases, phantom limb pain goes away on its own, but in some, it causes debilitating pain sensations. 

What is phantom limb pain?

Phantom limb pain is the perception of pain or discomfort in the limb which is no longer there. Doctors used to believe it was a psychological hallucination of an amputee, but now evidence proves that the pain and discomfort sensations are real, the effects of which can be crippling.

Difference between phantom limb pain and residual limb pain

• Phantom limb pain sensations– The person still feels sensations in the missing limb however, logically, no limb means no pain in the site. The person experiencing phantom limb pain might forget about the amputated limb and try to walk with a missing leg. 
• Residual limb pain: This pain affects the residual limb (stump) to which amputation occurred. Residual limb pain occurs due to nerve damage and causes pain in the stump for several days.
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What do phantom limb pain sensations feel like?

Patients start experiencing soft tingling pain sensations within a week after amputation, which lasts up to several days. Some people also describe the pain as stabbing, pinning, cramping, throbbing, and burning sensations.

What causes the painful sensations in the Phantom limb?

Phantom pain starts occurring soon after limb loss. Phantom limb pain occurs because nerve endings are suddenly lost with amputation, producing uncoordinated nerve activity due to the “live wire” of the cut end of the nerve. This activity produces signals which the spinal cord and brain cannot process. 

This misinterpretation produces a sensation that the person may feel pain sensations in part, which are no more.

Hence, a misinterpretation of neural signals makes amputees feel phantom limb pain.

How is phantom limb pain diagnosed?

The amputation specialist will conduct a physical examination of the residual limb to rule out why phantom limb pain sensations occur. The patient may confuse residual limb pain with phantom limb pain. The specialist will further order blood tests and imaging scans like ultrasound to conclude phantom pain occurrence.

How is phantom limb pain treated?

The phantom limb pain treatment aims to ease pain and discomfort symptoms. They include

• Antiseizure medications.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) or pain relievers.
• Antidepressants.
• Beta-blockers.
• Muscle relaxers.
• Injections

Also Read: How TMR helps treat phantom limb pain

Some treatments aim to rehabilitate electrical impulses perception of nerves, the brain, and the spinal cord. These include

• Spinal cord stimulation.
• Neurostimulation.
• Transcutaneous electrical nerve stimulation (TENS).

If non-surgical approaches do not help much Dr Demetrius Evriviades recommends surgery. There are two types of surgeries, namely:

TMR Surgery

Target muscle reanimation (TMR) uses microsurgical procedures to reroute cut and damaged nerves to nearby muscles, giving the nerve endings a new network and new endings. Once the nerves rehabilitate and adapt to functioning towards their new muscle target, the pain and discomfort ease and subside naturally. Technically, this microsurgery completes the neural circuit helping the brain process a new network and manage sensations more normally.

RPNI Surgery

This surgery is called the regenerative peripheral nerve interface (RPNI) technique. In this, the residual peripheral nerves are wrapped in an autologous muscle graft, taken from nearby. The wrapped nerve in grafts gets a new site for new nerve growth and thus develops nerve connections.

Both TMR and RPNI surgeries are microsurgery that also removes neuromas (benign nerve tissue tumours) as a  preventive measure. 

What other therapies help ease phantom limb pain?

The specialist will also incorporate the following treatments to ensure the best rehabilitation:

• Acupuncture.
• Biofeedback.
• Massage.
• Meditation or mindfulness exercises.

Dr Demetrius Evriviades is a renowned reconstructive and plastic surgeon with more than twenty years of experience in the field. His expertise is handling complex procedures like amputation rehabilitation, targeted muscle reanimation (TMR), and critical pain issues experienced by amputees.

The amputation itself becomes a physical and mental challenge for amputees. It is Dr Demetrius’ goal to help amputee patients in rehabilitation and pain relief. Book a consultation with Dr Demetrius and talk about your amputation pain.