What is Phantom Pain?

Phantom pain is a condition which affects some amputees. When an episode of phantom pain is experienced, the amputee has the sensation of pain in the missing limb, usually at the furthest point in the limb, such as the fingers of an amputated arm. The sensation of pain can be tingling, stabbing, crushing, or searing, and it can be a very intense experience. There are a number of ways to cope with phantom pain, and the problem is common enough that it is often discussed with amputees during the early stages of their recovery.

The cause of phantom pain appears to be a rewiring of the brain. When a limb is amputated, the brain is forced to remap itself to compensate for the missing limb, and sometimes this creates a situation in which signals in the brain may misfire. While the pain feels very real, it is in fact entirely in the patient's mind, although the perception of pain is the same as it is when the pain is real. A closely related phenomenon is phantom limb sensation, in which an amputee or someone born without a limb has the sensation that the limb is actually present.

Several things appear to increase the risk of phantom pain. If an amputee experienced considerable pain prior to amputation, phantom pain may be more common. Likewise in amputees with stump pain, or patients with prosthetics which do not fit correctly.

A variety of medications can be used to treat phantom pain, ranging from antidepressants to change the brain chemistry, to painkillers to address the sensation of pain. This condition can also be treated with spinal cord stimulation, nerve blocks, acupuncture, or the use of a Transcutaneous Electrical Nerve Stimulation (TENS) unit. Neurosurgery may also be used to target the malfunctioning area of the brain, and some patients also experience relief by “exercising” the phantom limb to work out the pain.

Pain in an amputated limb is a very real problem, even if it is really due to misfiring neurons. Phantom pain can be debilitating and extremely frustrating, especially when combined with the psychological issues often associated with amputation. Feelings of stress and loss related to the amputation may be amplified by phantom pain, making the amputee feel even more distressed. Historically, amputees have also had trouble communicating about phantom pain, because their complaints have been dismissed under the logic that since the limb isn't there anymore, it can't possibly be painful.

It's a good idea to talk about phantom pain with a doctor who may be able to recommend some possible treatments or coping methods. Support groups for amputees also offer suggestions for dealing with phantom pain.