Phantom Limb

Overview

Phantom limb pain is a real and often intense sensation of pain in a limb or part of a limb that has been amputated, whether due to surgery or an accident. The pain can vary in intensity and duration, lasting from seconds to days. In addition to phantom limb pain, individuals may experience two related phenomena:

• Phantom sensations: These occur when the person feels that the amputated limb or extremity is still part of their body, without the presence of pain. For example, someone may feel as though they can still move a missing leg or arm, or may attempt to walk on an amputated leg, forgetting it is no longer there.
• Residual limb pain: This type of pain is localized in the remaining part of the amputated limb, often referred to as the stump. It is usually caused by medical issues such as nerve damage or nerve entrapment, where the nerve is compressed. About 70% of people with limb loss experience residual limb pain.

Despite the challenges these conditions pose, there are management strategies available to help alleviate the discomfort and improve quality of life for those affected by limb loss and its associated pains.

Symptoms

Phantom pain symptoms can be temporary or persist for several days. In the initial six months following limb amputation, the severity and occurrence of pain tend to diminish. However, up to 80% of individuals may still experience phantom pain up to two years post-amputation.

The sensations associated with phantom pain can include:

• A sensation of burning or soreness.
• Feelings of being squeezed, pinched, or as if in a vice.
• Experiences of itching or a tingling sensation.
• Sensations of shooting pain or stabbing.
• A pulsating or pounding feeling.
• The sensation of the limb being twisted.

Make an appointment with your healthcare provider if you experience:

• Infection symptoms, such fever or redness in the remaining leg.
• Severe discomfort that makes it difficult to sleep or go about everyday tasks.

Causes

Residual limb pain, affecting the stump left after an amputation, can be caused by a variety of issues. These issues include bruising, bone infections (osteomyelitis) or the formation of bone spurs, nerve damage which leads to neuropathic pain, or inflammation resulting in neuroma. Additionally, poor blood circulation, the use of a prosthetic device that fits poorly, pressure injuries such as bedsores, and infections of the skin or wounds also contribute to discomfort and pain in the residual limb.

Risk factors

Phantom pain may occur to anybody who has had an amputation. Some patients discover that when they are not using their prosthetic device, the discomfort is severe.

The following conditions might trigger the phantom limb pain:

• Angina or chest pain.
• Changes in the barometric pressure or temperature.
• Constipation.
• Herpes zoster (shingles).
• Physical contact or sex.
• Cigarette smoking.
• Stress.