Phantom Pain

Phantom sensation / pain is experienced by most amputees at some point following their amputation, it is however the severity and frequency that varies. The phantom sensation does not only refer to the feeling that the amputated limb is still present, but also to any sensation or pain originating from the stump. This sensation can vary from a minor tingling feeling to a severe, sharp, stabbing pain which requires pain management and professional assistance.

 

What causes it?

There is no universally accepted explanation for the cause of phantom pain, but here are some theories:

Stress

This could increase the phantom pain as the psychological state has a great influence over pain in general.

Previous experience with pain prior to amputation

Continued pain in the joints or muscles prior to the amputation are thought to have an effect post-operatively.

Inactivity

Staying in the same position for extending lengths of time may increase phantom pain as there is no physical or mental distraction away from the pain. As amputees experience phantom pain differently and to varying degrees, you will need to find what works best for you. Here are some suggestions:

Exercise

Exercising the stump (muscle contraction and slow release) will increase blood circulation and generally reduce the phantom pain. General exercise may also provide relief (and distraction).

Mobilisation

Allowing the stump to start loading as soon as it is ready to do so can prevent or reduce phantom pain and assists with the general well being of the amputee.

Warm wrap/bath

Warmth may increase blood flow to the stump. Try using a warm towel or dip into a warm bath.

Activity

Remove the focus away from the pain by exercising or distraction (watch tv or listen to music).

Massage

Massage your stump, thus increasing circulation

Pressure relief

Remove the prosthesis if there is pain with it on as the socket may be causing a nerve to pinch. Leave it off for a few minutes and then re-apply.

Take note

Keep a notebook of when the phantom pain occurs and its intensity to help you identify the cause. If the phantom pain is intense, here are other suggestions for management:

TENS (Transcutaneous Electric Nerve Stimulation)

Mild electric impulses are transmitted to specific areas inorder to interfere with the pain. The electric current is not painful and the pain relief continues beyond the treatment session.

Medication

Medication which reduces nerve sensation can be used to reduce the phantom pain, but may not remove the pain totally.

Pain Relief Operations

A single nerve (rhizotomy) or nerve bundles (cordotomy) may be surgically cut inorder to prevent the transmission of pain from those nerves to the brain. Unfortunately, amputees are at greater risk of injury in that area as they do not have any protective reflexes of pressure, pain or temperature there.

Alternative Medicines

Relaxation, skin stimulation and acupuncture are some alternatives available.

Nerve Block Injections

Specific substances are injected into a nerve to block the transmission of pain. This may however also cause muscle paralysis and loss of all feeling in this area.

Leave a Reply