Phantom Limb Pain

Pain felt in an area where an arm or leg has been removed. Although the limb is gone, nerve endings at the amputation site continue to send pain signals to the brain as if the missing limb is still there. Pain may range from mild to debilitating and may be accompanied by tingling, cramping and hot or cold sensations.

There are no definitive treatments for phantom limb pain, but several medications, including tricyclic antidepressants, anticonvulsants and opioid medications, may offer some relief.

Transcutaneous electrical nerve stimulation (TENS) may offer relief to some patients. Acupuncture also may help. One unique treatment involves a mirror box, a device with mirrors that makes it appear as if the limb still exists. The patient performs symmetrical exercises while imagining he or she sees the missing limb actually moving.

Local anesthetics, steroids or both can be injected directly into the stump. Doctors also can insert tiny electrodes along the spine and use them to deliver a weak electric current to allieviate pain. Nerve blocks employ injected medications to block pain signals.

If other measures fail, surgery may help. Brain stimulation involves placing electrodes in the brain to deliver low-level electrical current to ease pain. The nerve in the stump also can be surgically resected or revised.

Robert S. Dinsmoor is a medical writer and editor based in Massachusetts.

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