Understanding Phantom Limb Pain

Amputation is the surgical removal of a limb or extremity such as arm, leg, foot, hand, toe, or finger.

Injury, cancerous tumor, infection are some reasons that may result in amputation of body parts. When a person loses a limb, recovery of the wound takes time. A person may undergo severe physical and mental trauma and it may take months or even years to get back to normal life.

In some case a person may experience phantom limb pain or phantom pain after amputation. Phantom pain is a sensation that a person feels coming from a body part that’s no longer there and has been removed. People with phantom pain feel that the amputated limb is still there and is hurting.

Anupama Kapur, Senior Psychologist associated with ‘Unlimited Potentialities’ , says, Phantom pain is a pain that comes from
a body part which is no longer there such as arm or leg which may have been lost due to an amputation or injury. The onset is generally within the first week of amputation, though it may get delayed at times, pain may be continuous or comes and goes and is usually described as shooting, pins and needles, cramping or throbbing. Not everyone who has lost a limb develops phantom pain, but the risk is increased if there has been pain in the limb before amputation, or there is ongoing pain in the remainder part of the limb. There is no test to diagnose the problem.“

Causes & Signs

For years, doctors considered the pain to be a post-amputation psychological problem, however, it has been found that the pain is a physical sensation that comes from the pain sensors in the spinal cord and brain. While in some cases, phantom pain is extremely severe, in others it can exist as a sensation of itchiness or a twitch.

Dr Madhur Chadha is a pain specialist and feels that patients should be counseled about the phantom limb pain phenomenon at least post operation to prepare them mentally.

The lack of awareness about phantom pain remains a major hurdle and most patients tend to suffer throughout their life as they do not get the right guidance and information about their condition. Many lives could be improved if patients are helped through a rehabilitation process and receive professional guidance to understand the issue. Phantom pain is not just a psychological issue, it is a physical problem and affects the quality of life of a person.

The exact cause behind phantom pain is not yet known and may vary from person to person.

Some factors that may result in phantom pain are damaged nerve endings, scar tissue at the site of the amputation and the physical memory of pre-amputation pain or trauma in the affected area. Stress, anxiety and weather changes have also been observed to make the pain more intense for some people.

Treatment

The condition is not entirely curable and most treatments are not very effective, although some interventions may help find some relief but very rarely.

Medications such as antidepressants, spinal cord stimulation, vibration therapy, acupuncture, hypnosis are some treatments that can be opted for.

Mirror box therapy, local injection therapy, non-opiate analgesic, deep brain stimulation, nerve cuff stimulation are some other techniques that can be tried for relief.

“I did not experience any phantom pain after my leg was amputated. Inner strength and high tolerance to pain may also have an impact on way some people feel after losing a limb. I have tried my best to get over the loss of limb and get back on my feet and that has motivated me to stay positive. “ Himanshu Kumar, Para Cyclist