August 4, 2020

5 Ways to Deal With Phantom Limb Pain After Amputation

Pain and strange sensations are common

amputee dealing with phantom pain

Most people experience some pain after undergoing surgery. It’s part of the healing process and generally subsides as your tissues repair themselves. However, it’s not that simple if you’re recovering from an amputation.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

“After the initial post-surgical pain subsides, you may experience several types of sensations,” says pain management specialist Robert Bolash, MD. “Some might be painful and unpleasant and others might be strange and disconcerting.”

Doctors can help amputation patients control these sensations early on to limit long-term problems with post-amputation pain.

Amputation is sometimes necessary in cases of trauma — such as injuries from car accidents or military combat. Some medical conditions also progress to a point where amputation is necessary and people with vascular diseasediabetes and even certain tumors may eventually need an amputation.

Types of post-amputation sensations

“After the initial surgical incision and deeper tissues have healed, many ampu​tees report sensations associated with the removed limb,” says Dr. Bolash. “It’s important to differentiate between the types of sensations in order to understand and treat them.”

1. Phantom sensation

Sometimes you may feel that a removed body part is still in place.

“It can be an arm or a leg, but can even happen with those who have breast cancer and have had a mastectomy,” says Dr. Bolash. “These women sometimes have a sensation that the breast is still there.”

Advertisement

A person experiencing telescoping has the feeling their missing limb is still there, but that it has shrunk to a very small size, similar to a collapsed telescope. There’s no mention of pain with this common type of sensation, but it is unnerving. Most patients experience phantom sensations of some sort within six months of an amputation.

2. Phantom pain

Patients experiencing this sensation report an actual feeling of pain, ranging from mild to severe, in the missing body part. Patients often feel pressure, itching or even burning.

“Although amputations have occurred throughout human history, phantom pain first became clearly defined by a Civil War physician,” says Dr. Bolash. “This physician noted that as many as 90% of soldiers with limbs amputated during wartime developed some degree of phantom pain.”

About 95% of patients report feeling amputation-related pain and 80% feel phantom pain.

“It’s difficult to pin down the precise frequency because patients often are reluctant to report it,” he says. “It’s very real to them, but they can clearly look and see that the limb is gone, so they worry that their physician might begin to doubt their sanity.”

3. Residual limb pain

This type of pain occurs in the part of the limb that’s left behind — often referred to as the stump — after the amputation.

Advertisement

“At the amputation site, some people develop a neuroma,” says Dr. Bolash. “This occurs when a cut nerve ending forms a tiny ball on its end during healing or gets trapped in the suture line when the surgeon closes the incision.”

This is not phantom pain, but pain originating from the stump. Poorly fitting prosthetics or limb bruising can cause residual limb pain as well.

Five techniques for managing post-amputation pain

The success of treatment for post-amputation pain depends on your level of pain and the various mechanisms playing a role in causing the pain. While your surgeon may suggest beginning small exercises or managing your stress levels, there are five treatment techniques that go beyond the basics.

Here are five of the most effective treatment techniques:

  1. Mirror box therapy: The patient actually watches in a mirror while receiving physical therapy to re-map the brain’s neural pathways to register that the limb is no longer there. They feel the imaginary movement of the removed limb behaving as the normal movement through a mirror. This type of physical therapy with proven efficacy for patients with post-amputation pain.
  2. Local injection therapy: The physician injects a local pain-blocking agent at the amputation site. This can calm the painful signals sent by the nerve endings to the brain.
  3. Non-opiate analgesic: These prescription pain medications slow or limit how the painful nerves send signals to the brain.
  4. Deep brain stimulation: In this technique, a surgeon places tiny electrodes directly on the surface of the brain to help attenuate pain with electrical impulses.
  5. Neurostimulation: This technique involves placing an electrical device near the nerves traveling to the amputated extremity. Rather than blocking the nerve signals, it sends a pleasant signal through the nerve. Patients can control the neurostimulation unit via a small wireless remote control.

Don’t hesitate to get help

If you’re dealing with post-amputation sensations, it’s crucial to discuss it with your doctor immediately. Early treatment by an experienced pain management expert can reduce the chances that the problem will develop into something more severe in the future.

Related Articles

A vaccine syringe in front of a passport for international travel.
December 5, 2023
Which Vaccines Are Required To Travel?

Plan early — getting the right vaccines can help you stay healthy on your travels

Person overheated lying on chair on the beach; heart rythym next to him
December 5, 2023
How the Heat Can Affect Your Heart

Sizzling temperatures force your heart to work much harder

nocovaine needle entering mouth with dental mirror
December 4, 2023
How Long Does Novocaine Last?

The numbness and tingling should wear off in about two hours

bearded man sitting crosslegged holding clock in one hand, calendar in other
December 4, 2023
Are Bare Minimum Mondays Good for Your Mental Health?

Rethinking your Mondays might make the ‘Sunday scaries’ a thing of the past

A sad couple standing on each side of a large broken heart
December 4, 2023
Yes, You Can Die From a Broken Heart — But No, It’s Not Likely at All

The emotional toll of loss and other strong emotions can have life-threatening physical effects

Closeup of shingles virus presenting on shoulder of person
December 4, 2023
Is the Shingles Vaccine Worthwhile?

It’s 97% effective in preventing shingles in people between the ages of 50 and 69

Notes taped to window of possible new year's resolutions with hand in foreground holding marker.
December 1, 2023
How To Keep Your New Year’s Resolutions

Pick specific, measurable goals, but also be open to changing them if need be

person holding a thermometer with stress thought bubbles above head
December 1, 2023
Yes, There Is Such a Thing as Stress Sickness

From nausea, weight gain and eczema, stress can affect your immune system in many ways

Trending Topics

group of hands holding different beverages
November 14, 2023
10 Myths About Drinking Alcohol You Should Stop Repeating

Coffee won’t cure a hangover and you definitely shouldn’t mix your cocktail with an energy drink

Person applies moisturizer as part of their skin care routine after a shower.
November 10, 2023
Korean Skin Care Routines: What You Need To Know

Focus on the philosophy — replenishing and respecting your skin — not necessarily the steps

glass of cherry juice with cherries on table
November 8, 2023
Sleepy Girl Mocktail: What’s in It and Does It Really Make You Sleep Better?

This social media sleep hack with tart cherry juice and magnesium could be worth a try

Ad