Park Avenue Medicine & Surgery

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What is Phantom Limb Pain?

Undergoing surgery is no easy matter, especially if you are undergoing one to remove certain limbs. Even after the surgery has been completed, there can still be a difficult road ahead. One potential condition a patient that has completed surgery may encounter is known as phantom limb pain (PLP). PLP occurs when someone experiences pain in an area of the body that has been removed. It is a common phenomenon, with about seventy to eighty percent of amputees encountering it. It is mostly those who have removed their legs, arms, fingers, or toes that experience the issue. The pain does not have to be intense. It can range from a burning sensation to a more severe pain. The time span a patient can encounter PLP also differs, ranging from a few seconds to even hours. The intensity and occurrence of it usually decreases within the first few months, but it may still persist in some variation years after.

Someone who is experiencing PLP may shrug it off or may be too afraid to tell others. However, it is important to tell your physician if you are experiencing such feelings, in case treatment may be necessary. Because it is thought that the painful sensations originate from the brain and spinal cord, there are a wide range of therapies and medications available to help those dealing with PLP of various pain levels. One website, called www.amputee-coalition.org, states that, “Treating PLP effectively takes a multipronged approach. Medications of several different categories in combination with non-medication treatments seem to be most effective.” However, it is always best to consult your physician to know which treatment is the best for your case. Some examples of medications, taken from www.amputee-coalition.org, include anticonvulsants, beta-blockers, and muscle relaxants and examples of non-medication treatments include biofeedback, acupuncture, and use of a shrinker.

In addition, there are certain other conditions that may activate or actually increase the intensity of PLP. This includes, but is not limited to, using the restroom, smoking, or being exposed to lower temperatures. Being able to identify certain triggers can actually help someone reduce their PLP. For example, someone who has noticed smoking sets off their PLP can work toward quitting. However, while other activities or conditions cannot be avoided, the patient can at least be prepared for days where their PLP will be more intense. 

It is important to not confuse phantom limb pain with phantom limb sensation. As the name implies, phantom limb pain is an actual pain that the patient may endure while phantom limb sensation more closely refers to when the patient feels like a part of their body that has been removed is still there. People that have phantom limb sensations can feel itchy, tingly, or cold from where the limb was removed. Although PLP is not fully understood, there are experts who believe that it is at least partially caused by mixed signals from the brain.

PLP is a common occurrence and the pain that stems from it can be treated so that a person’s quality of life does not decrease. Although it is mentioned that this commonly takes place after surgery, there are some people who were born without certain limbs who also experience PLP. Therefore, someone does not necessarily have to have had surgery to encounter the symptoms. Whatever the case, if you believe you may be experiencing PLP, contacting your physician may be the best plan of action.

References:

  1. https://health.clevelandclinic.org/5-ways-to-deal-with-phantom-limb-pain-after-amputation/ 

  2. https://www.amputee-coalition.org/limb-loss-resource-center/resources-for-pain-management/managing-phantom-pain/

  3. https://www.mayoclinic.org/diseases-conditions/phantom-pain/symptoms-causes/syc-20376272 

  4. http://www.upmc.com/patients-visitors/education/pain-control/pages/phantom-pain-and-phantom-sensation.aspx 

  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198614/