Phantom Limb Pain: The Pain that Lingers

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The appendage may be gone, but the pain it once had lives on.

Phantom Limb Pain (PLP) refers to painful and lasting sensations that seem to be radiating from a limb, extremity, or other body part, that is no longer connected to the body. The suffering that PLP causes isn’t uncommon, either: between 60-80% of all amputees experience some kind of phantom sensation in a lost limb.

A mysterious condition that is still being researched

Though the exact cause of PLP is unknown, the pain is thought to be caused by signals traveling from the brain to the spinal cord getting crossed. Nerves that originally sent impulses from the limb to the brain continue to send information, until the brain “rewires” itself and adjusts to the changes in the body.

Identifying the pain and symptoms of PLP

The length of time in which this pain is felt varies from person to person, occasionally lasting only a few minutes, to hours, days, or more. Phantom Limb Pain most often occurs soon after amputation surgery, rather than limb loss due to accidents or sudden injuries. The feeling of the pain can vary from tingling or burning sensations, to itching or pressure.

Pain can arise from once normally routine activities

While the brain is adjusting to the absence of the body part, it finds new nerve pathways to send neural “information”. This can cause PLP to trigger from activities that did not involve the original limb, such as touching another part of the body, going to the bathroom, changes in outside barometric temperature, or fluctuations in blood pressure.

The pain can sometimes be avoided by identifying the activities that trigger it, which may include:

  • Changes in diet
  • Irregularities in the gastrointestinal system
  • Smoking cigarettes, drug use, or alcohol abuse
  • Spikes in blood pressure
  • Sudden rises or drops in barometric pressure (such as storms, or traveling between low and high elevations)

Not necessarily always a pain

The feeling derived from a phantom limb may also be a non-painful”or even pleasurable”sensation, as the brain works to “understand” the newly-modified nervous system. Documented reports have painted the spectrum of sensation from feeling like wearing a piece of jewelry or clothing, to feeling like the limb is attached and still moving as it used to.

Treatment and living with Phantom Pain

Fortunately for most people, Phantom Limb Pain is a fleeting experience, with symptoms that disappear over time. In some cases, however, lingering pain may persist for quite a while. Some studies have reported that medications such as acetaminophen and other NSAIDs can help reduce phantom sensations, and there have been reported successes involving low-frequency stimulation of the brain with electromagnetic therapies.

Other reported ways of easing PLP include:

  • Gently massaging the area that the missing limb was once attached to, or the other existing limb
  • Supplying cushioned support to the afflicted region
  • Changing the surrounding atmosphere to a more relaxing one with music or lighting

Most sufferers are unwilling to report phantom limb pain, believing it’s just in their head.

Phantom pain isn’t just in the mind, it’s the body’s way of adjusting to a new experience. Though patients complaining of it used to be dismissed in years past, PLP is a real, medically-recognized problem, and can be treated with a physician’s help. Phantom Limb Pain should always be reported to a doctor; it may be an indicator that something is happening during the body’s natural healing process. Together with your doctor, your body may be able to say goodbye to the departed limb more quickly and with less discomfort.

Sources:

Limb loss resource center: Amputee Coalition.
Phantom Limb Pain (study): Lone Nikolajsen MD, PhD & Troels Staehelin Jensen MD, PhD.
Phantom Limb Syndrome: NYU Langone Medical Center.
Significant Reduction in Phantom Limb Pain After Low-Frequency Repetitive Transcranial Magnetic Stimulation to the Primary Sensory Cortex (study): AMSUS.

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