Treating Phantom Pain After Amputations - Help for Phantom Pain Through Mirror Therapy and Support at the Clinic

People with phantom pain experience pain in limbs that are no longer present following an amputation. Nevertheless, patients can describe very precisely where it hurts and how severe the pain is. 

Phantom pain is not imaginary. Some people may experience such severe pain that they even attempt suicide. This highlights how important it is for you to consult a doctor if you suffer from phantom pain.

Phantom pain can be attributed to changes in the brain @ kanpisut /AdobeStock

The exact cause of phantom pain is currently unknown. However, both psychological and physical processes are involved. 

Currently, there are three main scientific models explaining how phantom pain arises:

• Peripheral causes: Pain resulting from nerve regeneration, neuromas, and irritation of blind-ending nerves in the amputation stump
• Spinal causes: May originate directly in the spinal cord
• Central nervous system causes: May result from a reorganization of the pain-perceiving structures in the brain, e.g., in the thalamus and cortex

From a psychological perspective, the body appears to continue to exist as a whole in the brain, even after the amputation of body parts. As a result, certain patterns of stimulation persist, which contribute to phantom pain.

Phantom pain is a common phenomenon among patients following amputation. An estimated 50 to 60 percent of patients experience pain in the amputated limb after surgery. In 85 to 97 percent of those who undergo surgery, phantom pain occurs within the first month after the procedure.

Phantom pain is often described as pain attacks rather than as a constant ache. 

The nature of the pain is usually:

• stabbing
• cutting
• burning, or
• cramping

As mentioned earlier, in some cases the pain can be so severe that those affected attempt suicide.

The diagnosis of phantom pain is usually based on the patient’s descriptions. However, doctors must rule out pathological changes. For this reason, they typically conduct further examinations. 

Above all, it is important to rule out inflammation, circulatory disorders, and hardening in the area of the amputation stump as causes of pain. 

To do this, doctors use imaging techniques such as:

• X-rays
• Angiography, or 
• Magnetic resonance imaging (MRI)

Treatment for phantom pain depends primarily on the duration and intensity of the pain. The therapeutic methods used are no different from those used in general pain management for acute or chronic pain.

The following treatment methods are used for phantom pain:

• Medication for pain management (e.g., ibuprofen, NSAIDs, opioids)
• Physical/manual therapy
• Psychosomatic treatment approaches
• Thalamic stimulation
• Mirror therapy
• Neural therapy, as well as
• Other alternative therapies

In recent years, another promising therapeutic approach has emerged: the myoelectric prosthesis. 

This involves stimulating the nerve endings in the stump area, thereby restoring the function of the lost body part to the brain.

Mirror therapy tricks the brain by positioning the healthy body part in front of a mirror as if it were the missing one @ Köpenicker /AdobeStock

As with other pain conditions, the treatment of phantom pain can be very lengthy. Even after successful therapy and relief from pain, phantom pain can recur.

Nevertheless, the prognosis for phantom pain is generally good. Between 30 and 90 percent of those affected may experience relief or even complete freedom from pain.

Patients with phantom pain are best cared for at a pain clinic or by a specialist in pain medicine. Neurologists and non-physician healthcare providers, such as physical therapists, are also potential points of contact.