Causative and risk factors
Earlier phantom pain was believed to be a psychological disorder. However in recent times, it has been understood that this phenomena actually occurs due to remapping of the body’s sensory circuits after a body part is lost.
Loss of an arm or leg is more prone to develop phantom pain. However removal of other body parts can also lead to this phenomenon.
You are at a higher risk of developing phantom pain if you suffer from pain in the amputated stump or pain in the affected part before amputation is performed.
Clinical presentation
The person may feel no pain but only the presence of a part that is no longer there.
Various sensations may be felt in the absent part such as numbness, tingling, shooting, throbbing, burning etc. The pain tends to begin within the first few days after an amputation. Certain factors which can trigger phantom pain are stress, extreme changes in weather or pressure on the adjoining body part.
Phantom pain can lead to immense psychological stress or distress to the patient.
Diagnosis & Investigations
Phantom pain is diagnosed solely on the basis of the symptoms narrated by the patient, where there is a recent history of traumatic or surgical amputation. There is no specific diagnostic test.
Treatment
The patient is advised to exercise regularly, reduce his stress levels and focus on other activities.
Pain relieving medications are prescribed. Sometimes, injectable painkillers are given. If simple pain relievers do not work, higher drug classes are prescribed such as narcotics, anti-depressants or anti-convulsive drugs.
Acupuncture therapy can bring relief to the patient.
Transcutaneous electrical nerve stimulation – In this therapy, a device is used to send minor electrical currents to the affected body part.
Stimulation of the spinal cord by means of applying minor electric currents to it via electrodes can relieve the pain. Use of an electric prosthesis can help reduce phantom pain.
The outlook is extremely variable. Some patients get well on their own without any medication whilst some may struggle with phantom pain for years.
