Reno Pain

Phanton Limb Pain

Best Phanton Limb Pain Doctors in Reno, Sparks and Carson City, Nevada.

Phanton Limb Pain

Having a limb removed is a huge adjustment for a person. But when coupled with feelings of phantom limb pain, it becomes drastically more difficult. Both difficult to comprehend and difficult to live with, phantom limb pain is a very real condition that occurs as the body adjusts to the limb being gone. It is a complex pain condition, but one that has promising treatment options that can help to alleviate pain. The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas are experts in helping amputee patients finally find the relief they need to help cope with their missing limb. 

What is Phantom Limb Pain?

Phantom limb pain is pain that is felt in the part of the limb that was amputated or removed. So if a person’s leg was amputated from the leg down, they might feel pain in their foot, even though the foot is no longer part of their body. Phantom limb pain is very common and affects more than half of all people who have had an amputation. 

While pain sensations can vary, most people report experiencing:

  • Tingling
  • Itching
  • Burning
  • Stabbing
  • Throbbing
  • Cramping
  • Hot or cold
  • Twisting
  • Numbness
  • Feelings that the limb is still attached and is moving or shrinking

The most common symptom is pain, which can range from mild to severe and can last anywhere from seconds to days or weeks. 

While anyone who had a limb removed can experience phantom limb pain, it is most common in lower limb amputation versus an upper limb. Pain could also mimic the pain sensations felt in the limb prior to the amputation. Many of the sensations can lessen over time, while some people suffer from chronic pain conditions that can become difficult to treat. This often leads to not only a diminished quality of life, but also leads to additional physical and emotional factors. Partnering with a trained pain management specialist is the best way to treat your phantom limb pain symptoms.  

Who is at Risk for Developing Phantom Limb Pain?

There are many different types of sensations that a patient could experience after an amputation. While pain is the common common sensation, not all involve pain. Those at risk for developing phantom limb pain are those who had an amputation. These patients can suffer from: 

  • Phantom pain: pain in the limb after amputation
  • Phantom sensations: the missing limb still feels like it’s part of the body
  • Phantom pain syndrome: pain and other sensations are felt in the area of the body where the limb was removed
  • Residual limb pain: pain the affects the remaining part of the limb, usually due to tissue or nerve damage

Patients who had pain in the limb prior to amputation are also at risk for experiencing phantom limb pain, as well as those who use a prosthetic limb. A person who had a hand or foot amputated has a greater risk for experiencing phantom sensations because the fingers and toes are associated with the cortex of the brain.

The number of years since the original amputation surgery also plays a role in phantom limb pain. Many people report feelings of pain during the first six months after surgery, with the pain generally lessening. Additional research shows that most people continue to have some form of phantom limb pain two years post surgery. 

What Causes Phantom Limb Pain?

There is no clear reason why phantom limb pain occurs, but most healthcare providers believe it’s caused by a miscommunication in the nervous system. The peripheral nerves send signals to the spinal cord and brain, which tell the body to move. After an amputation, the nerve connection still exists, even through the nerves in the hand, for example, aren’t there anymore. After all, an amputation is a traumatic event. While a person is physically adjusting to life without an arm, the brain is also adjusting to its normal nerve connections being altered. The nerves may send more signals or incorrect signals to the brain, which increases sensitivity and could lead to pain. 

How is Phantom Limb Pain Treated?

Treatment for phantom limb pain focuses on the neurological aspect of the condition. The most common treatment methods include: 

  • Medications: studies have shown that tricyclic antidepressants, sodium channel blockers, and anticonvulsant medications are all helpful in treating pain sensations related to phantom limb pain. While opioids are recommended for other painful neurological conditions, they are not effective for phantom limb pain. 
  • Physical therapy: ensuring that prosthetics properly fit and the patient is using the prosthetic properly can resolve a lot of pain sensations. Also, desensitization therapies such as gently touching and massaging the residual limb to create similar sensations to those felt in the amputated limb have proven helpful. 
  • Complementary therapies: massage, acupuncture, biofeedback and meditation have all proven helpful for providing pain relief
  • Mirror therapy: a simple and non-invasive way to treat phantom limb pain, mirror therapy involves a mirrored box with two openings, one for the amputated limb and one for the other limb. The patient performs exercises with the limb so that it appears that the missing limb is moving as well, which has proven effective in lessening pain. Virtual reality is a newer option that can also achieve this same result. However, mirror therapy is not effective for patients who have had both arms or both legs removed, as there is nothing to mirror. 
  • Phantom motor execution (PME): this therapy involves placing electrodes to a patient’s stump, and asking the patient to perform a series of eight different movements. These attempted movements “trained” a computer program which showed a superimposed limb on the screen. This allows the brain to believe that it is moving the limb in real time. This helps that patient to visualize the missing limb as well as engage the part of the brain that controls that limb’s movements. PME is an effective treatment for double amputee patients. 
  • Interventional injections: injection therapy has proven helpful for dealing with both upper extremity limb pain (interscalene blocks or stellate ganglion blocks) and lower extremity limb pain (lumbar sympathetic blocks). These injections help patients to more comfortably enjoy other treatment options, such as physical therapy. 
  • Neuromodulation: this treatment option blocks nerve signals to the brain, even those that seem to be coming from a missing limb. Transcutaneous electrical nerve stimulation (TENS) or spinal cord stimulation have proven effective treatment options when other conservative methods have failed to provide relief. 

The best way to determine which treatment option is best for you and your specific feelings of phantom limb pain is to partner with a trained management specialist. Most often, a comprehensive approach is helpful in treating the many symptoms of phantom limb pain. The 

Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas can help patients who are suffering from phantom limb pain finally find relief. 

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