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Chapter 25 - Phantom Limb Pain

from Part V - Extremities

Published online by Cambridge University Press:  01 December 2023

Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
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Summary

Phantom limb pain (PLP) is a common source of distress and discomfort post-amputation. Up to 85% of amputees will experience PLP at some point and many cases become chronic pain conditions. While the pain has been well documented for decades, the exact pathophysiology is still unclear, and thus hindering a more accurate means of treatment. Patients with significant pain in the limb pre-amputation, lack of psychological counseling, and more proximal amputations in general seem to be more prone to pain; however, the presentation of PLP varies greatly from case to case. There are many noninvasive therapies, exercises, and medications that are recommended as first-line treatment, but the most effective and best-evidenced treatments involve electrical stimulation of peripheral nerves. Despite this lead on a promising treatment, the quality of evidence supporting or refuting any given modality is overall weak and requires much more homogenous study to truly be analyzed for efficacy.

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Publisher: Cambridge University Press
Print publication year: 2023

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