Many people who have an amputation experience some degree of stump pain or “phantom limb” pain.
Phantom limb sensations are sensations that seem to be coming from the amputated limb. Occasionally, these can be painful (phantom limb pain).
The term “phantom” doesn’t mean the painful symptoms are imaginary. Phantom limb pain is a real phenomenon, which has been confirmed using brain imaging scans to study how nerve signals are transmitted to the brain.
The symptoms of phantom limb pain can range from mild to severe. Some people have described brief “flashes” of mild pain, similar to an electric shock, that last for a few seconds. Others have described constant severe pain.
Stump pain can have many different causes, including rubbing or sores where the stump touches a prosthetic limb, nerve damage during surgery and the development of neuromas.
Treating stump and phantom limb pain
Stump and phantom limb pain will usually improve over time, but treatments are available to help relieve the symptoms.
Medications that may be used to help relieve pain include:
- non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen
- anticonvulsants – such as carbamazepine or gabapentin. This medication can be started prior to your amputation. Please speak to your doctor about this.
- antidepressants – such as amitriptyline or nortriptyline (these medications work directly on the nerves in your leg)
- opioids – such as codeine or morphine
- corticosteroid or local anaesthetic injections
Self-Help Measures And Complementary Therapy
There are several non-invasive techniques that may help relieve pain in some people. They include:
- checking the fit of your prosthesis and making adjustments to make it feel more comfortable
- applying heat or cold to your limb, such as using heat or ice packs, rubs and creams.
- wrapping your limb in a thin blanket and applying a hot water bottle underneath
- massage – to increase circulation and stimulate muscles
- acupuncture – thought to stimulate the nervous system and relieve pain
- transcutaneous electrical nerve stimulation (TENS) – where a small, battery-operated device is used to deliver electrical impulses to the affected area of your body, to block or reduce pain signals
- mental imagery (see below)
Research has shown that people who spend 40 minutes a day imagining using their phantom limb, such as stretching out their “fingers” or bunching up their “toes”, experience a reduction in pain symptoms.
This may be related to the central theory of phantom limb pain (that the brain is looking to receive feedback from the amputated limb), and these mental exercises may provide an effective substitution for this missing feedback.
Another technique, known as mirror visual feedback, involves using a mirror to create a reflection of the other limb. Some people find that exercising and moving their other limb can help relieve the pain from a phantom limb.