Phantom pain is pain that occurs in a body part that has been surgically removed or is congenitally absent, usually in the limbs, although it can also occur in other regions of the body after surgical removal or amputation. Phantom pain can be difficult to treat. In some cases, phantom pain improves over time after an amputation surgery. However, in some cases, it can be more persistent. There are different treatment options for phantom pain; sometimes a combination of different therapies is used.
There is no medication that is specifically used to treat phantom limb pain. However, certain medications that are used to treat nerve pain can have a significant positive effect on phantom limb pain in some patients. For example, tricyclic antidepressant medications can be effective in treating phantom pain in some people. Anticonvulsant medications, usually used to treat epileptic seizures, can also work on phantom pain and nerve pain. In some cases, narcotic pain medications may be tried, but these are usually not the first choice to use because they are habit-forming.
There are some non-invasive therapies that can have a positive effect on phantom limb pain. These therapies may be tried along with medication. One thing that may help is electrical stimulation of the nerves in the area of the amputated limb, called transcutaneous electrical nerve stimulation (TENS). This can be done at home with a device that releases a mild current through electrodes placed on the skin. This helps to interfere with the pain signals before they can travel to the brain. Use of a myoelectric prosthetic limb, a prosthetic that is controlled by the patient’s own muscle contractions in the stump of the amputated limb, can actually decrease phantom pain. An exercise involving a mirror box that reflects the image of the remaining limb to make it look like it is still there has also been shown to be helpful in treating phantom limb pain. This treatment can be done as a part of physical therapy or occupational therapy.
If the phantom pain still persists after trying oral medication and non-invasive treatments, other treatments like injections of medications or spinal cord stimulation may help. If no other treatments are effective, surgeries such as deep brain stimulation or further surgical resection of the remaining stump can be helpful in treating phantom pain.