Phantom limb pain (PLP) refers to ongoing painful sensations that seem to be coming from a limb that’s no longer there. Doctors once believed this post-amputation phenomenon was a psychological problem, but experts now recognize that these real sensations originate in the spinal cord and brain.
The onset of this pain most often occurs soon after surgery. It can be mild to extremely painful. It is estimated that nearly 80 percent of the amputee population worldwide has experienced this kind of pain. Most people experience a significant decrease in pain within two years of their amputation surgery.
For most patients, phantom limb sensations will disappear or decrease over time without treatment. However, when it continues for more than 6 months, it generally requires a doctor’s assistance for improvement.
The exact cause of phantom pain is unclear, but it appears to come from mixed signals from the spinal cord and brain. The nerve endings at the amputation site continue to send pain signals to the brain that make the brain think the limb is still there. Sometimes, the brain memory of pain is retained and is interpreted as pain regardless of signals from injured nerves.
Treatment is usually based on the amount of pain the patient is feeling, and multiple treatments may be combined. Medications are generally the first step in treating the nerve pain. There are a variety of other noninvasive therapies that have worked for some patients with this condition. Spinal cord stimulation and other neurostimulation technologies can also be effective in relieving pain for patients.