Phantom Pain and Residual Limb Pain After Amputation Questions Answered

Male amputation patient who found relief for phantom and residual limb pain.

In this post, IHTSC nerve pain specialists answer frequently asked questions about phantom pain and residual limb pain after amputation. They cover common causes and treatments, as well as explain the benefits of the Nerve Injury & Limb Pain Program’s team-based approach to care.

How Can You Make Phantom Pain Go Away?

Surgeon Kathryn Peck, MD talks about phantom limb pain and treatment options available to help make the pain go away.

What Is Phantom Pain?

Phantom pain is something that 80 percent of people who have experienced an amputation feel after the amputation. It can range from anything from pain like a burning sensation to the feeling of either your fingers or toes that are no longer there, but you feel that presence.

What Types of Treatments Are Available?

Things that we do to help treat this include conservative nonsurgical measures and operative measures. 

Non-operative treatments include using multimodal medications such as:

  • Beta-blockers
  • Pain medication
  • Anti-inflammatories
  • Anticonvulsant therapies

All of these are used in conjunction with each other to help target different pain pathways. Some other measures that are not medication related but are not operative include:

  • Tens units
  • Acupuncture
  • Mirror therapy

And other modalities help trick the brain into thinking that the limb is there, so it helps lessen that pain.

Operative measures include something called targeted muscle reinnervation, which is a surgical technique where we take one of the major nerves, such as the median nerve, and take a small regional sacrificable nerve branch that goes into a muscle and then bring those two nerve endings together, so that big nerve has an avenue through which to regenerate in hopes of avoiding a painful nerve ending or neuroma, as well as providing the brain with more normal signaling pathways. 

It substantially cuts down on the phantom pain, and we can also put a muscular cuff around that nerve coaptation as well. That really does help with the phantom pain as a complement to using these other modalities.

Find Relief for Phantom Limb Pain

Our nerve pain experts would be happy to help you with your phantom pain if you would like to come and see us. We can further evaluate your condition to see if you’d be a candidate for any of these effective techniques and treatments.

What Is Residual Limb Pain?

Surgeon Jeffrey Greenberg MD, MS explains what is residual limb pain and how it can be treated.

Residual Limb Pain

Residual limb pain in amputees is common and affects a large percentage of patients following both upper and lower limb amputations.

How is Residual Limb Pain Different from Phantom Pain?

Not every cause of residual limb pain is treatable, and the causes can come from multiple reasons. For example, phantom limb pain can occur after amputation and frequently is very difficult to eliminate.

However, there are sources of residual limb pain that are inappropriately attributed to untreatable phantom limb pain that are treatable by experienced nerve surgeons.

What is Neuroma?

A prime example of this is residual limb pain caused by peripheral nerve neuroma. A neuroma is a mass of disorganized nerve fibers and scars that can cause pain shock-like sensations.

Decreased use of the injured extremity and difficulty with prosthetics are where neuromas can develop at the end of nerves that are cut when an amputation occurs.

How are Neuromas Treated?

Many symptomatic neuromas can be successfully treated using contemporary nerve reconstruction techniques.

How can a Specialist Help with Post-Amputation Residual Limb Pain?

The surgeons at the Indiana Hand to Shoulder Center that participate in the Nerve Injury And Limb Pain Program are experts in evaluating, diagnosing, and treating residual limb pain problems.

A consultation with our group is recommended if you are suffering from residual limb pain. The consultation will include a detailed evaluation by our group of experts to determine the cause of your problem.

Following your evaluation the group will formulate and review individualized treatment recommendations based on your specific situation and problem.

What Are the Benefits of Team-Based Care?

Surgeon Sameer Puri MD, talks about IHTSC's Nerve Clinic and the benefits of having team-based care for patients with complex nerve injuries and nerve pain.

A Team-Based Approach to Nerve Pain

Many complex nerve injuries or nerve pain problems don't have clear straightforward solutions. Oftentimes, patients have seen multiple doctors in multiple different locations before coming to see us.

We felt strongly that a team-based approach is the best way to manage patients with these sorts of problems because it helps us to make sure that we can think about all the options or pathways that are available and to help come up with the best approach to solving these problems for people that don't often have a lot of hope.

A lot of times, there are things that we can do to help.  By getting our heads together in a room and thinking about the different ways that we can help fix these problems, we’re oftentimes able to come up with solutions that wouldn't always be available at first glance.

What Causes Nerve Pain After Amputation?

When a nerve is cut, it can continue to send signals to the brain even if it no longer has a target. It's almost like a live wire at the end of a residual limb. Sometimes that can lead to very painful sensations both from direct palpation or touching on the cut nerve.

With residual limb sensations or phantom limb pain, there are some options we have that we can sometimes try to help alleviate some of those symptoms. Sometimes we can plan for surgeries at the time of amputation to help decrease the risk of pain that has developed after an amputation.

How We Help Patients

There are some options that the surgeons who are part of the Nerve Clinic have specialized expertise, experience, and interest in helping to take care of patients with complex nerve injuries and nerve pain.

We take care of patients with very complex nerve injuries, whether they’re due to trauma or after amputation or residual nerve pain that can develop after injuries or previous surgeries.

Schedule an Appointment With an IHTSC Nerve Specialist

Learn More About IHTSC Nerve Injury & Limb Pain Program

Get Relief for Pain After Amputation

If you are suffering from nerve pain or injuries after amputation, we invite you to come to our clinic to see a nerve specialist. The surgeons at IHTSC’s Nerve Clinic will evaluate and determine if you are a candidate for any of their nerve pain techniques.

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Disclaimer: The materials on this website have been prepared for informational purposes only and do not constitute advice. You should not act or rely upon any medical information on this website without a physician’s advice. The information contained within this website is not intended to serve as a substitution for a thorough examination from a qualified healthcare provider. The display of this information is not intended to create a health care provider-patient relationship between the Indiana Hand to Shoulder Center and you.