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Treatment Strategies and Effective Management of Phantom Limb–Associated Pain

  • Hot Topics in Pain and Headache (N Rosen, Section Editor)
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Abstract

Purpose of Review

Phantom sensations are incompletely understood phenomena which take place following an amputation or deafferentation of a limb. They can present as kinetic, kinesthetic, or exteroceptive perceptions. It is estimated that phantom limb pain (PLP) affects anywhere from 40 to 80% of amputees.

Recent Findings

Psychiatric illnesses such as depression, anxiety, and mood disorders have higher prevalence in amputees than in the general population. Pharmacologic treatment has been used as first-line therapy for amputees suffering from PLP with agents including gabapentinoids, amitriptyline, and other tricyclic anti-depressants, opioids, and local anesthetics. Non-invasive treatment modalities exist for PLP including sensory motor training, mirror visual therapy, and non-invasive neuromodulation. Non-invasive neuromodulation includes interventions like transcutaneous electrical nerve stimulation (TENS) and transcranial magnetic stimulation.

Summary

While many promising therapies for PLP exist, more clinical trials are required to determine the efficacy and protocols needed for maximum benefit in patients suffering from PLP.

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Authors and Affiliations

  1. Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA

    Ivan Urits & Vwaire Orhurhu

  2. Creighton University School of Medicine, Phoenix, AZ, USA

    Danica Seifert, Allison Seats & Stephen Giacomazzi

  3. Valley Anesthesiology and Pain Consultants, Phoenix, AZ, USA

    Michael Kipp & Omar Viswanath

  4. Midwestern University, Glendale, AZ, USA

    Michael Kipp

  5. Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA

    Alan D. Kaye

  6. Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA

    Omar Viswanath

  7. Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA

    Omar Viswanath

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  1. Ivan Urits
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Correspondence to Ivan Urits.

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Conflict of Interest

Ivan Urits, Danica Seifert, Allison Seats, Stephen Giacomazzi, Michael Kipp, Vwaire Orhurhu, and Omar Viswanath declare no conflict of interest. Alan D. Kaye discloses that he is on the Speakers Bureau for Depomed, Inc. and Merck.

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Urits, I., Seifert, D., Seats, A. et al. Treatment Strategies and Effective Management of Phantom Limb–Associated Pain. Curr Pain Headache Rep 23, 64 (2019). https://doi.org/10.1007/s11916-019-0802-0

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  • DOI: https://doi.org/10.1007/s11916-019-0802-0

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