Phantom pain overview
Pain felt after limb or body part loss
Phantom pain, sometime referred to as Phantom Limb Pain or simply ‘PLP’ is the pain felt by someone who has had a part of their body removed or amputated and where the pain is coming from, or seems to come from, the amputated body part.
It is most common where for example, a foot or a leg or finger or hand has been amputated, although can also occur for other parts of the body, for example after the removal of a breast (mastectomy) or part of the tongue or even removal of a tooth.
A closely associated but different form of pain is ‘residual limb pain’ sometimes called ‘stump pain’, which again is felt by amputees but the pain is clearly coming from the remaining part of the limb. Residual limb pain and phantom limb pain often happen at the same time. Some people who undergo amputation also report continuing to feel sensation from their removed limb, this is known as ‘phantom limb sensation’.
Phantom pain is most closely associated with limb loss, either via amputation or from injury, however it can also affect people who are born without limbs due to a congenital birth defect, and people who have had some damage to either the spinal cord or a nerve root affecting a specific limb or part of the body.
Causes And Triggers of phantom pain
How phantom pain may develop
For a long time, phantom pain was dismissed as being a psychological issue, but medical science now has a better understanding of why it happens and what causes it.
Possible contributing factors include:
- Regrowth of remaining nerve endings after amputation
- Continued brain activity linked to the amputated limb
- Pain experienced in the limb before amputation
- Residual limb pain after amputation
- Changes in communication between the nerves, spinal cord and brain
Phantom pain episodes may also be triggered by:
- Urinating or defecating
- Smoking
- Sexual activity
- Angina or chest pain
- Shingles (herpes zoster)
- Touching the remaining section of the limb or body part
- Weather conditions, including cold temperatures and changes in barometric pressure
Phantom pain diagnosis
Distinguishing phantom pain from residual limb pain
Phantom limb pain is relatively straightforward to diagnose, however it is important to distinguish it from residual limb pain, where the cause of the pain may be for example, an infection or the presence of a neuroma (which is a tangle of nerve endings that sometimes forms after amputation or loss of a limb).
Recognition that phantom limb pain is caused by a form of dysfunction of the remaining nerves, the spinal cord and/or the brain’s ability to sense pain, means that this type of pain needs to be treated quite differently from other types of pain.
Ready to take the next step?
Comprehensive pain assessments
Individual treatment planning
Medication review and optimisation
