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I was asked by a reader a few months ago to write an article on phantom pain. I was working on a lecture on chemo-electrical stimulation for painful neurological conditions and thought it was a good time to revisit a pain article in The Sentinel.

Phantom pain is an amputation phenomenon where the person still “feels” the lost body part. Most phantom pain occurs in people who have lost arms or legs, but it can be felt with the loss of any body part – remember John Wayne Bobbitt?

You may also experience phantom sensation, which is the feeling of a lost body part that is painless. The chances of having phantom pain is increased if there was pain in the limb prior to the amputation.

It is believed our central nervous system (the brain and spinal cord) is responsible for the phantom pain. One theory is that the brain is trying to reconnect to the lost body part. The brain tries to maintain a sense of order and, in some situations, it will reprogram itself to substitute the missing body part to another portion of the body still present.

Any phantom pain should be evaluated by your doctor. A possible reason for the pain may not be phantom pain but an entrapment or enlargement of the cut nerves at the amputation site. Entrapment of the nerve in scar tissue or pressure against a prosthesis may be the true source of pain.

There are no specialized tests to diagnose phantom pain. It is a clinical diagnosis based upon how you describe your symptoms to your doctor and his physical exam.

Potential treatments are multiple. Over the past several years, the pharmaceutical companies have come out with drugs for “nerve” pain. Other medications have been used “off label” to treat nerve pain. Medical drug classes to treat the pain include narcotics, antidepressants, anticonvulsants, anesthetics and certain hormones. Vitamins, such as Thiamin, B6, B12, alpha lipoic acid, are used homeopathically.

Injections, electrical stimulation therapy, exercises and acupuncture are also used to help the pain. Pretending to exercise the lost body part may also help significantly.

Trying to relieve stress and anxiety in your life will also help. Stress affects so many things. Especially since phantom pain originates in the brain, it is important to keep our brain healthy and relaxed.

More involved treatments, such as brain and peripheral nerve stimulation, may be employed. Surgery is an option in those cases where the pain involves an entrapment of the nerve tissue.

Phantom pain may resolve on its own, but I recommend you or someone you love seek a professional evaluation for treatment options.

Dr. Seth Steber is a member of the medical staff at Carlisle Regional Medical Center. He is accepting new patients and has office locations in Carlisle, Shippensburg and Palmerton. Contact Carlisle Foot & Ankle Specialists at 717-960-8970 to schedule an appointment.

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