Phantom limb pain (PLP) is a painful sensation perceived in a limb that has been amputated. Unlike residual limb pain (pain at the surgical site), phantom limb pain is felt as if it's coming from the missing part of the body—such as the fingers, toes, foot, leg, hand, or arm.
Phantom limb pain can begin days or weeks after amputation and may persist for months or even years. It can significantly affect quality of life, mobility, sleep, and emotional well-being.
What Causes Phantom Limb Pain?
The exact cause of PLP is not fully understood, but it is believed to result from a combination of:
Peripheral nerve injury at the amputation site
Neuroma formation (painful nerve endings)
Abnormal signaling in the spinal cord
Rewiring of the brain’s sensory map (central sensitization)
Emotional and psychological factors (e.g., stress, anxiety, PTSD)
Risk factors for phantom limb pain include:
Traumatic amputation
Poorly controlled pre-amputation pain
Infection or complications at the surgical site
Common Symptoms
Burning, stabbing, shooting, or cramping pain
Sensation of tingling, itching, or pressure in the missing limb
Pain that comes and goes or is constant
Cold or electric shock-like sensations
Triggered by stress, weather changes, or prosthetic use
Conservative Treatment Options
Medications
Neuropathic pain medications (e.g., gabapentin, pregabalin, amitriptyline)
NMDA receptor antagonists (e.g., ketamine)
Topical agents (e.g., lidocaine, capsaicin)
Opioids (reserved for severe cases under specialist care)
Non-Pharmacologic Therapies
Mirror therapy – uses visual feedback to "trick" the brain into seeing the missing limb
Graded motor imagery – retrains brain perception using movement visualization
TENS therapy (transcutaneous electrical nerve stimulation)
Biofeedback and cognitive behavioral therapy (CBT)
Prosthetic training – advanced prosthetics with sensory feedback may reduce pain
Interventional Pain Management Options
For patients with persistent or severe phantom limb pain, advanced interventional techniques may offer meaningful relief:
Peripheral Nerve Blocks
Local anesthetic injections at the amputation site to reduce pain signaling from the nerves
Epidural or Spinal Nerve Root Blocks
Reduces pain from spinal nerve levels corresponding to the amputated limb
Sympathetic Nerve Blocks
Used especially for cold, burning, or vasomotor pain symptoms
Stellate Ganglion Block (upper limb) / Lumbar Sympathetic Block (lower limb)
Can help reset overactive pain signaling in the nervous system
Spinal Cord Stimulation (SCS)
An implantable device that modulates pain signals at the spinal cord level
Proven to be effective for phantom limb pain and complex regional pain syndrome (CRPS)
Peripheral Nerve Stimulation (PNS)
A minimally invasive option that directly stimulates the affected nerve to override pain
Especially useful for focal neuroma-related phantom pain
IV Ketamine Infusions
Helps reduce central sensitization and NMDA receptor overactivity in treatment-resistant cases
When to Seek Help
You should consult a pain specialist if:
You experience persistent or severe pain after limb amputation
Pain interferes with prosthetic use, sleep, or mobility
Conservative treatments haven’t provided relief
Find Relief from Phantom Limb Pain
At Parkview Spine & Pain, we offer a comprehensive, multidisciplinary approach to phantom limb pain. Our team specializes in nerve-focused interventional procedures, neuromodulation, and rehabilitative therapies designed to restore function and improve quality of life.
👉 Schedule your consultation today to explore personalized treatment options for phantom limb pain.