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Abstract
Phantom limb pain is pain that is perceived in a part of the body which is no longer present. It is estimated that 80 percent of amputees experience phantom limb pain. Although the term is "phantom limb pain" the feeling is often more of a burning, twisting, itching, or pressure sensation than pain. The exact mechanism of phantom limb pain is unknown although proposed mechanisms include pain origination from either the central nervous system or the peripheral nervous system. Since the exact mechanism of phantom limb pain is unknown, treating this pain may be difficult. Treatments include pharmacological and non-pharmacological. Pharmacological treatments include NSAIDs, opioids, anti-convulsants, beta-blockers, and calcium channel blockers. Non-pharmacological treatments include mirror therapy, cognitive behavioral therapy, acupuncture, guided imagery, massage, and biofeedback. Amputees experiencing phantom limb pain typically have the best outcome with a multi-disciplinary approach that includes both pharmacological and non-pharmacological management.
Keywords: Pain, limb pain, phantom pain
Introduction
Phantom limb pain is perceived pain in a part of the body that is no longer present. Phantom limb pain is differentiated from stump pain in that stump pain is pain in the region of the body which is still present (1). Phantom limb pain may feel like a burning, twisting, itching or pressure (2). Phantom limb pain is believed to occur in nearly 80 percent of the amputee population worldwide (2). One study estimated that in the United States in 2005 there were about 1.6 million people with limb loss and the number is projected to increase to 3.6 million by the year 2050 (3). Trauma, vascular problems, cancer, and congenital limb deficiency are some of the common causes of limb loss (1). The conflict in Iraq and Afghanistan has contributed to a recent increase in the number of traumatic amputations (4). People that experience phantom limb pain may be reluctant to communicate their pain to others due to fear of being considered "crazy" (2). However, the earlier the pains are reported; the sooner treatment can be started (2).
There have been several factors that have been found, among those with absence of a limb, to be associated with increased risk for phantom limb pain. These factors include female sex, upper extremity amputation, presence of pre-amputation pain, residual...