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Phantom pain is an unpleasant post-operative phenomenon that affects some patients after the procedure of amputating a part of their body. People affected feel pain located in the amputated parts of the body. Despite their absence, pain is perceived as real and can have a very disruptive impact on daily functioning. In many cases, phantom pain resolves shortly after the amputation procedure is performed. However, the pain does not always go away on its own, and then there is a need for specialist treatment.
Phantom pain – what is it?
Phantom pain is a fairly common phenomenon that has been known in medicine for a long time. Typically, phantom pain is felt in the place of the removed limb or parts of it – in the arm, leg or fingers. It can also affect other parts of the body, such as the eye, tooth, some internal organs, and the breast. In addition, phantom pain can occur regardless of whether the body part was amputated as a result of a mechanical accident or was damaged as a result of diseases, such as cancer.
Phantom pain attacks
In most cases, phantom pain is not felt all the time, but occurs at regular intervals. Its impact usually increases in the evening and at night and decreases during the day. Apart from the paroxysmal course of phantom pain, permanent phantom pain should also be mentioned. Moreover, attacks or intensification of pain may occur when the area of the amputated limb – the stump – is irritated, as well as under the influence of stress, malaise, depression.
Phantom pain may appear from the first moments after surgery and last for the next few months. The impact of phantom pain decreases over time, leading to its complete disappearance. Patients suffering from this condition describe that the source of phantom pain travels from the illusory limb to the stump over time, with a decrease in pain intensity. Only in a small number of cases (less than 5% of amputated patients) do phantom pain worsen over time. People who suffer from phantom pain most often describe it as being persistent or throbbing, radiating, stabbing, paralyzing, or causing a burning sensation.
The causes of phantom pain
The occurrence of phantom pain is difficult to predict unequivocally. It most often occurs in adult or elderly patients undergoing amputation. Doctors note that people who suffered from regular and severe bouts of pain before surgery, for example due to cancer, are at risk of developing phantom pain. In such situations, the feeling of pain may accompany patients after undergoing amputation surgery for up to several years.
The nervous connections in our body are responsible for the occurrence of the phenomenon of phantom pain. If we experienced intense pain during the long period preceding amputation, it was most likely recorded as a permanent connection in the tissues of our nervous system. After the amputation operation, when it is no longer possible to stimulate the removed limb, our nervous system begins to recreate the missing sensations to which it is used to feeling. Phantom pain is therefore of a neurological nature and is related to pain patterns established in our nervous system.
Other common causes of phantom pain include:
- tissue violation at the site of the amputated limb, as a result of which the structure of the blood supply to the stump changes,
- problems with plastic modeling of the amputation site,
- inflammation, poorly fitting prosthesis, abrasions and other irritation of nerve connections at the site of amputation.
How Can I Deal With Phantom Pain?
Phantom pain tends to disappear on its own over time. Therefore, the most frequently used preventive treatment is to prevent pain or reduce the impact strength. For this purpose, specialized forms of analgesic treatment are used in the period preceding and following the amputation surgery. The medications administered include painkillers and agents that reduce the state of nervous system excitation. Antidepressants are also often given, as malaise can exacerbate the sensations of phantom pain.
Its development is also influenced by the plasticity of the place after the removed limb. Especially the proper modeling of the muscle lobes, careful securing of the nerve connections and systematic control of the blood supply to the stump after the surgery can reduce the level of the perceived pain. Rehabilitation also influences the appearance of phantom pain and its course. Rehabilitation should begin as soon as possible after the amputation operation. The performed exercises should lead to the reconstruction of the nerve connections running through the reconstructed tissues. Precise and gentle sensory stimulation of the amputee site is also important, as it will allow the generation of new sensory patterns to replace the old ones.