Chapter 108 - Phantom Limb Pain

Abstract

Phantom limb pain, which refers to a painful sensation perceived in a body part that is no longer present subsequent to surgical or traumatic removal, is one of common complications after an amputation. Peripheral, spinal segmental, central, and psychological mechanisms are considered factors in the development of phantom limb pain. Phantom limb pain often leads to permanent disability and impairs quality of life, and pain persisting for more than 6 months is difficult to treat. Medications including tricyclic antidepressants, anticonvulsants, opioids, and N-Methyl-d-aspartate receptor antagonists have been generally accepted as effective. Positive results have been reported in rehabilitation therapy including biofeedback, mirror therapy, motor imagery, phantom motor execution, and noninvasive brain stimulation. As an increasing number of studies have suggested a central mechanism for phantom limb pain, new therapeutic interventions based on the central reorganization or plasticity have been suggested.