What Causes Phantom Pain, and How Is it Treated?

The sensation of phantom pain can vary widely. Depending on the person, it might involve:

• throbbing
• tingling or pins and needles
• burning
• sharp pain, like shooting or stabbing
• cramping
• sensations that feel like electric shocks

The exact cause of phantom pain is unclear, but it’s thought to be related to:

Nerve damage

The removal of a body part causes damage to peripheral nerves. This can irritate and overexcite the nerve endings, causing spontaneous sensations.

Central sensitization

Your peripheral nerves lead to your spinal nerves, which are connected to your spinal cord.

When a peripheral nerve is damaged during amputation or injury, central sensitization may occur. This involves increased neural activity and sensitivity in the spinal cord, resulting in phantom pain.

Brain remapping

After a body part is removed, the brain redirects sensations from that part to another area of the body. This is called remapping or reorganization.

As a result, you may feel pain in the missing body part when the nerves are stimulated in the surrounding area.

Psychological factors

In some cases, certain psychological conditions can trigger or contribute to phantom pain. These factors include:

• depression
• anxiety
• increased stress

Phantom pain may go away on its own after several months. But if the pain persists, there are several treatment options:

Medications

The following medications are used to manage phantom pain:

• tricyclic antidepressants (most common)
• opioids
• nonsteroidal anti-inflammatory drugs
• anticonvulsants
• NMDA receptor antagonists

Medical treatment

Some medical therapies might also manage phantom pain:

• Transcutaneous nerve stimulation. This treatment, known as TENS, stimulates nerves using electrical currents.
• Central nervous system stimulation. In this treatment, electrical signals stimulate the brain or spinal cord via implanted electrodes.
• Biofeedback. In biofeedback, electrodes are placed near the affected area. A specialist will teach you how to control certain functions in the area.

In addition to medication and medical treatments, the following therapies may be used:

• Acupuncture. Acupuncture uses thin needles to stimulate certain areas of the body. Research on its benefits for phantom pain is still ongoing.
• Massage. Massaging the affected area may help relieve muscle tension. It’s also useful for managing stress and anxiety.
• Mirror therapy. This therapy may be helpful for certain types of phantom pain, including phantom limb pain. It uses a mirror box to reflect the healthy limb onto the amputated side, which tricks the brain.

You can also try these home remedies to manage phantom pain:

• Reposition your body. If you’ve lost a limb, propping the area on a pillow or cushion may help reduce phantom pain.
• Practice relaxation techniques. Since stress and anxiety can contribute to phantom pain, practicing relaxation techniques may help. This includes strategies like meditation, guided imagery, and breathing exercises.
• Enjoy your favorite hobbies. Activities like reading or playing music can help distract you from the pain. They can also help relieve stress and anxiety.
• Join support groups. Meeting individuals who have similar amputations or injuries in support groups can help you cope with your symptoms.
• Follow your treatment plan. It might take time to find a treatment plan that works for you. For best results, follow your doctor’s suggestions and be open about your concerns.

Phantom pain can develop immediately after a body part is removed. But sometimes, it can take months or years to develop.

Visit a doctor as soon as you notice phantom pain or similar sensations. You should also seek medical help if you have phantom pain that:

• fails to get better with treatment or remedies
• gets worse
• is severe or debilitating

Research on phantom pain prevention is still ongoing. However, there are some strategies that may help minimize the symptoms:

• Pre-amputation pain reduction. High pain levels before an amputation are associated with phantom pain. Focusing on pain management before the amputation may help reduce the risk.
• Pre-amputation counseling. For planned amputations, receiving counseling before the procedure is associated with lower levels of phantom pain.
• Different types of anesthesia. Phantom pain after an amputation is linked to general anesthesia. However, the risk is lower with different types of anesthesia, like neuraxial anesthesia and peripheral nerve block.
• Depression management. Depression after an amputation or removal of a body part is a major contributor to phantom pain. Managing depression through medication and therapy may help.

Speak with your doctor about coping with depression or possible methods for reducing your risk of phantom pain.

Phantom pain is different from referred pain. While phantom pain involves a missing body part, referred pain involves two body parts that you have.

In referred pain, pain in one part of your body causes pain in another part. For example, if you have a back injury, you might feel the pain in your thigh or groin.

If you experience pain in a body part you no longer have, it’s called phantom pain. It often involves amputated limbs, but it can also affect other areas, like the eyes, nose, or breasts.

Phantom pain can happen after a body part has been removed due to amputation or injury. The exact cause is unclear, but it might be related to nerve damage, central sensitization, or brain remapping. Psychological conditions like depression and stress can also play a role.

Depending on your symptoms, phantom pain is treated with medication and medical treatment. Remedies like massage, relaxation, and hobbies may also help.