What Actually Causes Phantom Limb Pain?

If you have painful sensations in a part of your body that was amputated, you’re not alone. Estimates show anywhere between 60-85% of people who undergo limb amputation experience phantom limb pain, or PLP. 

So how can you have such intense, real sensations when a limb is no longer there? Our team at Metro Pain Centers shared these insights into PLP and what treatment can offer relief from your symptoms.

Recognizing phantom limb pain

First, we should note that not all phantom sensations cause pain. Some people have other sensations, like feeling as though the limb is still there. These types of sensations aren’t PLP. 

PLP symptoms include:

• Burning or stinging
• Cramping or twisting
• Crushing, throbbing, aching, or sharp pain
• Tingling or a “pins and needles” sensation

PLP symptoms often start within a week following an amputation, but they can also set in months afterward. They often occur in the portion of your limb that’s farthest away from your body, like the hand in an amputated arm.

Once PLP begins, it can come and go or remain constant. 

How your body feels sensations

To better understand the source of phantom limb pain, it’s helpful to look at how your body feels things in general.

Each part of your body is connected to specific areas of your brain through your nervous system. Your central nervous system includes your spinal cord and brain. Your peripheral nervous system contains the rest of the nerves in your body, including those in your limbs. 

When you touch something, your peripheral nerves send messages to your brain by way of your spinal nerves, which are part of your spinal cord. Your brain then interprets these messages and sends a signal back so your body knows how to respond. 

So, for example, if you pick up a cup of coffee, your hand itself doesn’t know it’s hot. Instead, your peripheral nerves fire off sensory information to your brain. In response, your brain tells your hand to put the cup down to avoid getting burned.

The source of PLP

It’s believed that several factors could come into play with the unique pain sensations of phantom limb pain.

Remapping

If you lose a limb, it stops sending sensory information to your brain, which causes neurons in a specific area to become inactive. But, it doesn’t stay that way. Instead, nearby neurons start to expand into the region and take over the void. This leads to remapping or reorganizing the neural connections in your brain — a process known as neural plasticity.

As your body’s sensory circuitry rewires in your brain, it can lead to changes in how you feel. For example, you could experience phantom sensations in your amputated arm or hand if someone touches your face.

Nerve damage and sensitization

Amputation can cause unpredictable changes to nerves in both your peripheral and central nervous system. And, when a peripheral nerve gets severed, the neurons in your central nervous system can become more active and sensitive to their signaling.

As a result, your brain can start receiving frequent and mixed signals, causing it to adjust incorrectly. Unfortunately, this process can cause your body to default to the most basic message that something’s wrong — pain. 

Treating phantom limb pain

This deeper understanding of PLP has provided more effective methods of treatment. And, with the help of image scanning tools like MRIs and positron emission tomography (PET) scans, we can identify activity within the brain causing the neurological response.

To treat PLP, we could recommend a variety of therapies, such as:

• Medications
• Steroid injections
• Nerve blocks
• Transcutaneous electrical nerve stimulation (TENS)
• Spinal cord stimulation

You can also take steps at home to help with PLP symptoms, ranging from relaxation techniques to wearing your prosthesis, which could help trick your brain into thinking the amputated limb has returned.

You don’t have to live with phantom limb pain. Contact the Metro Pain Centers office closest to you by phone, or click the “request appointment” button to book online today.