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Prevention
By Mayo Clinic staffBecause the risk of developing phantom pain is higher for people who have experienced pain in the limb before amputation, some doctors inject an anesthetic to the spine (epidural) in the few hours or days leading up to surgery. This may reduce pain immediately following surgery and reduce the risk of lasting phantom limb pain.
Two drugs have shown promise in preventing phantom pain:
- Calcitonin (Miacalcin). Researchers aren't sure why calcitonin — a hormone produced by the body that slows the rate at which your body breaks down bone — provides pain relief. You may receive this drug directly into a vein (intravenously) during the week after amputation.
- Ketamine (Ketalar). This anesthetic drug is sometimes given after surgery to help prevent phantom pain. Its side effects can include sedation, hallucinations and delirium.
- Pain: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm. Accessed Aug. 21, 2009.
- Dillingham TR, et al. Upper limb amputations. In: Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007:595.
- Mosaku KS, et al. Psychological reactions to amputation in a sample of Nigerian amputees. General Hospital Psychiatry. 2009;31:20.
- Ramachandra VS, et al. The use of visual feedback, in particular mirror visual feedback, in restoring brain function. Brain. 2009;132:1693.
- Radbruch L. Pain in cancer survivors. In: Walsh D, et al. Palliative Medicine. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/155581031-4/0/2038/259.html#4-u1.0-B978-0-323-05674-8..50258-9--chapter1. Accessed Aug. 21, 2009.
- Jeffries GE. Post-amputation pain. Amputation Coalition of America. http://www.amputee-coalition.org/inmotion/mar_apr_98/pain_mgt/page1.html. Accessed Aug. 21, 2009.
- Chan BL, et al. Mirror therapy for phantom limb pain. New England Journal of Medicine. 2007;357:2206.
- McNutt S. New paths in phantom limb pain treatment. Amputation Coalition of America. http://www.amputee-coalition.org/inmotion/mar_apr_07/phantom_treatment.html. Accessed Aug. 21, 2009.
- Bajwa ZH, et al. Cancer pain syndromes. http://www.uptodate.com/home/index.html. Accessed Aug. 21, 2009.
- Acupuncture for pain. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm. Accessed Aug. 21, 2009.
- Phantom pain: An update. Amuptee Coaltion. http://www.amputee-coalition.org/communicator/vol3no1pg3.html. Accessed Aug. 21, 2009.
- Fast facts on amputation/phantom limb pain. American Pain Foundation. http://www.painfoundation.org/learn/library/pain-conditions/amputation/fast-facts-amputation.html. Accessed Aug. 21, 2009.
- Giustozzi AA. Chronic pain management. In: Ferri's Clinical Advisor 2009. St. Louis, Mo: Mosby; 2009. http://www.mdconsult.com/das/book/body/155122192-13/876983605/1701/135.html#4-u1.0-B978-0-323-04134-8..50006-9--cesec586_2770. Accessed Aug. 21, 2009.
- Martin DP (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 26, 2009.
