rodgerole at mail.ev1.net
Mon Sep 22 17:35:55 PDT 2003
Can anyone comment on how long it takes this to go away? I've heard that for some people, it is an on going problem. I hope that is the exception rather than the rule! Jim Street
Hi Jim, My phantoms were intermingled with diabetic neuropathy,but I got considerable relief by taking neurontin. (1200mg/day) They were mostly gone after 5-6 months,but I still get an occasional twinge. Don't know for sure if it's the neuropathy or if the phantoms are still hanging on. I suspect neuropathysince I have similar feelings in the foot I have left. Here is a list of things suggested for relief if the pp's bug you to much.
Ole rak 01/02
SUGGESTED PHANTOM PAIN TREATMENTS
Acupuncture is a healing art that has been practised in China for
several thousand years to treat a variety of ailments, including chronic
pain. Acupuncture involves the insertion of tiny needles into the skin at
specific sites. The needle is then twirled for a few minutes or a low
electrical current is applied. It is not fully understood how
acupuncture works - the Chinese healing art stresses the energy flow of the Ch'i,
or life force, while western medicine suggests it stimulates the
production of the body's natural painkillers called endorphins.
Preoperative: Epidural Blockade
When amputation surgery is performed, whether caused by trauma or
disease, the amputee is often in pain before the surgery commences. It is
thought that this pain imprints on the brain and creates a "pain path"
which then causes phantom limb pain after the limb is removed. By using
an epidural, an injection of anaesthetic to the spine, usually for a
period of 72 hours prior to the surgery, the message of pain is blocked
from reaching the brain and creating a "pain path." It has been reported
that people who have an epidural blockade prior to surgery experience
less pain during the postoperative period, as well as a reduction in the
frequency and severity of phantom limb pain. It is also thought that
the epidural reduces pain by cutting off the pain messages associated
with the surgery, which still register in the brain even though the
patient is unconscious.
Postoperative: Local anaesthetic (examples: Lidocaine, Marcaine,
Novocaine, Pontocaine, Xylocaine) These medications act on nerve cells by
making them incapable of transmitting pain messages for a short period of
time. They may be given as spinal (a small needle into the spinal
column, in the lower back), epidural (a small needle and catheter into the
spinal column, in the lower or mid-back), by local injection or a wide
variety of nerve blocks. These may be used to relieve trigger points and
reduce stump pain.
Advocates of biofeedback feel that phantom pain may happen because of
anxiety, which may increase muscle tension and contribute to the pain
cycle. "Hyperactive muscles" cause irritation in the cut ends of the
nerves in the residual limb. Electrodes are attached to the residual limb
which detect when the muscle is tensed and trigger a flashing light or
buzzer to provide feedback. Once the amputee has become aware of the
muscle tension they learn to relax the muscle. When an appropriate
decrease in muscle tension is reached the feedback stops. The focus of this
treatment is to teach the muscle(s) how to relax, thereby relieving the
Some amputees may find relief through chiropractic - which means
"treatment by hand." Chiropractic does not involve drugs or surgery, but
instead concentrates on the spine in relation to the total body. Doctors of
chiropractic, or chiropractors, specialize in the understanding and
treatment of the different parts of the spine: bone (vertebrae), muscles
and nerves. When a vertebral joint is not working properly it can create
an imbalance which disturbs the nervous system. This can lead to excess
strain being placed on other joints, resulting in some form of pain.
Through manual adjustment, or manipulation of the spine, chiropractic
works to correct misalignments of the spine thus alleviating pain.
Applying cold to the residual limb may help alleviate some of the
discomfort associated with phantom limb pain or muscle spasms. Refreshing
coolness can be administered through cold compresses, ice packs or cool
baths. Amputees may also wish to try a cooling cream or gel. One newer
product available is Biofreeze, which is an analgesic cryotherapy gel
made from the extract of a South American holly shrub. Biofreeze creates
a cooling sensation within the skin that can last several hours.
Another gel, Glenalgesic Blue, is a topical pain fighter for the prompt and
temporary relief of muscular aches and pains, containing menthol,
alcohol and camphor. [See also Heat.]
Cranial Sacral Therapy
This type of therapy, involving the study of bone and joint
misalignment related to the head, has been practised by many different cultures
for thousands of years. Therapeutic touch is applied to the head, and
meditation and visualization techniques may also be used in conjunction
with cranial sacral therapy. A therapist treating phantom pain may
"massage" the missing limb, as well as encourage visualization of the lost
limb in an effort to help amputees release any sense of grief, loss or
anger towards the missing limb(s).
The nerves in the stump of the amputated limb can be very sensitive,
especially directly following the amputation. Not only does
desensitization reduce nerve sensitivity, it can also reduce pain and discomfort
overall. Rubbing the stump with a piece of terry cloth, gently
manipulating the stump manually, tapping the stump, or using a vibrator can all
help to desensitize the nerves, alleviating sensation and pain. [See also
Dietary and Herbal Supplements
Some amputees have found certain dietary supplements or homeopathic
food products help reduce phantom limb pain. Examples of dietary
supplements amputees have tried include: potassium; calcium; magnesium, and
injections of Vitamin B12. Certain herbal products have also been found
useful by some amputees including juniper berries (interestingly called
"ghost-berry" by Native Americans). Antioxidants such as Pycnogenol (a
pine bark extract sold in Canada as a food product) and Grape Seed
Extract are extremely concentrated bioflavonoids, which until 1936 were known
as Vitamin P. Antioxidants attack free radicals, which are unstable
atoms inside our bodies that attack all body tissues, degrade collagen and
reprogram DNA. Free radicals are believed to be the underlying cause in
many diseases. Antioxidants are found in high concentrations in grape
seeds and pine bark, and in lesser amounts in grape skins, cranberries,
lemon-tree bark and hazelnut tree leaves. Antioxidants are available in
liq uid and pill form.
*Amputees should always consult their doctor before taking any
supplements or herbs, as these are not harmless, but can have powerful side
effects. They may also interfere or conflict with other medications being
taken at the same time.
Another theory behind phantom limb pain suggests that it occurs because
the nerves in the residual limb lack the stimulus once provided by the
missing limb. One electrical treatment, transcutaneous electrical nerve
stimulation (TENS), uses low current at a low-frequency oscillation to
stimulate the nerves and provide pain relief. The amputee feels a
gentle tingling without increased muscle tension. Depending on the severity
of pain, the small-battery operated device can be used for 20 minutes
to a few hours of stimulation, several times daily, and the amputee can
be taught how and when to apply treatment. Because TENS can cause
arrhythmia, it should not be used by people with advanced heart disease or a
pacemaker. Your doctor will advise if this is suitable for you.
Exercise increases circulation and stimulates the production of
endorphins (chemicals naturally produced in the brain that kill pain). Many
amputees find that moderate and frequent exercise can help to reduce
phantom pain. Flexing and relaxing the muscles on the residual limb also
helps some amputees.
Farabloc is a fabric which contains extremely thin steel threads but
looks and feels like linen. The makers state that Farabloc has a
shielding effect from ions and magnetic influences, which protects damaged
nerve endings. It stimulates blood circulation and produces a pleasant
feeling of warmth. It can be cut and sewn, washed and ironed like any other
fabric, and is available in blanket forms of various sizes. People may
have socks, sheaths, or custom residual limb covers made from Farabloc
or the material may be incorporated directly into a prosthetic socket.
Applying soothing warmth has been reported to help deal with occasional
bouts of phantom limb pain. Warm baths, a heating pack, a Magic Bag, or
wrapping the stump in warm, soft fabric to increase circulation are all
examples of how heat can be used. There are also rubs and gels which
generate heat, such as Rub A535 or Tiger Balm. More advanced forms of
heat therapy can be used under the guidance of a trained professional.
Some amputees alternate between applying heat and cold. [See also Cold.]
Keeping a Journal
Some amputees write down dates and times as well as other factors that
may be present when they experience phantom limb pain, such as stress.
A record kept over time may indicate factors that influence or trigger
the occurrence, frequency or severity of an attack of phantom limb pain
in the same way that migraine sufferers have found that certain foods
trigger their migraines.
Magnets have been used for thousands of years to treat many conditions,
including recently phantom limb pain. Magnetic therapy involves
applying a magnetic field to the body to relieve pain and speed up the healing
process. The application of electromagnetic fields have been shown to
affect cell permeability and improve oxygen delivery to the cells, which
can lead to better absorption of nutrients, improved circulation, and
clearance of waste products. Magnets may also reduce inflammation and
pain, and promote healing. The magnets are usually incorporated into
bracelets, belts, or fabric straps, and are available in differing
strengths and sizes. These products are available from several companies such
as Nikken and Bioflow. (It is recommended that you consult your doctor
before trying magnetic therapy to ensure it is a good choice for you.)
Massaging your limb is a good way to increase blood-flow and
circulation, which may help to alleviate some discomfort. Massage may also help
to reduce swelling and loosen stiff muscles, which can provide some
relief from pain.
Medications are useful in the treatment of pain (especially chronic
pain). However, many amputees prefer to try other avenues of relief first.
It is important for the amputee to understand all the possible
side-effects of over-the-counter and prescription medications, including the implications of long-term use.
Anti-Inflammatory Drugs (examples: acetaminophen [Tylenol], aspirin,
ibuprofen [Advil, Motrin]
Acetaminophen, aspirin and ibuprofen are all examples of medication
which can reduce mild swelling or soreness, and are useful for mild to
moderate pain. They are non-addictive and may be effective for occasional
bouts of phantom pain. One amputee uses Tylenol Arthritis Pain for
relief from his phantom limb pain.
Antidepressants (examples: Amitriptyline, Elavil, Pamelor, Paxil,
Developed to treat depression, many antidepressants have been found to
be useful in the treatment of many chronic pain conditions, including
phantom limb pain. These drugs work centrally on the brain to either
block or increase certain chemicals that help regulate normal brain
Anticonvulsants or anti-seizure medications (examples: Tegratol,
These drugs have also been found useful in the treatment of phantom
limb pain. They act directly on the nerves both in the residual limb and
in the brain to alter neurotransmission, thus calming nerves in the
residual limb which may have become over-active following amputation. These
drugs are prescribed in small doses and are gradually increased to a
level which promotes relief. It is also very important to decrease the
dose gradually before ceasing to take the medication.
Narcotics (examples: Codeine, Demerol, Morphine, Percodan, Percocet)
These drugs mimic the pain killing chemicals released by the brain in
response to pain. While they are very effective as temporary solutions
for pain after surgery, trauma, or to treat cancer pain, they are highly
addictive and in the majority of cases should not be used for a
prolonged period. Amputees who have only an occasional severe attack of
phantom pain may benefit from a limited course of this type of drug. When
these drugs are taken on a regular basis the patient becomes addicted and
desensitized to the drugs, requiring more of the drugs while achieving
less effective pain relief.
Both physical and mental tension can make pain worse. Meditation may
help to reduce phantom limb pain by relaxing tense muscles and lowering
anxiety levels. The aim of meditation is to produce a state of relaxed
but alert awareness, this is sometimes combined with vizualisation
exercises that encourage people to think of pain as something remote and
separate from themselves.
Some amputees may find individual or group therapy beneficial. Some
have even tried hypnosis. Trained professionals can help amputees learn
coping skills and can provide psychological and emotional support for
dealing with pain.
Bandaging and shrinker socks apply even pressure to the residual limb
which may help to reduce or alleviate phantom limb pain.
Wearing Your Artificial Limb
As well as improving circulation, putting on your artificial limb and
moving around may also help alleviate phantom limb pain.
More information about the Amp-l