Phantom pain for an amputee is no joke. It can be traumatic enough to have lost a limb but when pain continuously occurs in that area, it will feel incredibly real and more than a little disconcerting. It’s worth noting that 9 out of 10 amputees are likely to experience phantom pain in the first few weeks following their amputation and even though surgery may go well, the patient must come to terms with the loss. The pain experienced may vary from person to person but, tingling, cramping, stabbing pains, or burning sensations are possible. Most people report that the symptoms gradually lessen although there are triggers that can seemingly spark off the sensations unexpectedly. These are on an individual level.
For some people, the pain becomes a part of everyday life and it’s important to manage these symptoms effectively. Pain management is an important part of the whole recovery process and goals made will have the purpose of reducing pain levels experienced as this provides quality of life once more. The sensations associated with phantom limb pain often mimic pain that was still experienced when the body part was there and will usually, occur in the distal parts of the limb. Initially, people may be reluctant to admit that they are feeling pain in this area as they are concerned that others will think they are crazy. But, acknowledging it, simply means treatment can commence. It occurs through mixed signals being released from the spinal cord or brain and many of the latest therapies will look at how to change these signals to prevent pain from occurring.
There are different treatments for phantom limb pain and these include:
- Physical therapy
- Massage of the residual limb
- Spinal cord stimulation
- Interventional injections
Medication can help to improve pain, and these include:
- Tricyclic antidepressants
- Sodium channel blockers
Stellate ganglion blocks are often used where there is phantom limb pain for the upper extremities. Blocks will often be used with other therapies such as physical therapy for maximum benefits.
To understand how it works, we need to look at the sympathetic nervous system where there are nerves which regulate specific functions of the body including sweating, blood pressure, and heart rate. If a peripheral nerve becomes damaged, the sympathetic nervous system acts like a conductor for pain signals when they do not usually. So, this type of block can be used for alternate health condition or to fix trauma to the nerves themselves.
A stellate ganglion is a collection of these nerves placed at the last vertebra of the neck, they are in front of the vertebrae and operate as a pair and this enables sympathetic function for the upper extremities but also, for both sides of the face. For obvious reasons, a medical diagnosis should be sought to determine the extent of the damage and how to manage pain. When doctors recommend this diagnostic treatment, there may be improvements to pain experienced in the neck, chest, and head, even those caused by angina, it may also reduce sweating. It is minimally invasive, and following a local anesthetic, contrast dye is an injection to make sure the needle is in the right position and a numbing medication is injected into the stellate ganglion.
This treatment and can be used for a variety of conditions including shingles, reflex sympathetic dystrophy, and post-traumatic stress disorder so it is worth considering if phantom pain or any of these other conditions need to be treated as this can give life some normality.