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Phantom Limb Syndrome
(Phantom Pain; Phantom Limb; Neuropathic Pain)
by Dianne Scheinberg, MS, RD, LDN
Phantom limb syndrome is the perception of sensations, including pain, in a limb that has been amputated. People with this condition have feelings in the limb as if it were still attached to their body. This is because the brain continues to receive messages from nerves that carried impulses from the missing limb.
The exact cause of phantom limb syndrome is unknown. It is thought that the sensations are due to the brain’s attempt to reorganize sensory information following the amputation. The brain must rewire itself to adjust to the changes in the body.
Risk Factors TOP
Phantom limb syndrome is more common in adults than in children. Other factors that may increase your chance of developing phantom limb syndrome include:
Symptoms may occur in people who have had a limb removed and people who are born without a limb. The symptoms are perceived in a limb that does not exist.
Phantom limb syndrome may cause sensations of:
Following an amputation, it is important to tell your doctor if you have pain or other sensations. Earlier treatment generally improves the chances of success.
There is no medical test to diagnose phantom pain. You will be asked about your medical history. A physical exam will be done. The doctor will want to know about the signs, symptoms, and circumstances that occurred before and after the removal of the limb. Diagnosis can be made based on your symptoms of any sensations from the missing limb.
Fortunately, most cases of phantom limb syndrome following amputation are brief and infrequent. For those people who suffer from persistent pain, treatment can be challenging. There is only limited data to support the following therapies.
Your doctor may recommend the following to help with your symptoms such as:
Electrical Nerve Stimulation
In some cases, electrical nerve stimulation may be used. Examples include:
To help reduce your chances of getting phantom limb syndrome, some believe that administering pain medication at the time of the amputation may prevent persistent pain afterward. The effectiveness of this approach has yet to be confirmed.
Amputee Coalition of America
National Institute of Neurological Disorders and Stroke
Casale R, Alaa L, et al. Phantom limb related phenomena and their rehabilitation after lower limb amputation. Eur J Phys Rehabil Med. 2009;45(4):559-566.
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Flor H, Nikolajsen L, et al. Phantom limb pain: a case of maladaptive CNS plasticity? Nature Reviews Neuroscience. 2006;7:873-881.
Foell J, Bekrater-Bodmann R, et al. Phantom limb pain after lower limb trauma: origins and treatments. Int J Low Extrem Wounds. 2011;10(4):224-235.
Peripheral neuropathy. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated April 14, 2017. Accessed November 9, 2017.
Resources for pain management. Amputee Coalition website. Available at:
...(Click grey area to select URL)
Accessed November 9, 2017.
Richardson C, Kulkarni J. A review of the management of phantom limb pain: challenges and solutions. J Pain Res. 2017;10:1861-1870.
Rothgangel AS, Braun SM, et al. The clinical aspects of mirror therapy in rehabilitation: a systematic review of the literature. 2011;34(1):1-13.
Weeks SR, Anderson-Barnes VC, et al. Phantom limb pain: Theories and therapies. 2010;16(5):277-286.
Wolff A, Vanduynhoven E, et al. 21. Phantom pain. Pain Pract. 2011;11(4):403-413.
Last reviewed November 2017 by EBSCO Medical Review BoardRimas Lukas, MD
Last Updated: 12/20/2014
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