Doctors use several approaches to treat phantom limb pain.
first approach is often medications. No medications have been developed
specifically to treat phantom pain. No drug works for everyone, and
medications don't help everyone. People with phantom pain may need to
try several different drugs to find one that works. Medications commonly
used to treat phantom pain include:
Intravenous infusions of calcitonin during the week after amputation
can reduce phantom limb pain. Calcitonin is a hormone produced by
the body that lowers calcium and phosphate levels in your blood and
slows the rate at which your body breaks down bone. Researchers
aren't sure why it provides pain relief.
Amitriptyline (Elavil), a tricyclic antidepressant, sometimes
relieves phantom pain. Doctors prescribe a lower dose for phantom
pain than that for depression, so side effects may be less severe.
You'll need to take amitriptyline for one to two weeks before you
notice an effect, and you may not receive the full benefit for four
to six weeks. Amitriptyline may also promote sleep, which can make
you feel better. Additional tricyclic antidepressants that may
provide pain relief include doxepin (Sinequan), desipramine (Norpramin),
nortriptyline (Aventyl, Pamelor), imipramine (Tofranil), venlafaxine
(Effexor) and bupropion (Wellbutrin).
When antidepressants don't ease phantom pain, doctors may prescribe
the anticonvulsant drug carbamazepine (Carbatrol, Tegretol).
Carbamazepine controls some types of seizures in the treatment of epilepsy and relieves the facial pain of trigeminal neuralgia. Other
anticonvulsants that may reduce phantom pain include gabapentin (Neurontin),
lamotrigine (Lamictal), phenytoin (Dilantin, Phenytek), tiagabine (Gabitril),
topiramate (Topamax)and valproic acid (Depakene). As with other pain
medications, they don't work for everyone.
Doctors usually use the drug chlorpromazine (Thorazine) to treat
psychotic disorders such as schizophrenia. Sometimes it offers
relief to people with phantom pain.
Clonazepam (Klonopin) is a benzodiazepine, a drug that slows down
the central nervous system. It has many uses, including as a
treatment to relax muscle spasms. Clonazepam may relieve phantom
pain for some people.
Opioid medications, morphine and related painkillers, may be another
option. Taken in appropriate doses, they may provide acceptable
control of phantom pain. However, they may not be appropriate for
people who have a history of substance abuse or pulmonary disease.
An anesthetic originally developed for use in animals, ketamine has
some effect on phantom pain. Hallucinations and delirium are among
ketamine's side effects, however, so doctors don't usually prescribe
it unless other drugs have been ineffective.
This drug is primarily used to treat high blood pressure. Because it
affects pain pathways, it can also be very helpful in a variety of
central pain syndromes, such as phantom pain.
This drug is a muscle relaxant and anti-spasticity drug. It can be
used to treat nerve-related (neuralgic) pain syndromes, painful
muscle spasms associated with central lesions and abnormal nerve (neuropathic)
with medications, treating phantom pain with nonsurgical therapies is a
matter of trial and observation. The following techniques may relieve
electrical nerve stimulation (TENS).
In this approach, a tiny electrical current is applied at specific
points on a nerve pathway. Electrodes placed on your skin make it
possible to deliver the current exactly where it's needed without
causing further pain. This procedure is effective for treating stump
pain, which is often associated with phantom pain. It isn't used to
treat phantom pain. Treatments can be repeated as necessary without
the need for surgery, and there are fewer side effects than with
medications. TENS may be a good approach for people who can't take
or don't get relief from medications.
In this procedure, an electrical current passes through a wire coil
located inside a hand-held device, which is held against your scalp.
The electrical current creates a strong magnetic pulse that passes
through your scalp and skull when the device is held to your head.
The magnetic pulse stimulates nerve cells located in the underlying
brain. Pain relief may last for a week or longer, and you'll need
repeated treatments. This procedure is experimental when used for
Electroconvulsive therapy (ECT).
This noninvasive approach involves applying a small electrical
current through the brain to cause a seizure. Before the current is
administered, you receive medication to prevent pain and physical
injury during the seizure. Although ECT is usually used to treat
depression or other mental disorders, it can be effective against
drugs and noninvasive procedures fail to provide relief, surgery may be
an option. Surgical options include:
Your doctor inserts tiny electrodes along your spinal cord. A small
electrical current delivered to the spinal cord sometimes results in
Deep brain stimulation is similar to spinal cord stimulation except
that the current is delivered to the brain. A surgeon uses a
magnetic resonance imaging (MRI) scan to position the electrodes
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