

This complex pain can be difficult to treat. PAP is a complex condition with mechanisms that can be located at the residual limb, spinal cord, and brain - or a combination. Surgical Management: Neuromodulatory treatment and surgery for neuromas have been found to help select patients with PAP. Rehabilitation Management: Mirror visual feedback and cognitive behavioral therapy are often effective adjunct therapies and have minimal adverse effects. Newer studies are evaluating alternative drugs such as ketamine and local anesthetics. Common medications used include tricyclic antidepressants, gabapentin, and opioids. Medical Management: The majority of chronic PAP is due to phantom limb pain, which is neurogenic in nature. There are two main types of PAP: residual limb pain (RLP) and phantom limb pain (PLP), with an estimated 95% of people with amputations experiencing one or both. After an amputation, many people experience pain in the area where their amputated limb had been.Thats called phantom.

1 For the purposes of clinical assessment and treatment, it is important to differentiate PLP from other amputation-related phenomena, such as stump-pain, (ie, pain in the remaining part of the limb), 2. This affects both prosthetic wear and quality of life. It is estimated that more than 80 of patients with partial or total loss of a limb develop chronic phantom-limb pain (PLP), ie, pain that seems to be located in the missing limb.

Patient generally describes sensations either as normal or an unpleasant warm tingling. Published - Residual limb pain affects people with limb loss with phantom limb pain rates as high as 85.Phantom limb pain describes painful sensations that are perceived to originate in the amputated portion of the extremity. Phantom limb pain sensations are a perception of continued presence of the amputated limb. Phantom limb sensations were first described in 1551 by the French military surgeon.
