Phantom outside the opera – a review of current findings on treating phantom pain

Purpose
Presentation of the latest discoveries and progress in treating phantom limb pain (PLP).

Views
A variety of strategies are used in PLP therapy. Among non-pharmacological methods the best results are obtained by mirror therapy, which creates the illusion of an existing healthy limb. Other advantages of this therapy are its non-invasive character and low cost. Other methods of which much is expected are: graded motor imagery (GMI), hypnosis, electromagnetically shielding limb liner, and virtual reality. Many drugs are taken into consideration as potential agents that may lower the pain, including nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, opioids, antidepressants, anticonvulsants, etc. Although nowadays nonsteroidal anti-inflammatory drugs are most commonly used, researches are mostly focused on gabapentin, which shows efficacy. From a psychological point of view, it is important to remember that following amputation patients experience grief for the loss of the prior body image. Many factors pre-dating surgery contribute to difficulties in undergoing such a process, as well as a feeling of increasing pain, so it is worth including teams of psychologists who take care of patients before and after amputation.

Conclusions
Current attempts to treat PLP, show differing degrees of efficacy among patients, so it is therefore impossible to set a consistent treatment scheme. For this reason alone, it is recommended to select appropriate therapy on an individual basis. Knowing the precise pathophysiology of an individual’s pain could be helpful in improving the treatment methods. The character of pain of this sort suggests the necessity of engaging specialists from different fields in order to treat the condition.