Diagnosis
When pain occurs after amputation, it is very important to take a detailed medical history and describe the patient’s pain exactly. A distinction must be made between phantom pain and residual limb pain, i.e. pain on the remaining residual limb of the removed body part. These can be caused by inflammation, bruising, nerve injury or circulatory problems, for example.
The person affected should show the exact location and describe the type, intensity and duration of the pain. In addition, attention should be paid to whether the pain can be triggered or alleviated by certain factors. Since this can be difficult for the person affected, it may be useful to keep a pain diary after an amputation.
Frequency distribution
The frequency of phantom pain varies between extremely rare and almost every amputation, depending on the studies. Mean values range from 50 to 75%, so it can be assumed that phantom pain is a common problem after amputations and occurs in more than half of amputees. A distinction must be made between so-called phantom sensations, non-painful feelings in the amputated body part, which are experienced by almost every person affected after an amputation. Phantom pain occurs most frequently the closer to the trunk (proximal) of the body the amputation was performed. When phantom pain occurs, it usually begins in the first month after the amputation, but in more than half of cases it continues for more than a year.In less than 10% of patients, phantom pain first occurs after the first year after amputation.
Symptoms
Usually relatively short time after the loss of the body part, more rarely also only months to years after the event, pain occurs in the no longer existing body part. The pain is often described as burning, stabbing, shooting or drilling and is usually stronger at night than during the day. Phantom pain can occur as a recurring pain attack or, more rarely, as persistent pain.
Often the pain is similar to the pain felt before the loss of the body part. In many cases, various factors can influence phantom pain. These can be external factors such as heat or cold, but also internal factors such as stress, fear and general well-being can have an influence on phantom pain.