Phantom-Limb Pain

Abdallah Kabbara, MD
Assistant Professor
Department of Anesthesiology & Perioperative Medicine
Case Western Reserve University
Director, Pain Management
St John’s Medical Center
Cleveland, OH

Ali Mchaourab, MD
Associate Professor
Department of Anesthesiology & Perioperative Medicine
Case Western Reserve University
Chief, Pain Medicine
Cleveland Veterans Affairs Medical Center
Cleveland, OH

Richard W. Rosenquist, MD
Professor
Department of Anesthesia
Director, Pain Medicine Division
University of Iowa
Iowa City, Iowa

Historical Background - TOP

Phantom limb pain is chronic pain perceived in an absent body part. Post-amputation pain syndromes have been described after the loss of many different body parts, including the nose, tongue, breast, testis, anus, extremities and fingers. The incidence of pain involving the various structures is largely unknown due to inadequate reporting. It is believed that the incidence of post-mastectomy phantom sensation in the amputated breast is between 22 and 64%.1 However, most women do not report symptoms to their doctors because of psychological and social factors. Phantom limb pain is believed to occur in up to 80 % of all amputations postoperatively, and is more frequently observed in patients with preoperative pain.2 The phantom limb phenomenon, was first described in 1552 by Ambroise Paré who postulated that central pain memory and peripheral factors are both significant causes.3 It was not until 1871 that the term phantom limb pain was popularized by Mitchell.4

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