Phantom Limb Pain Management.

J Hand Surg Am · Feb 2025 · Review

Spezia MC, Dy CJ, Brogan DM

Division of Hand and Microsurgery, Department of Orthopaedic Surgery, Washington University School of Medicine, MO

Hand & Upper Extremity

SUMMARY — THE REDUCTIONThis review of phantom limb pain management in a growing amputee population highlights emerging surgical techniques as promising but calls for more randomized trials to guide treatment selection.
Abstract, as published

With an estimated 2 million major limb amputees and projections reaching 3.6 million by 2050, the increasing prevalence of limb loss in the United States underscores the importance of addressing complications associated with limb loss. Phantom limb pain (PLP) is a common and often chronic condition affecting 40% to 80% of amputees. The heterogeneous pathology of PLP encompasses cortical, spinal, and peripheral mechanisms that present a challenge to providing effective treatments. The spectrum of available treatments spans pharmacologic interventions, noninvasive modalities like mirror therapy, and surgical techniques. A review of the current body of evidence on the treatment of PLP favors novel methods of surgical management. Nonetheless, a majority of literature pushes for the evaluation of other methods of ameliorating PLP as imperative to offering patient-centered options that address the myriad of etiologies that contribute to this pathology. More extensive research, especially randomized controlled trials, is needed to establish the long-term efficacy of interventions, compare the impact of different treatments, and identify which modalities are most effective in various patient populations.

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