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Even though the limb has been removed, either by trauma or surgery, the nerve endings at the stump continue to send pain signals to the brain, making the brain think the painful limb is present. Sometimes, the brain retains the memory of the pain that occurred, which is continuously perceived regardless of signals from injured nerves.

As with other types of pain, certain conditions and substances can trigger phantom limb pain. These triggers include:

. Touch
. Cigarette smoking
. Urination or defecation
. Sexual intercourse
. Cold exposure
. Changes in barometric pressure

Other than pain, with amputation, the patient experiences other sensations, such as cramping, burning, tingling, heat, and cold in the stump area. Some patients report that the pain feels like it is much further down, where the leg or arm used to be.

The exact reasons certain individuals develop phantom limb pain while others don’t is not understood. Some factors can increase the risk of this condition, such as:

. Pain before the amputation - For patients who had severe pain before the limb removal, the chance of phantom limb pain is greater following amputation.
. Stump pain - Patients who have stump pain following amputation are more likely to develop long-standing phantom limb pain.
. Poor-fitting prosthesis - If the artificial limb (prosthesis) fits poorly, it can cause residual pain.

Heat application - Applying a heating pad to the stump helps alleviate stump pain.

Physical therapy - The therapist uses massage, electrical stimulation, and ultrasound to alleviate pain. In addition, the therapist teaches relaxation techniques for distraction.

TENS - The transcutaneous electrical stimulation device is worn on the outside of the body. Wires from a small unit lead to electrodes, which are place on the painful region. The device sends electrical impulses to interfere with pain signals and suppress pain. TENS was proven effective for reducing phantom limb pain in several clinical studies.

Spinal cord stimulation - This device is surgically implanted in the buttocks or abdomen. Small wires with electrodes are positioned near the spinal cord to deliver impulses that interfere with pain signals.

Medications - Commonly prescribed medications include anticonvulsants, antidepressants, neuroleptics, beta-blockers, and calcium channel blockers. For severe pain, narcotic analgesics are used.

Botox - According to a research study, injection of Botox into the trigger points on the stump relieved phantom limb pain. This substance works by paralyzing the muscle and causing the release of acetylcholine.

Stump injections - The doctor will inject a long-acting anesthetic or a corticosteroid into the stump. In a recent clinical study, the majority of patients enjoyed decrease in phantom limb sensations following bupivacaine injections.

Mirror Treatment - there is new research and positive results with a simple treatment that involves utilizing a mirror to simulate having the amputated limb still present.