Phantom Pain and Its Management

After limb amputation a perception that the amputated limb is still there will always occur. It follows a specific pattern that is related with body image (Neuromatrix and Neurosignature theory by Melzack) called phantom limb sensation. Phantom limb pain is a different condition. It is highly variable, very individual and have a correlation with the experience of pain in the same limb before amputation. Phantom limb phenomenon is a continuing memory with or without pain of self-body perception or body image that is not there any more, modulated by neurohormones and neurotransmitters to reach homeostasis balance. The reactivation of pre-amputation pain memory (engram) is stronger in a diabetic limb amputee compared with a traumatic limb amputee because of longer pre-amputation pain experience. The prevention strategy of phantom pain in diabetics is very important. All steps must be taken to prevent this from happening, through good and careful management in the pre-amputation stage.