Beware of Ghost Pain That Makes Life Difficult!

watch out for life-complicating phantom pain
watch out for life-complicating phantom pain

Anesthesiology and Reanimation Specialist Prof. Dr. Serbulent Gökhan Beyaz gave important information about the subject. Phantom pain or phantom pain is defined as the feeling of the amputated limb after the amputation of any limb and the continuation of the pain felt in that limb. Generally, gangrene occurs as a result of impaired blood circulation in the hands or legs due to any health reasons such as diabetes or high blood pressure, and that limb must be surgically amputated so that the gangrene does not reach further dimensions. This is how the commonly known phantom pain is. However, in recent years, it has been understood that it is seen not only because of amputation, but also after breast operations for cancer or cosmetic purposes. In fact, it has been stated that the pain that does not go away after gynecological operations such as gallbladder, prostate and uterus-ovary of an organ removed from the body may be phantom pain. The cause of this phenomenon is not fully understood, but it is thought that a large part is affected at the spinal cord level. In non-congenital limbs, this phenomenon is not usually observed.

After a limb is amputated for any reason, three different pain states can be seen simultaneously or individually. The first is the pain in the amputated limb, which we call phantom pain, the second is the pain that occurs in the body part that remains after the limb is amputated, and finally, the presence of the limb as if the amputated limb is still in place or moving. In addition, patients may experience burning, tingling and pricking sensations.

Pain begins after the operation. Although it varies from patient to patient, it can sometimes continue for many years, even if it decreases over time and heals completely, especially in young people. It is known that patients have difficulty in accepting that they feel an absent limb and having pain, and even in explaining and expressing this to their relatives and social circles.

The first step in treatment is to reassure patients that phantom pain is normal after the loss of a limb and that these sensations are real, not imaginary; this information alone can reduce patients' anxiety and sadness. Applying ice packs to the stump may provide relief for some patients with phantom pain. Heat application increases pain in most patients, possibly due to increased conduction of small nerve fibers, but may be worth a try if cold application is ineffective. Vibration with the TENS device may provide partial pain relief in some patients. In this syndrome, which is very difficult to treat, a spinal cord stimulator known as a pain pacemaker or spinal cord stimulator can be applied. In addition to all these, it is beneficial for the patient to receive psychological support in order to cope with the pain.

Because phantom pain can be so severe and have devastating consequences, the pain physician must treat it quickly and aggressively. Particular attention should be paid to the insidious onset of severe depression, which obliges hospitalization with suicidal measures.

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