What is the best way to manage phantom limb pain?

Abstract

No single best therapy for phantom limb pain (PLP) exists. Treatment requires a co- ordinated application of conservative, pharmacologic, and adjuvant therapies. Evaluative management (including prosthesis adjustment, treatment of referred pain, and residual limb care) should be tried initially (strength of recommendation [SOR]: C, expert opinion). Other first-line treatments such as transcutaneous electrical nerve stimulation (TENS) (SOR: A, multiple high-quality randomized, control trials [RCTs]), and biofeedback (SOR: B, numerous case studies) can reduce PLP. Pharmaco- therapy, including opioids, anticonvulsants (gabapentin), and nonsteroidal anti- inflammatory drugs (NSAIDs), can also relieve pain (SOR: B, initial RCTs and inconsistent findings).