Treatment of Phantom Pain
Until recently phantom limb pain and stump pain have been difficult to control, all this changed once FDA approved Percutaneous (under the skin) Peripheral Nerve Stimulators (PNS).
What is Peripheral Nerve Stimulation?
Peripheral nerve stimulation, frequently referred to as PNS, is a commonly used approach to treat sub-acute and chronic pain. It involves placement of small electrical device (a wire-like electrode) next to one of the peripheral nerves. (These are the nerves that are located beyond the brain or spinal cord). The electrode delivers rapid electrical pulses that are felt like mild tingles During the testing period (trial), the electrode is connected to an external device, and if the trial is successful the wire like electrode is implanted under the skin near the nerve. A generator is worn over the skin to generate electricity. The patient is able to control stimulation by turning the device on and off and adjusting stimulation parameters as needed.
Dr. Kalava is the only physician in Florida who specializes in placement and management of Peripheral Nerve Stimulation as it requires extra-ordinary skills in the ability to use ultrasound and identify and target the peripheral nerve that is attributable to phantom pain and stump pain.
Upper Limb: Any of the 3 main nerves i.e., Radial, Ulnar or Median Nerve either individually or collectively might be responsible for pain. PNS can successfully achieve >50% reduction in pain and improve functionality and lead to better quality of life.
Lower Limb: Femoral or Sciatic Nerves, either individually or collectively might be contributing to phantom/stump pain.
Insurance Coverage: Medicare and some private insurances fully cover the placement of peripheral nerve stimulators.
Steps in Diagnosing & Managing your Phantom/Stump Pain:
Diagnostic Nerve Block(Ultrasound Guided): To identify which nerve is causing pain or responsible for symptoms and also to ascertain whether this is centrally mediated or peripherally mediated.
Mayo Clinic Information on Phantom Pain (Click Here)
Radio Frequency Ablation for Phantom Pain (Read More)
Clinical Evidence on Military Veterans & Peripheral Nerve Stimulation Outcome (Read Here)
Clinical Evidence in Civilians and its Efficacy (Read Here)