Post-Amputation Pain Management Specialist in Tampa, FL
Arun Kalava MD FASA EDRA
Treatment of Post-Amputation/Phantom Pain
Until recently, phantom limb pain and stump pain have been difficult to control. All this changed once the 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 subacute and chronic pain. It involves placement of a small electrical device (a wire-like electrode) next to one of the peripheral (not in the brain or spinal cord) nerves. The electrode delivers rapid electrical pulses that feel like mild tingles during the testing period. 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. Once implanted, a generator is worn over the skin to generate electricity, and the patient is able to control stimulation by turning the device on and off and adjusting stimulation parameters as needed.
Why choose Breakthru Clinic?
Dr. Kalava is one of the very few physicians in Florida who specialize in placement and management of PNS. We pride ourselves in using ultrasound guidance and thus eliminating any exposure to harmful radiation (x-ray). These procedures are done in the office and sometimes need mild sedation to perform. PNS can successfully achieve greater than 50% reduction in pain in the majority of patients, improving functionality and leading to better quality of life.
What are the main nerves that sense pain?
Upper Limb: A nerve can either individually or collectively be responsible for pain.
Radial Nerve
Ulnar Nerve
Median Nerve
Lower Limb: A nerve can either individually or collectively be responsible for pain.
Femoral Nerve
Sciatic Nerve
What is the insurance coverage?
Medicare, Aetna, and some private insurances fully cover peripheral nerve stimulation.
Steps in Diagnosing & Managing your Phantom/Stump Pain:
Clinical Examination
Diagnostic Nerve Block (Ultrasound-Guided): To identify which nerve is causing pain or responsible for symptoms and also to ascertain whether your pain is mediated by the central nervous system (brain and spinal cord) or the peripheral nervous system (beyond the brain and spinal cord.)
What are other therapeutic options?
Research
Mayo Clinic Information on Phantom Pain (Read 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)
