Information for Patients Phantom Limb Sensation & Pain Pain in the postoperative period must be distinguished between normal postoperative (ie, surgical) pain and phantom limb pain. Surgical pain usually responds well to opioids. Phantom limb pain usually is a burning, stinging, electric pain, and it can be increased with anxiety and stress. While phantom pain is quite common initially, if it is still present at 6 months postsurgery, the prognosis is unfavorable. Phantom pain may respond well to neuroleptics such as Elavil and Neurontin. Phantom limb sensation also must be differentiated from phantom limb pain. Phantom limb sensation is the sensation that the amputated limb is still present. Patients usually report that the absent hand/arm/limb is itching, tickling, or moving through space. Phantom sensation is perceived as a "funny" or "different" feeling but usually is not perceived as painful. Another common phenomenon is telescoping. Telescoping is the sensation that the distal part of the amputated extremity has moved proximally up the arm. A patient might report that it feels like the entire extremity has shrunk so that the hand is now up at the elbow. This is a normal part of the nerve healing process and usually fades with time. Three theories as to why patients experience phantom limb pain and sensation exist. One theory is that the remaining nerves continue to generate impulses. A second theory is that the spinal cord nerves begin excessive spontaneous firing in the Phantom Pain Links: Pain Managment: Phantom Limb Pain
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absence of expected sensory input from the limb. The third theory is that there is altered signal transmission and modulation within the somatosensory cortex. 
