Living with pain is physically and emotionally stressful, so often, people who experience chronic pain are also more likely to develop depression. But the opposite is also possible. A study presented at the recently concluded American Academy of Orthopedic Surgeons annual meeting found that amputees with psychiatric and medical conditions are more likely to experience phantom limb syndrome.
According to Alan H. Daniels, MD, an orthopedist at East Providence, Rhode Island, phantom limb syndrome was considerably associated with generalized anxiety disorder, major depressive disorder, suicidal ideation, and post-traumatic stress disorder.
Daniels and his colleagues also found a significant link between phantom limb syndrome and hypertension, low back pain, obesity, osteoarthritis, and osteoporosis.
Phantom limb syndrome is described as a shooting or stabbing pain, numbing, and cramping—an incredibly debilitating experience for patients. Because of the study’s findings, Daniels emphasized in an interview with MedPage Today that healthcare providers need to prepare to treat comorbid physical and mental health disorders that may develop alongside phantom limb syndrome. This is crucial for the well-being of many amputees.
But despite this significant link, researchers didn’t find an association between phantom limb syndrome pain levels and a higher prevalence of physical and mental disorders. Because of this, Daniels noted a need for further prospective studies.
For this retrospective study, the researchers analyzed 64,158 patients from an extensive insurance database who had experienced at least one amputation. Although only 5% were diagnosed and coded in the database as having phantom limb syndrome, Daniels noted that it’s more likely under-reported. Many patients may not find it overly bothersome.
As of this publication, current treatments for phantom limb pain have limited effectiveness and focus on controlling symptoms by relieving pain in damaged nerves. Some common pain relievers include antidepressants, over-the-counter pain medications, and narcotics.
Meanwhile, alternative treatments include acupuncture and mirror therapy. The latter is used to trick patients’ brains into thinking that the amputated limbs are still there. Research is still ongoing on these alternative pain treatments.
One of the biggest takeaways from this retrospective study is investigating the effects of pre-amputation counseling and treatment for psychiatric conditions. Daniels pointed out that caring for patients’ mental health pre- and post-amputation surgery may prevent the onset of phantom limb syndrome as well as post-amputation anxiety or depression.
According to Daniels, future database research will answer whether phantom limb syndrome or psychiatric comorbidity comes first.