This is pain in the absent extremities of the patient. The precise causes are not yet fully understood, but appear to be both physical and psychological in nature. In one study(1) it was shown that by wearing a stump cover made of Umbrellan from medi to shield the residual limb from electromagnetic forces, a significant reduction in phantom pain could be achieved – without side effects.

537 amputees took part in the survey, which consisted of 33,294 replies to questions. The group consisted of 71.1 per cent men and 28.9 per cent women. 6.1 per cent of all participants were under 30 years old, 22 per cent were aged over 70. The reason most often cited for amputations were accidents, followed by peripheral arterial occlusive diseases. Amputations in diabetes mellitus and war injuries were far more common in men, whereas amputations for tumours were more common in women. In 4.5 per cent of all participants an arm had been amputated, in 95.5 per cent a leg. 74.1 per cent of the men and 76.8 per cent of the women suffered from phantom pain. Its intensity was generally rated as between VAS 5 and VAS 8 (on a scale of 0 to 10). The proportions of the various types of pain in all citations were:

• Burning: 13.6 per cent
• Tingling: 20.4 per cent
• Like a cramp: 15.3 per cent
• Like an electric shock: 21.0 per cent
• Like a knife cut: 23. 4 per cent
• Other: 6.3 per cent

Electric shock and knife cut types of pain were frequently associated with hypersensitive skin or scars, increased sweating and sensitivity to pressure; more rarely in association with overheating, undercooling, pallor and bluish discolouration.

The more intense the pain immediately before amputation – the stronger the phantom pain.

79.5 per cent of the patients who were pain-free before amputation had phantom pain, and 84.75 per cent of those with chronic pain. Some 95.7 per cent of patients who had also experienced pain in the last few days before amputation suffered phantom pain. 419 patients (78 per cent) reported that they had phantom sensations – 76.3 per cent of the men and 83.7 per cent of the women. In the group with phantom sensations, the phantom temperature was cold in 16.5 per cent, warm in 19.5 per cent and normal in 64 per cent. 30.1 per cent of these amputees (23.5 per cent of all those questioned) were unable to move the phantom limb, the others generally described free mobility, but in some cases only if they concentrated hard or closed their eyes.

Germany's largest ever survey on phantom pain

The large-scale survey was initiated by Dr. Uwe Kern, Specialist in Anaesthesia and General Medicine, Specialist in Pain Therapy, Chirotherapy and Sports Medicine, of the Pain and Palliative Centre, Wiesbaden. Under the sponsorship of medi, a manufacturer of modern prosthesis parts and aids against phantom pain, all those who had undergone arm or leg amputations were asked to describe their pain experiences by answering 62 questions. Information on the occurrence and extent of phantom pain and the nature of phantom sensations varies considerably in the literature. Explaining the reason and methods of the survey, Dr. Kern said, "The aim of this first and, to our knowledge, largest-ever nation-wide survey was to investigate the importance of this problem in Germany". It is the largest enquiry among amputees about phantom pain in Germany. The purpose was to utilise the experiences of those affected in order to find new ways of treating and overcoming phantom pain and to accelerate the progress of development.