The care of patients with phantom limb pain in a pain clinic.

Patients referred to the Pain Clinic at the University of Virginia Medical Center with genuine phantom pain rather than stump pain have been treated by a variety of technics. Simple revision of drug therapy has proved helpful in some instances, as has repeated injection of trigger areas or neuromata, though surgical excision has proved necessary in some patients. Mechanical stimulation by stump tapping, prosthetic application, or electrical transcutaneous stimulation also may be useful. Sympathetic nerve block is occasionally very rewarding. Most patients need some form of psychological therapy. Rarely is cordotomy or higher central nervous system surgery required. There is no single best mode of therapy for phantom limb pain, nor can patients be guaranteed a permanent cure.