Treatment options are many and varied. So when I give you a list of 10-15 options don't expect them all to work nor that the first one you try will work. You may try your first option and get good results but you may need to try half of the list before you get relief. Don't get discouraged. Here we go.
1) Patting/Tapping: This is gentle, think burping a baby. It is exactly like it sounds, patting or tapping the residual limb to provide a change in information that the nerves in the leg are taking to your brain. This is a part of desensitization of your limb, in the long run this will help prepare your limb for having a liner and a socket on.
2) Rubbing: Again this is gentle, you can also use a soft (think silk or microfiber) cloth on your skin. You are looking to give the nerves/brain something else to process. This is a part of desensitization of your limb, in the long run this will help prepare your limb for having a liner and a socket on.
3) Mirror Therapy: This has a lot of research behind in from the VA and it does work, again this is something that works for some individuals. You would place this between your legs with the mirror facing your non-amputated limb so that your eyes/brain see you with two legs again. Then you can move or rub your leg on the sound limb to address the pain in the region that amputated side that is no longer there.
4) Guided visualization/meditation: Okay so this one isn't for everyone, it does however help your brain with the distraction that it needs. There are so many options on YouTube, just search guided meditation and you will get options for taking walks on the beach or in the woods, or visualize yourself in a mountain hut or on a tropical island. Distraction is the key element, so finding something that works for you may take a few different tries. From experience try both male and female voices as that can definitely make a difference in being able to relax.
5) Virtual Reality (VR): This works along the same lines as guided visualization/meditation but is a more active approach. It is a great tool for distraction and changing the focus of what your mind is addressing. There are multiple platforms available for use with gaming systems or your cellphone. Research is key to finding what will work best for you. This can also be done as a therapy treatment where available where you would see yourself completing exercises with limbs intact.
6) Repositioning Limb: Sometimes the way we are sitting with our limb (arm or leg) can trigger phantom limb symptoms. Easy solution is to change position, may need to try several options to decide if this will work for you.
7) Biofeedback: Using EMG biofeedback has been shown to help with cramping PLP and is used to help with learning to relax the muscles that are involved. Temperature biofeedback is used when there is a "burning" PLP in the residual limb and you learn to raise the heat in the extremity by increasing blood, this is typically when you find that your residual limb is colder which is attributed to decreased blood flow.
8) Acupuncture/Accupressure: While there is not a lot of evidence to explain why it works, there has been evidence to show that it does help decrease the need for pain medication. Acupuncture would require going to someone who practices traditional chinese medicine where are accupressure can be performed at home with someone who knows which pressure points are needed to reduce the pain.
9) TENS: Technique has long been used for pain management with low back pain, ankle and knee pain has been shown to work with electrodes placed either near the end of the residual limb, on the opposite leg at the "site of the pain" or at the level of the spine where the nerves from the leg/arm come back into the spinal cord. Work with your physical or occupational therapist to figure out pad placement
10) Massage: This is generally safe especially if you have no sutures or staples present. You can have a licensed professional give you a massage, it can be a self massage or someone you trust with some guidance can perform a massage. It touches on so many benefits that include, relaxation and improving blood flow to the limb massaged that this is good even if it doesn't help with the pain.
11) Music: This is completely individual, it can be used to relax (maybe in combination with a massage) or as a distraction (favorite artist or radio station). Find something that works for you, if you don't have earbuds or headphones now may be the time to look into a pair so that you have access to music just about anytime anywhere. If you are focused on music and/or moving to the music this can give you relief from the pain.
12) Shrinker: Wearing your shrinker or liner for the majority of the day can also help manage symptoms by providing a general level of pressure over your residual limb. If you are just starting with a liner you may need to slowly increase your wear time of the liner and use a shrinker when you take the liner off as liners do not let your skin breath and for some patients this process takes time to build up for all day wearing.
Below is a link to an article published by the Amputee Coalition of America that has some of the above techniques mentioned as well as broader descriptions of the techniques. May you find a couple of techniques that assist in your pain management.
phantom-pain.pdf (amputee-coalition.org)
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