Phantom limb pain after amputation is best understood as arising from:

• A Nociceptive pain due to stump neuroma formation at the cut nerve ends
• B Central sensitisation and maladaptive cortical remapping in the somatosensory cortex combined with peripheral and spinal sensitisation ✓
• C Psychological hallucination with no neurological substrate
• D Vascular ischaemia of the stump causing referred pain

Explanation

Phantom limb pain is a complex neuropathic pain condition involving peripheral sensitisation (neuroma discharge from cut nerve ends), central spinal sensitisation (wide dynamic range neuron wind-up), and cortical reorganisation (expansion of adjacent cortical representations into the deafferented area). Neuroimaging shows maladaptive somatosensory cortex remapping that correlates with pain intensity. Treatment includes mirror therapy (to reverse cortical reorganisation), gabapentinoids, tricyclic antidepressants, TENS, and targeted muscle reinnervation (TMR) to reduce neuroma pain.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.