Phantom limb pain is reported by more than half of individuals undergoing limb amputation, and is defined as a painful sensation in the absent limb. Mechanisms of PLP have not been identified, and treatment has been attempted with a variety of medical, non-medical, and surgical interventions, most of them unsuccessful.

A 40-year old male with an amputated right leg and disarticulated hip secondary to a post-operative staph infection presented with severe phantom pain that initiated in the hip and buttocks, and radiated to the groin, rectum, and down the leg to foot, ankle, and toes. The intensity of the pain was reported as 10/10, with the least pain as 8/10. The patient also reported insomnia, poor quality of life, and depression. Prior treatment included nerve blocks, chemical ablation, opioid and non-opioid analgesics, intrathecal pump, TENS, and SCS. The first SCS system caused painful paresthesia requiring analgesics for pain control, and was subsequently explanted. The patient was offered a trial with a rechargeable, current-controlled independent contacts SCS system, had a successful trial, and proceeded to permanent implant with two percutaneous leads and the Precision system.

Following initial pain relief, lead migration secondary to the patient's ambulation on one foot occurred, and a revision was performed. A second occurrence of migration led to the placement of the Artisan™ paddle lead. The patient reports excellent pain relief, decreased use of pain medications, and improved quality of life. Through the use of multiple stimulation programs, the patient has been able to effectively manage his pain over a wide range of activities. Pain control has allowed use of a leg prosthesis for the first time.

While the use of SCS in treatment of chronic neuropathic pain of the limbs has demonstrated effectiveness, it should also be considered in management of phantom limb pain.