Spinal Cord Stimulation for the Treatment of Phantom Limb Pain: A Narrative Review

Pain Physician. 2026 Sep;29(6):483-491.

ABSTRACT

BACKGROUND: The annual number of amputations is estimated to be between 200 and 500 million worldwide. The different etiologies of these amputations can be sorted into the following categories: traumatic, vascular, infectious, and tumoral. Since the twentieth century, progress has been made in stump management, surgical techniques to treat amputation, and rehabilitation, with improvements made in the prostheses designed for amputees. Among amputees, 10-79% will suffer from stump pain and phantom limb pain (PLP). Several studies have highlighted the various neuromodulation techniques available for the management of PLP, including spinal cord stimulation (SCS).

OBJECTIVES: To provide a review of the literature about the impact of SCS on PLP.

STUDY DESIGN: A narrative review about the use of SCS as a PLP treatment, conducted in accordance with relevant elements of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.

SETTING: An academic medical center.

METHODS: In the review, we included case reports and case series about patients with PLP. The literature search identified 206 articles. After the removal of duplicates, 13 articles were excluded, as were 17 articles published before January 1980. One hundred sixty articles were reviewed by 2 authors. Of those articles, 9 met our criteria and were therefore included within the review.

RESULTS: The patients' median age at the time that surgery was indicated was 56.6 ± 14.4 years. Three patients presented with an upper-limb amputation, and 24 presented with a lower-limb amputation. Of 27 patients who suffered from amputation-related pain and were treated with SCS, the total reduction in pain, found by combining all the scores, had a mean (SD) value of 60.1% (27.6). Among all the studies reviewed, one included the performance of a functional evaluation before and after surgery, using an improvement of the functional scale.

LIMITATIONS: The review contained no prospective controlled trials, and only a small number of articles could be included in the analysis.

CONCLUSIONS: Based on our review of the literature concerning the effectiveness of SCS as a PLP treatment, the procedure seems to be a favorable option. Stimulation also appears to have a role to play in somatosensory feedback.

PMID:42804302