Consensus of Chinese Painologist Experts on Diagnosis and Treatment of Phantom Limb Pain

Phantom limb pain (PLP), defined as neuropathic pain perceived in the missing portion of an amputated limb, represents a common and refractory condition significantly impairing patient rehabilitation and quality of life. Its pathogenesis is multifactorial, involving complex interactions between peripheral mechanisms (e.g., neuroma formation, ectopic discharges), central nervous system reorganization (including cortical remapping and spinal cord sensitization), and psychological components. Patients frequently present with heterogeneous pain descriptors, such as burning, shooting, or cramping sensations, which often coexist with residual limb pain, complicating clinical assessment. Despite the availability of diverse therapeutic interventions-ranging from pharmacotherapy (e.g., gabapentinoids, antidepressants, NMDA receptor antagonists) and physical modalities (e.g., transcranial magnetic stimulation, mirror therapy) to interventional procedures (e.g., nerve blocks, neuromodulation) and psychological approaches-treatment outcomes remain variable, and standardized clinical guidelines are lacking. This consensus, formulated by a panel of Chinese pain specialists, systematically reviews contemporary evidence on the epidemiology, pathophysiology, diagnosis, and management of PLP. It aims to establish practical, evidence-based recommendations to guide the standardized diagnosis and stratified treatment of PLP, thereby optimizing therapeutic efficacy and improving functional outcomes for affected individuals.