Methadone for phantom limb pain

Objective: The objective of this case series was to determine if severe phantom limb pain could be reduced with oral methadone. Design: Four cases of phantom limb pain refractory to multiple treatment modalities were treated with oral methadone. Setting: Pain clinic at a major university medical center. Patients: Four patients with severe, intractable phantom limb pain. Intervention: Oral methadone was administered, starting with a low dose of 2 to 5 mg twice a day or three times a day and slowly titrated upward to achieve pain relief. Outcome Measures: Repeated administration of a visual analog scale for pain. Results and Conclusions: Administration of oral methadone may be of value in the treatment of phantom limb pain; controlled clinical trials would be appropriate to verify this observation.