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.