Phantom sensation is ubiquitous among persons who have had amputation;
however, if it develops into phantom pain, a thorough clinical invest
igation must ensue. We illustrate this with the case of a 49-year-old
woman, 14 years after traumatic amputation of her left 2nd through 5th
fingers, and 10 years after traumatic left transfemoral amputation. S
he had had phantom sensation in her absent fingers for pears and devel
oped progressive pain in her phantom fingers 3 months before presentat
ion. Nerve conduction study revealed a high-normal distal motor latenc
y of the left median nerve and a positive Bactrian test (sensitivity 8
7%). She was diagnosed with ''phantom'' carpal tunnel syndrome and tre
ated with a resting wrist splint, decreased weight bearing on the left
upper limb, and two corticosteroid carpal tunnel injections with mark
ed improvement. Clinicians should recognize that phantom pain may be r
eferred from a more proximal region and may be amenable to conservativ
e management. (C) 1997 by the American Congress of Rehabilitation Medi
cine and the American Academy of Physical Medicine and Rehabilitation.