Phantom limb pain after amputation can be frustrating, disruptive, and difficult to manage – especially when it continues long after the initial healing process. Residual limb pain can also affect comfort, sleep, mobility, prosthetic use, and everyday activities.

But persistent pain after an amputation doesn’t always have a single cause. At Westcoast Brace & Limb, we believe the first step is understanding where your pain may be coming from. Sometimes the answer may involve evaluating the fit and function of your prosthesis. For others with chronic post-amputation pain, it may be appropriate to explore additional treatment options.

That’s why Westcoast Brace & Limb is now offering screenings to help identify lower-limb amputees who may benefit from further evaluation for the Altius® Direct Electrical Nerve Stimulation System, an FDA-approved implanted treatment option for certain adults living with chronic phantom and residual limb pain.

For some lower-limb amputees, phantom or residual limb pain continues despite efforts to manage it.

When pain becomes chronic and difficult to manage, additional evaluation may be appropriate. One newer option available for certain adult lower-limb amputees is the Altius® Direct Electrical Nerve Stimulation System.

What Is Phantom Limb Pain?

Phantom limb pain is pain that feels as though it is coming from a limb or portion of a limb that is no longer present.

The sensation can vary from person to person and may feel like burning, aching, throbbing, stabbing, cramping, or shooting pain. For some, it occurs occasionally; for others, it can become persistent and interfere with daily life.

Phantom sensations aren’t necessarily painful. Phantom limb pain specifically refers to pain perceived in the amputated portion of the limb.

What Is Residual Limb Pain?

Residual limb pain is felt in the part of the limb that remains after an amputation.

There are many possible reasons someone may experience residual limb pain. This is one reason it’s important not to assume that persistent pain automatically requires a particular treatment.

For someone who uses a prosthesis, the prosthesis itself is one of the things that should be evaluated.

Could Your Prosthesis Be Contributing to Your Pain?

Before looking beyond the prosthesis, it’s important to make sure the device is fitting and functioning appropriately.

Changes can occur over time, even with a prosthesis that previously felt comfortable. Your residual limb can change in size or shape, your activity level can change, and the way you walk can evolve.

A prosthetic evaluation may look at factors such as:

  • Socket fit
  • Residual limb volume changes
  • Areas of excessive pressure
  • Alignment
  • Prosthetic components
  • Skin irritation or breakdown
  • Changes in gait or function

Sometimes the solution may start with the prosthesis.

An adjustment to your prosthesis or its fit may improve comfort and reduce pain.

At Westcoast Brace & Limb, that’s an important part of our screening process. Our goal isn’t simply to determine whether you might qualify for another treatment. It’s to help determine what may be contributing to your pain and what the appropriate next step may be.

When Persistent Pain May Require Another Approach

What Is the Altius® System?

Altius is an implanted neuromodulation device developed by Neuros Medical specifically for chronic post-amputation pain.

The FDA approved the Altius Direct Electrical Nerve Stimulation System in August 2024.

Its approved indication is as an aid in managing chronic, intractable phantom and residual lower-limb post-amputation pain in adult amputees.

Unlike treatments that address pain elsewhere in the nervous system, Altius delivers electrical stimulation to a targeted peripheral nerve in the amputated limb. The system is also patient-controlled, allowing the patient to initiate treatment when needed.

How Does Altius Work?

The Altius System includes an implanted pulse generator and one or two cuff electrodes. A cuff electrode is placed around the targeted nerve in the amputated leg and connected to the implanted pulse generator.

When treatment is activated, the system delivers high-frequency alternating-current electrical stimulation to the targeted nerve. Patients use an external controller to initiate therapy when needed. The goal is simple: stop the pain signal before it reaches the brain.

The system is implanted surgically, so determining whether someone may be an appropriate candidate requires evaluation by qualified medical professionals. The FDA also specifies that the system should not be used in people who are unable to operate it or who are unsuitable for Altius implant surgery.

Could You Be a Candidate for Altius?

Completing a screening does not mean that Altius is appropriate for you or that you are committing to treatment.

It is simply the first step in helping our team better understand your amputation, prosthesis, pain, and symptoms.

Westcoast Brace & Limb is working with local physician specialists to identify patients who may be candidates for further evaluation. If you’re still experiencing persistent phantom or residual limb pain following a lower-limb amputation, we can begin by looking at the complete picture—including your prosthesis.

Why Is the Altius System Different?

Several features distinguish Altius from other approaches to chronic post-amputation pain:

FDA-approved for chronic post-amputation pain. Altius is FDA-approved as an aid in managing chronic, intractable phantom and residual lower-limb post-amputation pain in adult amputees.

Targets a peripheral nerve. An implanted cuff electrode is positioned around the targeted nerve in the amputated leg, where the system delivers electrical stimulation.

Patient-controlled treatment. The patient uses a handheld controller to initiate treatment when needed.

Screening comes first. For Westcoast patients, the process begins by understanding the pain and evaluating the prosthesis—not by assuming one treatment is the answer.

How the Westcoast Brace & Limb Screening Process Works

1. Complete the Candidate Screening Questionnaire

Tell us about your amputation, your prosthesis, and the pain you’re experiencing. The questionnaire only takes a few minutes and helps our team better understand your symptoms.

2. Meet With the Westcoast Brace & Limb Team

We’ll review your responses, evaluate your prosthesis, and talk with you about the pain you’re experiencing.

Sometimes changes to prosthetic fit or function may improve comfort and reduce pain. If we believe additional medical evaluation may be appropriate, we’ll explain the next step and answer your questions.

3. If Appropriate, We'll Coordinate an Evaluation With One of Our Physician Partners

A physician will perform a more comprehensive evaluation and determine whether additional diagnostic testing may be appropriate, including whether a temporary diagnostic nerve block could help assess the source of the pain and potential treatment options.

4. Learn About Your Treatment Options

Based on the results of your evaluation and diagnostic testing, you may have an opportunity to meet with a surgeon to discuss the Altius System and whether it may be an appropriate treatment option for you.

There is no obligation to proceed at any point. The purpose of the process is to help determine an appropriate approach for managing your pain.

Take the First Step

If phantom limb pain or residual limb pain is still affecting your comfort, sleep, mobility, prosthetic use, or quality of life, it may be time to take another look at what’s causing it.

Start with Westcoast Brace & Limb’s short Candidate Screening Questionnaire. We’ll review your information, evaluate your prosthesis and symptoms, and help determine what the appropriate next step may be.

There is no obligation to pursue Altius treatment.

Frequently Asked Questions About Phantom Limb Pain After Amputation

Phantom limb pain is pain perceived in the portion of the limb that is no longer present. Residual limb pain occurs in the remaining portion of the limb after amputation. A person can experience one or both.

It can. Socket fit, residual-limb volume changes, pressure, alignment, components, skin problems, or changes in gait and function can contribute to discomfort. That’s why a prosthetic evaluation is an important part of WCBL’s screening process.

No. Altius is FDA-approved as an aid in managing chronic, intractable phantom and residual lower-limb post-amputation pain in adult amputees, but individual candidacy requires medical evaluation. Completing WCBL’s questionnaire is a screening step, not a determination that the device is appropriate for you.

Yes. The FDA approved the Altius Direct Electrical Nerve Stimulation System on August 26, 2024 for its specified indication.

Yes. The system includes an implanted pulse generator and cuff electrode placed around the targeted nerve. It also uses external components, including a patient controller and battery charger.

No. The questionnaire is intended to help the WCBL team better understand your symptoms and determine whether prosthetic changes or further medical evaluation may be appropriate. There is no obligation to proceed with Altius treatment.

Want to Learn More About the Altius® System?

Before completing the screening, patients who want additional information can review these resources directly from Neuros Medical:

> How the Altius System Works

> Altius Patient Stories