Calcitonin in phantom limb pain

PLP is a challenging disorder that is often difficult to treat. Like all other types of pain, PLP is a tremendous source of morbidity and should be treated aggressively. Though evidence is very limited, one or two doses of intravenous salmon calcitonin 200 IU may be an effective treatment. The minor adverse effects reported in the literature would seem to indicate the relative safety of this regimen; however, clinicians should be aware of the rare but severe hypersensitivity reactions that can occur with salmon calcitonin. Intranasal calcitonin appears to be similar in efficacy to the parenteral formulation, at least in pain associated with vertebral crush fractures. Long-term studies using intranasal calcitonin for relief of PLP are warranted given the ease of administration of this dosage form.