A new clinical trial in Pittsburgh explores spinal cord stimulation as a non-opioid solution for people living with limb loss
For many people living with lower-limb amputation, phantom limb pain is a persistent and often debilitating reality. Traditional treatments, such as opioids and other pharmaceuticals, offer limited relief and carry significant risks. With clinical collaboration from UPMC, a new University of Pittsburgh-led research initiative is exploring a radically different approach: reducing pain by restoring sensation to the missing limb.
Led by Dr. Lee Fisher, associate professor of physical medicine and rehabilitation at Pitt’s Rehab Neural Engineering Labs, the team is launching a long-term clinical trial designed to evaluate a reduction in phantom limb pain using a fully implanted spinal cord stimulation system. The study is the first of its kind to directly test whether sensory feedback can reduce phantom pain — not just as a side effect, but as the primary goal.
“Pain is what drives people to seek care. If we can reduce it meaningfully, the sensory neuroprosthesis could become much more than a research tool,” says Dr. Fisher. “We’ve shown that sensory feedback can improve mobility. Now we’re asking: can it also relieve pain?”
The new trial builds on earlier research from Fisher’s lab, where participants used pressure sensors in a prosthetic foot that wirelessly connected to the implant. This real-time feedback allowed users to adjust stimulation while walking or standing — improving both mobility and confidence.
Now, the team is scaling that concept into a year-long clinical trial. In the first phase, researchers will use magnetic brain imaging to study how phantom limb pain affects brain activity in people with and without pain. In the second phase, six participants will receive the implanted system and use it daily for one year. Throughout the study, researchers will track pain levels, medication use and changes in brain representation of the missing limb.
This work reflects a strategic shift toward non-opioid pain management and aligns with UPMC’s mission to bring academic innovation into patient care. UPMC physiatrists, neurosurgeons and anesthesiologists will play key roles in implanting and evaluating the system.
“Pain relief is what motivates patients to undergo surgery—not just better prosthetic control,” Fisher says. “If we can show that this device meaningfully reduces pain, it could be a game-changer for clinical adoption.”
The trial is designed with accessibility and scalability in mind. Remote data collection and reduced lab visits help minimize participant burden — an important step toward making the system viable for real-world use by people with limb loss across Pennsylvania and beyond.
From the Lab: A Conversation with Dr. Lee Fisher
Q: Why is phantom limb pain so hard to treat?
A: We don’t fully understand it. It may stem from the brain’s representation of the missing limb or from peripheral nerve activity. By restoring sensory feedback, we hope to address the root cause and not just mask the symptoms.
Dr. Lee Fisher
Q: What makes this study different from previous work in sensory restoration?
A: Most past studies of sensory neuroprosthetics, including ours, focused on improving prosthetic control or balance. Pain relief was a secondary outcome, often anecdotal. We took feedback from our participants to heart and designed a clinical trial that, to our knowledge, is the first to evaluate pain relief as the primary focus. This study also builds on our previous work but, rather than primarily performing experiments in the lab, participants will have the opportunity to use the system day after day in their homes and the community, allowing us to understand the ways their usage effects pain over time.
Q: How will this research help patients in the real world?
A: Phantom limb pain affects over 70% of people with lower-limb amputation, and studies show that nearly 30% rely on chronic opioid therapy to control their pain. If successful, this system could offer a non-opioid, long-term solution designed for daily use at home, which makes it much more accessible than lab-based interventions.
Q: Is this something UPMC patients could eventually access?
A: That’s the goal. If the trial shows strong results, it could lead to broader clinical adoption. We’re designing the study with scalability in mind — from surgical feasibility to remote monitoring.
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