A new study led by ¿ì²¥ÊÓƵ researchers is shedding light on a little‑understood experience reported by many people living with limb loss: phantom limb telescoping.
For people with limb loss, phantom pain and discomfort in the remaining part of the body – sensations that seem to originate from a missing or altered limb – have long captured clinical and research attention.
New work by Andrea Aternali, a doctoral researcher in the Faculty of Health, Heather Lumsden-Ruegg, master’s researcher, and Department of Psychology Professor Joel Katz, is advancing understanding of this phenomenon.
"Despite decades of research on phantom limb phenomena, telescoping has been largely overlooked," says Aternali.
Phantom limb telescoping occurs when someone perceives their absent limb as slowly shortening or pulling inward toward the residual limb, the part that remains after amputation. While many people report the sensation, researchers still know relatively little about how it relates to pain or interacts with emotional factors such as anxiety, depression, resilience or coping. Addressing those gaps, Aternali explains, can help clarify whether telescoping reflects distress, adaptation or a mixture of both and lead to support for the marginalization experienced by individuals.
"We hoped that by understanding a sensation like telescoping, new ways might be found to help this community," she says.
Aternali and her team conducted a study – now published in – involving 51 adults with upper or lower limb loss. Using a custom web-based tool, participants indicated whether they experienced telescoping, among other factors. They also completed standardized questionnaires assessing pain, emotional well‑being and coping styles.
Nearly half of participants reported the phenomenon, suggesting it may be more common than previously thought. Younger adults and those with upper‑body amputations – particularly right-sided, below‑elbow – were more likely to describe it.
The data also revealed that those who felt a more telescope phantom (a shorter phantom limb) reported lower levels of phantom pain and less interference with daily activities. At the same time, they described higher levels of anxiety and depression than those who did not experience the sensation.
For Aternali, the findings indicate that telescoping may, in some cases, reflect the brain’s natural adjustment to limb loss rather than something driven only by distress or pain. The results point to a more nuanced picture in which the sensation may arise from a complex interaction between emotional factors and neural adaptation. That insight could inform more individualized approaches to care for people adjusting to life after amputation.
The researchers note that more work is needed to fully understand how telescoping develops. Studies following individuals over time, using brain imaging and testing targeted interventions – such as virtual‑reality treatments or psychological therapies – could offer deeper insight. Larger and more diverse samples, along with qualitative interviews, may also help illuminate how people make sense of the sensation in their daily lives.
Aternali, Lumsden‑Ruegg and Katz hope their findings will highlight the importance of supporting both the physical and psychological aspects of recovery. They suggest clinicians should routinely screen for anxiety and depression in patients who report telescoping and consider offering tailored psychological support when needed. Doing so, they believe, could help ensure that care reflects the full spectrum of experiences that shape life after limb loss.
"We hope this research informs future treatments for phantom limb pain," Aternali says. "By highlighting the link between telescoping, anxiety and depression, we aim to encourage holistic care supporting both physical and emotional well-being."