My phantom pain journey began in 1972 when I experienced a transfemorral amputation to "treat" bone cancer. As a scientist, I read papers and experiment on myself.
Early on, I stepped down from IV morphine to codeine (in hospital) which I continued to use to address phantom pain, but my family doc decided after a few months that I was in jeopardy of becoming dependent on it and tapered me off of codeine onto valium. I think he astutely realized that I was treating my mortal dread as much as pain with the codeine.
Over the years, the frequency of PhP gradually decreased, but it can resurface at any time. I think distraction plays a role in training the brain to filter the signals out. I was busy with college, then career and family, so I had plenty of distraction. I had severe bouts of PhP strike suddenly and relentlessly a few weeks after the birth of each of my children. No-one had any idea why of course, but I attributed it to pressure aggravation of nerves upstream of the severed nerves. It subsided each time.
After decades, it has become rarer and rarer for PhP to begin when I am awake and focussed (unless it is brought to mind for some other reason). Eventually even that has become a rare occurrence, and almost always awakening me from a sound sleep, or hitting me just as I am relaxed and dozing off. I figure my brain gets lazy and neglects the "disregard" filter.
My experience with opioids has been that they do not help my phantom pain at all, unless they are so strong that they render me almost senseless. Even then, if my attention turns to the PhP, its intensity seems barely diminished. I do find them very effective, for me, for acute post-surgical pain.
What does help me is ibuprofen. I have found that a prescription strength dose of OTC ibuprofen takes the edge off, and I can then distract myself and sometimes even fall back asleep after an hour or so. The most important thing is to hit it early, before it has a chance to really take over. I gauge the dose based on my experience of the intensity with which PhP initially hits. If necessary, I will take up to 800 mg/ 6 hours (with my doc's okay). Sometimes I only need 400 mg. I only need a second dose maybe a third of the time, and almost never a third dose. Sensory distraction also sometimes helps: a very hot bath, a massage, a barrage of swear words. (My husband is a very understanding guy.) There are just some terrible nights, but at this point, usually only one every month or three, on average.
I haven't found any relief in CBD oil, or TENS, but I am experimenting with a roll-on topical called PK-5, which I think may have helped some. "More research is needed".
It does help me to remember that, even if it's making me scream, it is "just pain", not injury.
I'm interested in the experience of others.