- Disabilities & the Disabled
Phantom Pain: What it means to hurt in an invisible space.
Phantom Pain Defined
When patients feel pain coming from a body part that no longer exists, they are experiencing phantom pain. Most of the time phantom pain is felt in a lost limb such as an arm or a leg, but this disorder can occur in the removal an appendage. For example, patients have reported the experience of phantom pain after the surgical removal of the breast, the eyes, the the tongue. 
What Causes Phantom Pain?
While many patients will experience the sensation of a phantom limb, not all patients will experience phantom limb pain. Phantom pain is classified neuropathic disorder, or a disease that targets the the brain, the spinal cord, and/or the nerves that connect the body and organs to those structures. It is possible that phantom limb pain is caused by damage of the central or peripheral neurons. Neuron's are specialized cells within the nervous system that are responsible for relaying information.
The sensory motor incongruence theory  suggests that the pain caused by a phantom limb is the result of a miscommunication between the mind's intention for the limb, and the actual movement of the limb. In other words, the neurons are not relaying pain signals correctly from the brain to the lost appendage.
Patient Uses Mirror Box to Relieve Phantom Pain
Characteristics of Phantom Pain
Phantom pain usually occurs within the first few days after an amputation has been performed, and can either be acute (quick onset short duration) or become chronic (slow oncoming, progressive). Phantom pain typically affects the part of the limb that is furthest from the body, such as the hand or fingers of an amputated arm. Patients often describe their phantom pain as tingling, shooting, stabbing, burning, throbbing, boring, and squeezing. Patients also describe their phantom limb as being twisted or distorted in an uncomfortable position . Thirty percent of patients have reported a symptom known as telescoping, or the retraction of the phantom limb toward the actual limb, and it is associated with a higher severity of phantom limb pain .
Minimally Invasive Therapies
Antidepressants are used to relieve pain caused by damaged nerves.
Injections: pain killers, local anesthetics, or steroids into the stump.
Transcutaneous Electrical Nerve Stimulation (TRENS), is a nerve stimulation technique to disrupt pain signals on the surface of the skin near the stump site.
Brain Stimulation: The surgeon places electrodes around the motor cortex.
Anticonvulsants, or epileptic drugs, are used to treat nerve pain by silencing damaged nerves so that inappropriate pain signals are either prevented or slowed.
Spinal Cord Stimulation: tiny electrodes are inserted along the patients spinal cord and a small electrical current is passed through to the spinal chord to relieve pain.
Acupuncture is used to stimulate the central nervous system and release endorphins to naturally relieve the pain.
Neurectomy (stump revision): Phantom pain may be caused by nerve irritation. A surgical option is to cut the nerves in attempts to eliminate the nerve irritation.
Narcotics may be used to help control phantom pain.
Nerve Block: medications used to disrupt the signal between the brain and pain receptors at the stump site.
Mirror Box: This is a device that uses mirrors to make an amputated limb appear whole to the patient. The patient performs symmetrical exercises with the phantom limb which my trick the brain and relieve pain.
N-methyl-d-aspartate (NMDA) receptor antagonists, are effective because they block the protein glutamate which is responsible for relaying nerve signals.
Phantom-Limb Pain: Characteristics, Causes, and Treatment
Do you, or someone you know, suffer from phantom limb pain?
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2) Flor, H. (2002). Phantom-limb pain: Characteristics, Causes, and treatments. The Lancet NEUROLOGY, 182-188.
3) Journals, O. (2005). Sensory–motor incongruence and reports of ‘pain’. Rheumatology, 1083-1085.
4) Staff, T. M. (2014, Dec. 3). Mayo Clinic. Retrieved from www.mayoclinic.org: http://www.mayoclinic.org/diseases-conditions/phantom-pain/basics/definition/con-20023268