Amputated Limb

Gertler clarifies that pain refers to the sensation and not the common cause, which is C-fibers firing in a specific area with tissue damage. (109) She asserts that pain is not essentially connected to tissue damage of a particular location, indicating to me inadequate understanding of the concept. If one pinches one's arm, though the sensation of pain may not be necessarily located in the arm, I contend that the pain felt is relevantly connected to the location pinched. Gertler provides the alleviating effect of painkillers as an example of a non-essential feature of pain. (117) Location is unlike this property, however, and is essential in conceptualizing pain. For instance, even an amputee, who had a leg removed and experiences a phantom leg-pain, is unable to describe the sensation they feel without making reference to a specific body part. Whether or not the pain is actually “located” anywhere is irrelevant, it matters only that the pain is conceptualized as having a location. Our understanding of pain relies fundamentally on where the pain is thought to be “located.” The fact that it is impossible to conceive of pain without reference to the “location” of the sensation proves that location is an essential feature of

When a body part is lost the corresponding part of the brain is not able to handle the loss and rewires its circuitry to make up for the signals it was no longer receiving from the missing digit. The rewiring might occur in one of two ways. Perhaps nerve impulses in the sensory cortex begin to course down previously untraveled pathways. The second theory is that neighboring neurons in the cortex may actually invade the territory left fallow because sensations are no longer received from the missing limb.

Pain perception can be less than might be expected from the extent of a physical injury. This was proven by a scientist called Susana Bantick, Oxford University, and colleagues who carried out a study on the influence of attention distracting pain processing (Bantick et al, 2002). During the experiment, brain processing was measured by measuring brain activity using fMRI. Participants rated pain from 1-10 when noxious heat stimulus was applied to their hand in the scanner. She then followed the same process but gave them a task which required cognitive processing; reducing the amount of focused attention on pain. Bantick, therefore, showed attention distraction can reduce the amount of pain perceived by the individual, also pain processing to the brain was reduced. This provides vital evidence that pain perception does not just depend on the injury alone.

The phantom limb pain the woman is experiencing is described as a painful condition of the amputated limb after the stump has completely healed. It is a chronic pain that occurs in more than 80% of amputees especially those who suffered pain in the limb before the amputation. Theories suggest that phantom limb pain results from redevelopment or hyperactivity of cut peripheral nerves, scar tissue or neuroma formation in the cut peripheral nerves, spinal cord deafferentation, and alterations in the thalamus and cortex. More so, the CNS integration, which involves reorganization and plastic modifications of the somatosensory cortex, effects the receptors in perceiving the pain of the amputated limb despite of the limb itself being absent. In addition,

What does it feel like to have a missing/paralyzed limb? I'm sure this question has popped into many of our heads at one point in time. You would think that the sensations and feelings from that limb would disappear altogether. However, for some people, they can still feel the presence of their limb even after it is gone. There is no clear answer as to why this happens, but one thing is for certain. A large percentage of people with phantom limbs will sometimes feel pain from that missing limb. There is nothing happening to the individual physically that would cause them to feel pain from their phantom limb. What is actually happening is that the nerves that are located at the area of amputation (the "stump") are sending signals to the brain, which tricks the brain into believing that the missing limb is still there. It is hypothesized that the brain may also interpret these signals as pain. I found this to be an interesting topic, as it gives a good example as to how our brains and nervous systems work when interpreting changes in the body.

Despite an almost electromyographically silent thigh, the brain was activated during the command for movements. This assured that the signals surged by the amputee demonstrated the substantial efforts resulting the alteration of oxygenated hemoglobin. Brodmann's areas 4 and 6 send orders to the limb that is nonexistent. Phantom limb pain is not just a phenomenon associated with a stump. The brain has not been damaged, and its areas of command and perception are still intact and in use. Also, fitting prosthesis immediately after amputation while the patient is still under anesthesia and then continuously beginning vibratory stimulus training may permit the preservation of perception in the sensory cortex and become an important factor in avoiding pain. The lower limb, although artificial is still sensed as "being

When someone goes to move their hand to pick up an object many parts of the brain become activated. The cerebrum, relates to motor movement and when it is activated chemical messages begin getting sent all over the brain. The parietal lobe, which is in fact in charge of motor movement, becomes aware and prepares the brain to get ready for the action, this is a normal process occurs in humans. The problem is that this same process is happening to patients who have missing limbs. They feel as though they are reaching out to grab an object but the amputated part cannot reach for the object (Ramachandran 45). It seems as though these “phantom limbs” are still receiving signals from the brain to conduct these actions. “Sensory input from the face and upper arm activates brain areas that correspond to the “hand”

When a person loses a limb, it is never a clean cut; whether it be the remnants of gore from the cut, the trauma of the loss, or the non-physical remnant of the limb itself, known as Phantom Limb Syndrome. Despite effecting 80% of all amputees, the sensation itself continues to mystify neuroscientists and is not yet fully understood. The most popularized type of phantom are the painful ones, seeing as it affects 50-80% of amputees regardless of whether their amputation was traumatic or done in a hospital for their health, but phantom limbs are not all painful and can come in many shapes, sizes, and types of sensations. (873)

For my final paper topic, I have chosen to discuss phantom limb pain. I was inspired to write about phantom limb pain after a recent visit to the Veterans Affairs hospital. I will be explaining the physiological aspects, including involvements of nerves, spinal cord, and the brain, as well as the psychological aspects, including grief, stress, depression and anxiety of phantom limb pain. According to Goldstein (2010), phantom limb pain is a phenomenon that a person whose limb has been amputated continues to experience the sensation of the limb (p.344). Along with the sensation of the amputated limb, patients can also experience pain, tingling, numbness, and temperature changes. People who were born without a limb can also experience phantom

Further studies in 1998 investigating the re-mapping component in the brain were conducted by researchers at the University of Toronto and The Toronto Hospital. The study recruited amputees who experienced phantom pain for surgery to map the sensory areas in the brain. During the mapping process, the conscious patients reported sensations they felt when certain areas of the thalamus were stimulated. Patients reported phantom sensations when areas of the thalamus were stimulated that formally were innervated by neurons from the missing arm, and also when areas on the stump were stimulated that activated these reorganized regions in the brain. Neurons were shown to continue to carry out their original roles, but with different sources of activation (7).

The earliest hypothesis regarding the cause of phantom limbs and pain was that of neuromas. These were thought to be nodules comprised of remaining nerves located at the end of the stump. These neuromas presumably continued to generate impulses that traveled up the spinal cord to portions of the thalamus and somatosensory domains of the cortex. As a result, treatment involved cutting the nerves just above the neuroma in an attempt to interrupt signaling at each somatosensory level (5). This and other related theories were deemed unsatisfactory because of the fact the phantom pain always returned, indicating that there was a more complex reason.

Prosthetic limbs have been around for centuries, but what is one thing they all have in common? They have all been a nuisance. In recent years technology of the modern day Prosthesis has ventured to new heights, but they have not perfected an artificial limb yet. With the amount of people in need of prosthetic limbs, the demand for a perfect prosthesis is tremendous. The perfect prosthesis shouldn’t feel or even look like an artificial limb. Prosthetics should go unnoticed throughout the rest of the amputee’s life.

Sacks discussed the ideas behind the phantom limb and how they affected many peoples live. The most interesting story was about a sailor that accidentally cut off his index finger. For forty years he thought he would poke himself in the eye whenever he moved his hand to his face. One day he lost the feeling in his entire hand including his phantom finger and his problem was cured (Sacks 66-67). Up to 70 percent of amputees confirmed that they still feel or still thought a missing limb was there. They often feel that they can reach out and grab something. Some won't sleep in a certain way because they feel the missing limb between them and the mattress. The sensations felt stem from the activity of the sensory axons

An extensive matrix of neurons in the brain gives us the sense of our own bodies and body parts. Pain results when this matrix produces an abnormal pattern of activity, as a result of memories, emotions, expectations or signals from various brain centres and not just from signals from peripheral nerves. Because of the lack of sensory stimulation or a person’s efforts to move a nonexistent limb, abnormal patterns may arise, resulting in phantom pain.

Phantom limb pain is a painful sensation experienced in a body part which is no longer part of the body, often due to amputation.(3) Individuals also reported that tingling as well as various types of pain have occurred, and these sensations may eventually disappear or may persist as cramping, shooting, burning or crushing