Helping Phantom Limb Pain Essay

The surgery being performed on your son consists of a few different procedures. First, what we did was to identify the muscles, blood vessels and nerves in both the arm and the stump. Then Dr. Ramos will trim the wound, and insert the supporting plate. This is what is holding your son’s arm in place, and also made reattachment possible. Before we did this, he had to trim the bone, which will make the right arm one inch shorter then the left arm. With the supporting plate in place, we will then be able to reattach everything else. The only bad news is that unfortunately Jim will never regain entire use of his right arm. Although all the vessels and muscles are connected properly the nervous system is too damaged to send messages to the brain. Because of this, recovering movement capabilities will be a slow process. Although with practice and physical therapy, Jim will slowly regain function and strength.

3. What organ system was most likely not reattached? Explain. Nervous system, it will never be the same again.

6. The reattached nerves would not recover as quickly and completely as the reattached muscles after Jim’s surgery because the body will repair itself by regenerating the muscles. Theses regenerating nerve muscles will automatically grow down the nerve and restore muscle by supplying it with nerves through regrowth. If they connect correctly the motor nerve to muscle and sensory nerve to skin will recover. If they do not connect correctly, they will not completely

What is pain? If you ask someone to tell you the definition of pain they will typically state something that hurts. Registered nurses should know the definition of pain and how it can be identified on their patients. However, Abdalrahim, Majali, Stomberg, and Bergbom (2010) propose that nurses did not receive adequate education in pain management and suggest the lack of knowledge hinders their ability to adequate control their patients’ pain. Therefore, the unethical treatment of pain can be traced back nurses.

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,

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

Phantom Limb Pain (PLP) is a serious condition that occurs when a person who has lost a part of their body though amputation, trauma (brachial plexus), or loss of nervous connections in an appendage, perceives that the limb is still there and experiences sensations coming from this area. It was first described in 1866 by S. Weir Mitchell, an American neurologist, through a short story published in Atlantic Monthly. While Mitchell may then have wondered if this was specific to wounded Civil War soldiers, it has since been established as quite common (1). Over 70% of amputees report phantom limb pain for years after amputation (2). Several theories have been proposed regarding PLP, although there is still much to be

To prevent the risk of developing phantom limb pain, doctors suggest the use of regional anesthesia through spinal or epidural few hours or days leading to the amputation. By doing this procedure, it might help to reduce the pain before the surgery hence reducing the risk of lasting phantom limb pain. Most amputees that have phantom pain, often feels to them as if they’re stuck in their last action with that limb. The mirror clears and retained memories of limb position from the brain. It is also helps neurons start making new connections in the brain.

In the mix of the newly formed neural pathways are pathways that aren’t all accountable for pain transmission. These neurons sprout into the dorsal horn, an area that transfers nociceptive afferent inputs, causing central sensitization. Central sensitization is the expansion of neuronal fields and excitability in a certain region of the body. Different neurotransmitters like substance P, neurokinins, and tachykinins conciliate an increase of activity at receptors important for controlling synaptic plasticity, known as NMDA receptors. Following this is a change in firing patterns of central nociceptive neurons, known as the “windup affect.” According to Jenson Nikolajsen (2001), stump or phantom pain in human amputees can be evoked by monotonous stimulation at the location of the stump. The “windup phenomenon” may cause a decrease in the intersegmental inhibitory devices at the level of the spinal cord. This results in spinal disinhibition and nociceptive inputs extending to supra spinal areas. (Subedi & Grossberg, 2011, pg. 2). This may be another potential cause for phantom limb pain due to the absence of afferent involvement and deviations at the level of the spinal cord (Subedi & Grossberg, 2011, pg.

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.

The areas of the brain associated with the “pain matrix,” the right posterior insula and the primary somatosensory cortex, showed a significant increase in activation in response to the control condition during the painful pin prick stimulus compared to no painful stimulus. There was also a significant increase in activation of the right posterior middle temporal gyrus, the middle frontal gyrus, the left supramarginal gyrus, and the precentral gyrus. A portion of the posterior insula was significantly activated during the hypnotic hypoalgesia condition with the painful prick stimuli. The painful prick stimulation in the hypnotic hyperalgesia condition showed an increase in the activation of the inferior parietal lobule, the precentral gyrus, and the posterior insula (Abrahamsen et al., 2010).

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