Phantom Limb Pain

The first article named “Phantom Limb Syndrome” has defined the phantom limb syndrome as the perception of the sensations on the amputated limb. In the article it was mentioned that the brain still receive messages from removed limb through the nerves. This article has also mentioned that the exact cause of the syndrome is unknown. In the article it was mentioned that “sensations are due to the brain’s attempt to reorganize sensory information following the amputation. The brain must essentially rewire itself to adjust to the changes in the body” (Scheinberg, 2015). The article points out that the adult are more likely to suffer from phantom limb syndrome than children. The article also mentioned that there are various risk factors which increase the risk of developing the phantom limb syndrome can be the pre-amputation pain, infection, damage on the spinal cord or nerves that supplied to the affected limb, blood clot on the amputated limb, etc.

Over the years scientists have noted many complaints of a strange form of pain called phantom limb pain. This pain is strange because it is located in an appendage that no longer exists. By many of the amputees the pain is described as totally unbearable. Phantom limb pain has even driven some victims crazy. For the amputee population this is a very real problem that definitely needs to be solved.

As a PTA I have been given a breath of knowledge in regard to the profession of physical therapy. However, I am not satisfied with this breath of knowledge. I yearn for the opportunity to gain a further understanding in terms of “how and why” physical therapy is successful at restoring function to individuals seeking

History: She has had problems with joints for many years, getting gradually worse. She had her right hip replaced in the last few years and has been left with chronic lateral hip pain and has been told she has a trochanteric bursitis. The latter was injected with good result, however, the response was only a few weeks. She complains of pain in her shoulders, hands, knees, and feet. Her jaw gets sore, more on the right. Her joints ache all the time, especially at night and often keep her awake.

The author starts off by recalling his personal experiences with phantom limbs. A young boy had a phantom limb phenomenon. The term phantom limb was first used by Silas Weir Mitchell in 1872. Phantom limb seems to occur because of the images created by the images of the body and makes the person always believe that it is all there even after an amputation. The body is basically trying to make sense of the amputation. It is not actually caused by incorrect neural activity. It is actually more built from the part of the brain that creates the mental image of the body. Turns out on 90 percent of amputee actually have a phantom limb experience. Researchers have tried to treat phantom limb with the mirrors and Virtual Reality.

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,

Of particular interest are returning combat veterans, which account for 1,645 limb amputations of which, 486 are multiple amputations (Congressional Research Service, 2015). With this rising prevalence of amputees and PLP come many treatment options and it is a Physician Assistants’ duty to know the most effective treatment plan based on his or her patients’ specific needs and conditions. The most common of these treatments for PLP include preemptive anesthesia, pharmacotherapy, and mirror

This summary for the final paper will discuss phantom limb pain, including the psychological and physiological causes, effects and the treatment options for phantom limb pain. When a limb is lost whether to traumatic amputation, disease, surgical amputation, or a congenital defect the amputee may experience sensations that the affected limb is still present. Some of the most common sensations that an amputee can experience are tingling, throbbing, piercing, pins and needles, resulting in what is perceived as pain in the missing limb. The exact causes of the phantom limb pain that many amputees experience is still relatively unknown, however, there are three main theories that are seek to explain the sensation of pain in the missing limb/limbs.

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

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.

Phantom limb pain occurs in an arm or leg following an amputation. It is pain in an extremity that no longer exists. This pain varies with different patients. Different activities may cause the pain. Some people with an amputated limb experience the opposite of phantom pain, which is phantom pleasure.

These studies found that these alternative methods did help to improve strength and function of these patients, but none of the studies had significant data to definitively prove this. While the data from these studies are not significant, it does not mean that they are entirely unimportant. Most of the researchers from these studies sent out follow up questionnaires about the enjoyment of the rehabilitation styles. All of the studies that did these questionnaires found that the participants had much greater levels of enjoyment and motivation while completing their from of rehab. This shows that while these alternative methods of hemiplegia rehabilitation might not be entirely effective on their own, they can serve a purpose when combined with traditional physical therapy methods. Physical therapist can utilize video games like the Wii or virtual reality software for patients that do not respond to or do not have proper motivation for traditional rehabilitation methods. This can help the physical therapist tremendously so they will have a tool at their disposal to help increase the motivation of the harder to work with patients. While the studies were performed well, they did have a number of limitations that hindered the research. Many of the studies, all besides one, had less than 50 participants, which leaves very little room for participant or conductor error. These small sample sizes also allow for outliers to throw off the data tremendously, as compared to if the study had a larger sample size. Another limitation that most of these studies had was that there were often a greater number of males to females. While this may not seem detrimental to these studies, it does provide doubt about the accuracy because of the differences between males and females, which may have skewed the data in a

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.

A therapeutic approach that has the potential to temporarily resolve the visuo-proprioceptive dissociation described in phantom limb pain is mirror therapy.(4) Mirror therapy was exposed by Ramachandran and Rogers-Ramachandran in 1996.(3) When doing mirror therapy, a patient is allowed to feel the imaginary movement of the amputated limb as normal body movement through a mirror by moving their intact limb while watching the reflection in a mirror. This induces the illusory perception of movement of their phantom limb. (3) (4) (6) The mirror image of the normal limb is believed to help reorganize and integrate the difference between proprioception and visual feedback and representations of the amputated limb, thus enhancing the treatment effect for phantom limb pain through the illusion or imagery of movement of the