Phantom Limb Pain Summary

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

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.

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,

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.

Furthermore phantom limb pain is simply a sensation of pain. A patient experiences the pain in an affected extremity that no longer exists (McCance & Huether). Although nerve fibers have the capability to regenerate this is a time consuming process that does not always yield a fully functional nerve (Subedi & Grossberg, 2011).

When they mean dead men can’t tell any tales they mean as in the can’t talk to anyone. The dead people can’t verbally talk to anyone, because their dead. Dead people can not just wake and start talking about things, it’s just not possible. They might not be able to talk, but there bodies can show what happened. Like in the story “Case Study: The Case of the Missing Leg” (page 12/28 in forensic anthropology article Identifying the Victim) it states that both of the legs they had found that were blown off from the explosion, they were both women but one was white and one was black. Then they found out a little later then when they buried the legs to the people they buried it to the wrong person. They really found out a lot more about the women

“Losing a leg was like having to learn how to suck in air through the pores of my skin. Somehow I survived, but each breath was painful” (Draanen 157). Jessica, from Wendelin Van Draanen’s The Running Dream, loved to run. Which is why when she lost her leg she described it as stated above, like learning how to take in air through her skin. Her leg was a part of her, something she loved to use, and when it was gone she felt off balance, both metaphorically and actually. I felt this way when someone very close to me died. His name was Zackary, or Zack for short, and he was my cat. When he died of a thickened heart wall and a thrombus collapse at the age of 1 and a half, I felt as if I had lost something vital to me. A body part that was necessary

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.

This is a situation that many of us have experienced before. I know as a tele nurse I have many times. A patient that was admitted to our unit yesterday was assigned to us. They came to the hospital with heart failure and now they are having chest pain. Pain rating is subjective. We must take into consideration factors that affect the patients physiologic, psychologic, sociocultural, emotional and behavioral state. My assessment of this patient happens as soon as I walk into the room. I would notice the patients behavior. Does the patient appear in pain (crying, holding chest, grimacing)? Are they short of breath, diaphoretic? I would ask the patient to rate his pain using a face pain scale from 1 – 10. Utilization of the acronym OLD CART

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

The phenomenon of phantom limb pain (PLP) in patients with amputations has always fascinated healthcare professionals. Although this condition is relatively easy to diagnose, the pathophysiology of PLP remains unclear. It is estimated that greater than 80% of patients with a partial or total loss of a limb develop phantom limb pain, which is a type of neuropathic pain that is perceived in the location of the amputated limb. 1 Studies have shown that up to 75% of patients develop pain within the first few days after amputation, however PLP can occur months or even years later. 2-4 It is primarily localized in the distal parts of the missing limb.5 Risk factors for PLP include gender (more common in women), presence of pre-amputation pain,

More than two thirds of amputees develop phantom limb pain (PLP). For this reason, there is much needed research to find an effective way to relieve this type of pain. Unlike any other pain such as nociceptive pain, phantom pain is tricky to treat with medication. There are other studies that have been done using mirror therapy and showed its significances in reducing phantom pain. However, there seem to be lack of research in the comparison in the effectivity of pain reduction with using pharmaceuticals versus mirror therapy. The purpose is the compare the two types of pain reducers and find their effectivity. The study is a randomized control trail that will be conducted at an outpatient facility. There will be 60 subjects who

Phantom limb syndrome is an extraordinary condition that is caused by amputating a limb or being born without a limb (Flor, 2002); This condition affects approximately 80% to 90% of patients who have had a limb amputated (Flor, 2002). The first documented case of phantom limb syndrome was in the mid 16th century (Nikolajsen & Jensen, 2001). The description was given by a French military surgeon by the name of Ambroise Paré (1510–1590) when he noticed that some of his injured patients would express that they were experiencing extreme pain in their missing limb (Nikolajsen & Jensen, 2001). He studied and wrote down the characterizations of this post-amputation state and attempted to create different models to explain how the phantom pain was

Telescoping, or shortening, of the phantom limb occurred in more than one fifth of participants, and was shown to be disproportionally more likely in cases involving traumatic limb loss, cancer-related amputation, and brachial plexus avulsion, or the tearing of the nerves that join the arm and shoulder (Teixeira et al., 2015), occurring roughly forty percent of the time in each of these cases (Giummarra et al., 2010). The likelihood of experiencing telescoping of the phantom limb was much greater amongst upper limb amputees, with more than two thirds reporting such sensations, than amongst lower limb amputees, at roughly one in five (Giummarra et al., 2010). The study revealed no correlation between the time since amputation and the frequency of phantom limb sensation perceptions(Giummarra et al., 2010). Eighty percent of respondents reported a normal or habitual positioning of their phantom limb, compared to twelve percent reporting abnormal or impossible positioning, with the latter twelve percent being comprised of mostly traumatic amputees (Giummarra et al., 2010). A more proximal location of amputation was also shown to be more likely to result in abnormal positioning perception than was a more distal amputation location (Giummarra et al., 2010). About 15% of amputees reported that the more distal portion of their phantom limb seemed to be floating or

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