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Most amputees complain of phantom pain. How is it possible for people to suffer pain from parts of the body that no longer exist? What is phantom pain and how is it treated?

Phantom painis a mystery of modern medicine. After amputating a leg, arm, but also the ear, breast or nose, patients report that they can still feel these parts of the body. This phenomenon is called phantom sensation and affects almost all amputees. It is based on the fact that a person still has the impression that a severed hand or leg exists. It is a kind of illusion - the word phantom can be translated as a ghost, a phantom. In the phantom, you can feel cold, heat, moisture, itching, as well as pressure and discomfort. You can feel the presence of a watch on a wrist that doesn't exist. Or warmth in phantom feet while basking by the fireplace. It happens that people suffering from phantom pain wake up at night because they are hurt by a badly placed phantom hand. Sometimes it is not only discomfort, but pain. Phantom pain is a rarer occurrence, affecting approximately 2-4 percent of amputee patients.

Phantom pain may only last for a while after surgery, e.g. several hours, days, months, until it finally disappears completely. They can also quiet down - even for a few years, and then come back, or appear only in the evenings and at night. Phantom pains also vary in severity - unfortunately most patients complain of pain, which is extremely troublesome and significantly reduces the quality of life. They describe it as: burning, crushing, giving the impression of electric shock. Where does he come from?

How does phantom pain arise?

Can you logically explain the mechanism of phantom pain?

The theory that there are areas in the brain responsible for specific body structures is somewhat contradicted by the fact that people who were born without any limb also suffer from phantom pain.

Neurology has several ideas about this. According to one of them, neuromas that develop at the intersection of nerves are responsible for phantom pain. They show pathological hyperactivity. Historically, in the treatment of phantom pain, pre-neuroma nerve transection was performed. It was supposed to prevent impulses from being transmitted to him. However, it only worked for a short time, because a new one was forming at the site of the intersection of the nerveneuroma.

Currently, there is a different theory. Rather, neuromas are responsible for the pain in the stump, which is why it is so important to carry out the surgery precisely, supply and treat the scar. On the other hand, the formation of phantom pain is largely explained by the existence of areas of the brain responsible for representing specific parts of the body. If a fragment is missing, chaos appears in the brain. Usually, the structures of the brain can be reorganized in a shorter or longer period of time. However, not always.

Is it possible to get rid of phantom pain?

The treatment of phantom pain is a great challenge for the doctor. It is important to look after the patient before surgery. He must be aware of the need for such a radical solution and that his life will change completely from now on. For example, he should come to terms with the fact that - at least for some time - he will be dependent on someone. Pain sensations depend on the general mental condition of a person, e.g. whether he is tired, experiences anxiety or has family support. Therefore, psychotherapy is very helpful here. Soon after surgery, the patient should also start intensive physical therapy. The point is that he should learn to function in a new situation as soon as possible and return to normal life. When it comes to pharmacotherapy, combination therapy, multi-drug therapy, is necessary because standard drugs usually do not bring relief to phantom pain. Non-steroidal anti-inflammatory drugs or weak opioids should be combined with co-analgesics. Strong painkillers - opioids - very good for cancer therapy, for example, in this case they do not work. Antidepressants, sometimes transcutaneous electrostimulation within the stump, also help with phantom pain.

Phantom Pain Treatment: Mirror Method

It turns out that very good results in treating phantom pain can be achieved by … looking in the mirror. It was first discovered by Professor Ramachandran from India. He positioned the mirror in such a way as to cover the patient's amputated limb and reflect the existing one. The mirror image of an arm or leg gives the illusion as if it was really the other limb. This creates an illusion that deceives the brain so effectively that it calms down - and the pain disappears, or at least significantly diminishes.

Important

Is it possible to induce phantom feeling without losing a limb?

Such experiments have been conducted. They consisted in the fact that the participant had, for example, a forearm tightened so as to stop the circulation for a few minutes. The entire arm was covered so that the test person would not see it. Then she was supposed to move her hand inspecific direction. It turned out that the respondents always felt that they had moved their hand while it was still in the same position.

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Neurology