Phantom pain is a phenomenon where individuals perceive pain in body parts that have been amputated or removed due to injury. It usually involves limbs that are no longer there but can affect various body parts like eyes, teeth, nose, tongue, breasts, penis, or even sections of the intestinal tract. This condition occurs post-amputation or injury and it highlights the complex nature of the brain's perception of physical sensations.

Phantom pain feels like a tingling, throbbing or burning pain. The duration of phantom pain can differ among infected. It can last from seconds to minutes, to days or  months. Usually, phantom pain diminishes in both frequency and intensity during the initial six months, but for many individuals, it can last for years. Many individuals hesitate to share their experiences for fear that they might be considered ‘crazy’. However, it's important to talk about the sensations early to find relief as soon as possible.

Vilayanur Subramanian Ramachandran, an Indian-American neuroscientist, conducted experiments on phantom pain, where he used a mirror to create the illusion of a missing limb. This helped some patients alleviate their phantom pain by retraining the brain's perception of the missing limb.

These experiments aim to explore how the brain processes pain signals in the absence of the amputated limb, helping improve pain management strategies for those experiencing phantom pain. Also, this proves that pain exists in reality and is not psychogenic pain.

 

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What Causes Phantom Pain?

According to a 2013 research by the University of Oxford, changes in the brain following amputation have been linked to pain arising from the missing limb, called "phantom pain”.

The actual cause of phantom pain is not entirely clear, but it is believed to be linked to nerve damage and central sensitisation. When a body part is removed, in most cases peripheral nerves get damaged. This might lead to irritation and overexcitement of nerve endings, which could be causing spontaneous sensations.

Also, central sensitisation can occur as damaged peripheral nerves connect to the spinal cord. This results in increased neural activity and sensitivity, and ultimately leading to phantom pain. Another factor is brain remapping, where sensations from the removed body part are redirected to another area, causing pain in the absent body part when surrounding nerves are stimulated.

In some cases, the reason behind phantom pain could be psychological factors like depression, anxiety, and increased stress, can also play a role in triggering or contributing to phantom pain. Understanding these factors helps tailor effective treatments for individuals experiencing phantom pain.

 

Treatment of Phantom Pain

The treatment of phantom pain varies, and it can be managed through different approaches. In some cases, medications alone may be effective, while in others, a combination of medications and therapies may be recommended. Additionally, there are instances where only therapies, such as mirror therapy, acupuncture, massage, or biofeedback, are utilised to address and alleviate phantom pain.

 

Medical treatment 

Treatment for phantom pain often involves medications aimed at managing the discomfort. Tricyclic antidepressants are commonly prescribed, along with opioids and nonsteroidal anti-inflammatory drugs. These medications help address the neural aspects of phantom pain and alleviate sensations associated with the condition.
In addition to these, anticonvulsants and NMDA receptor antagonists may also be part of the treatment plan. However, it is important to take medications under the doctor’s supervision only.

 

Mirror therapy

Mirror therapy can be beneficial for specific types of phantom pain, such as phantom limb pain. It involves using a mirror box to reflect the image of the intact limb onto the side where the amputation occurred. This optical illusion tricks the brain into perceiving movement and sensations in the missing limb, helping reduce phantom pain by promoting a more normalised sensory experience.

 

Biofeedback 

This method involves using electronic monitoring to provide individuals with real-time information about physiological processes, such as muscle activity or skin temperature. By gaining awareness and control over these processes, individuals may learn to regulate their body's responses and potentially reduce phantom pain.

 

Acupuncture 

Acupuncture is considered as a complementary therapy for managing phantom pain. This traditional Chinese practice involves inserting thin needles into specific points on the body to stimulate energy flow. While research on acupuncture for phantom pain is limited, some individuals report relief from symptoms. However, It's advised to consult with healthcare professionals to determine if acupuncture could be a suitable option to manage your phantom pain.

 

Massage

While it may not directly address the neural aspects, massage can promote relaxation, improve circulation, and ease muscle tension, contributing to an overall sense of well-being. Incorporating massage into a comprehensive treatment plan as a complementary treatment for phantom pain may offer additional comfort and support in some cases by relaxing tensed muscles.

 

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