Assessment #6

A Review of Current Theories and Treatments for Phantom Limb Pain

Vedika Bakre

ISM I

Mr. Walters

October 25, 2018

Collins, Kassondra L., et al. "A review of current theories and treatments for phantom limb pain." ​Journal

of Clinical Investigation​, vol. 128, no. 6, 2018, p. 2168+. ​Health & Wellness Resource Center​,

http://link.galegroup.com/apps/doc/A543610679/HWRC?u=j043905002&sid=HWRC&xid=fdc9

9270. Accessed 25 Oct. 2018.

Almost 50-80 percent of amputees can feel phantom limb pains soon after having their limb(s)

removed. Phantom limb pain is characterized by the intense episodes of pain through the missing limb

and is a debilitating condition that drastically hinders quality of life. Although, as aforementioned, 50-80

percent of amputees experience this horrible pain, the cause and treatment for these sensations is

unknown. It is known that amputations cause changes in the peripheral and central nervous systems

because of the severance of various nerves in the legs. This severance can lead to throbbing, stabbing,

electrical shock sensations, and even cramped/immobile limb sensations.

Something new that I learned while reading this article was the difference between phantom limb

sensation and phantom limb pain. PLS can be helpful to an amputee to get used to their prosthesis because

remembering the action will allow the amputee to more easily improve on balance and coordination. A

way to simulate phantom limb sensation is the rubber hand phenomenon. To achieve this effect, the

person’s own hand is hidden from view (typically under a table) while a rubber hand is placed in front of

their body. Both the rubber hand and actual hand are synchronously stroked with a brush, causing the
person to perceive the rubber hand as their own. The rubber hand is then hit with hammer, even though

the person is unharmed, they almost always flinch. This proves that the neuromatrix is extremely

malleable and is greatly affected by visual representations and somatosensory stimuli. There is obviously

no way that the participants can accurately experience the pain of PLP, the test represents the malleability

of the nervous system.

Studies have shown that people who experience pain prior to amputation have higher rates of

PLS. These studies find no evidence that preamputation pain plays a role in persistent PLP, on PLP

directly after surgery. For instance, on study of 58 patients undergoing an amputation showed that 72% of

people with preamputation pain experience PLP eight days after amputation, which then decreased to

65% at six months and 59% after two years. However, the location and characterization of the pain was

only similar to that experienced before amputation in 10% of patients.

Additionally, studies have shown that PLS isn’t the only contributor of PLP because if it was, it

should be possible to induce anesthesia into the limb and eliminate the experience of PLP. Even with the

injection of local anesthesia into the limp of amputees with PLP, it doesn’t lead to reduced PLP in all

instances. This is further proof that the amputation of the limb can cause a type of mental block as well.