Phantom Pain Essay

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Phantom pain refers to the phenomenal experience of pain in a body part that has been amputated or deafferented (Flor, Nikolajsen & Jensen, 2006). The characteristics of phantom pain have been described to occur in quick and sudden attacks of pain shooting up and down the amputated limb as well as cases of constant, excruciating pain whilst intensely perceiving the amputated limb to be cramped or postured abnormally (Katz, 1992). Approximately eighty percent of amputees report suffering from or at least experiencing some level of phantom pain post amputation; therefore it is a prominent issue (Flor, Nikolajsen & Jensen, 2006). Phantom pain is neuropathic pain that has no individual trigger but instead a plethora of psychobiological aspects of neuroplasticity that contribute to the cause of phantom pain (Grusser, Diers & Flor, 2003). The following will: outline the role of the peripheral and central factors associated with phantom pain and discuss the cortical reorganisation of the somatosensory cortex in relation to phantom pain. Peripheral and central mechanisms involving nerve lesions and their input are substantial when perceiving phantom pain. Due to the impairment of peripheral nerves in the process of amputation, regenerative sprouting of damaged axons occurs and the activity rate of inflamed C-fibres and demyelinated A-fibres spontaneously increases (Flor, 2002). As a consequence of this nerve injury, a neuroma, which is a mass of pruned and tangled axons, may form in the residual limb producing abnormal (ectopic) activity (Katz, 1992). Flor, Nikolajsen and Jenson (2006) proposed that ectopic discharge from a neuroma in the stump illustrates abnormal afferent input to the spinal cord, which is a possible mechanism for unpro... ... middle of paper ... ..., suggesting that cortical reorganisation mediates this relationship Flor (2002). Overall, there is an immense amount of research dedicated to understanding the psychobiological causes of phantom pain. A prevalent commonality between the literatures reviewed, suggested that symptoms of phantom pain are a neuro-psychobiological experience rather than a psychological disorder. This was evident by peripheral and central factors that associate the cause of phantom pain with the disruption of sensory nerve impulses due to the damage of sensory nerve fibers after amputation. As well as studies that demonstrated a positive correlation between progressive neuroplastic changes in the cortical reorganisation of the topographical structure in somatosensory cortex and worsening phantom limb pain, inferring that cortical reorganisation mediates the extent of pain experienced.

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