Amputees for centuries have reported a prolonged presence and feeling of their amputated limb or body part after it has been removed. This phenomenon has preempted what is understood as the phantom limb phenomenon, which is currently accepted as a natural consequence of amputation (Hill, 1999). Most common reports are found amputations of the arms and legs yet reported experiences have been documented post-amputation in other areas such as the breast, penis, eye, teeth and bladder (Giummarra, Gibson, Georgiou-Karistianis, & Bradshaw, 2007; Nicolelis, 2008).
Phantom limb sensation, phantom limb pain and pain in the residual limb are unique areas of this phenomenon and often the terms are misused. Pain in the residual limb is often confused with the phantom phenomenon yet it actually refers to the pain felt in the physical area above the level of amputation (Hill, 1999). However, phantom limb sensation (PLS) is described as any non-painful sensation that is presented where the limb is no longer present (Hill, 1999; Wilkins, McGrath, Finley & Katz, 1998). Conversely, phantom limb pain (PLP) is characterized as burning, tingling, throbbing, cramping, squeezing, shocking or shooting pains experienced where the limb is no longer present (Modirian, Shojaei, Soroush & Masoumi, 2009).
For pain in particular, many treatments have been created to ease the pain, but none have been successful at curing the pain (Modirian et al., 2009). One particularly popular treatment option is that of mirror treatment. In mirror treatment, an individual with an amputation is placed at a table with a mirror that is placed along the individual’s midline (Ramachandran & Rogers-Ramachandran, 2008). With the intact limb symmetrically positioned with the phant...
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...Hill, A. (1999). Phantom Limb Pain: A Review of the Literature on Attribute and Potential Mechanisms. Journal of Pain and Symptom Management, 17, 125-139. doi:10.1016/S0885-3924(98)00136-5
Kapoor, S. (2010). Phantom pain: emerging new therapeutic options. Disability and Rehabilitation, 32, 429. doi:10.3109/096328280903567901
Modirian, E., Shojaei, H., Soroush, M. R., & Masoumi, M. (2009). Phantom pain in bilateral upper limb amputation. Disability and Rehabilitation, 31, 1878-1881. doi:10.1080/09638280902810976
Nicolelis, M. (2008). Living with Ghostly Limbs. Scientific American Mind, 18, 52-59.
Ramachandaran, V., & Rogers-Ramachandran, D. (2008). Touching Illusions. Scientific American Mind, 18, 14-16.
Wilkins, K. L., McGrath, P. J., Finley, A., & Katz J. (1998). Phantom limb sensations and phantom limb pain in child and adolescent amputees. Pain, 78, 7-12.
Rehabilitation after amputation has changed significantly. It now includes a more in depth process and aftercare to ensure and a full recovery is achieved and reduces the potential for infections and complications. Patients are encouraged to take part in sport to aid them in their recovery and, with the use of specialized prosthetics, are readily available. It has also been said to help reduce Post Traumatic Stress Disorder which, according to a study by Abeyasinghe 2012, suggested that 42.5% of lower limb amputees suffered with PTSD (Abeyasinghe, de Zoysa, Bandara, Bartholameuz, & Bandara,
“Amputees by Choice” written by Bayne and Levy, conists of an unusual topic. Bayne and Levy examine and discuss two basic questions. The first question they look into is the motivations people to have a perfectly healthy limb amputated? The other question concerns what circumstances would a doctor comply with a patients’ wish to get a limb amputated. Along with the other two questions, Levy and Bayne discuss other erratic cases involving the amputation of one’s limbs. More specifically, Levy and Bayne attempt to define and analyze Body Dysmorphic Disorder (BDD). This disorder occurs when people think incorrectly about their healthy limbs. In addition to BDD, Apotemnophiles are sexually attracted to amputees, and are sexually excited by the fact that maybe becoming an amputee as well.
Strange as that this may sound, when a Wannabee person lose a limb they are actually gaining so much more of who they felt they are. As one Amputee said to his doctor “you have made me the happiest of all men by taking away from me a limb which put an invincible obstacle to my
It is caused by damaged nerves. It generally, causes a weakness or numbness but can
Have you ever wondered why when you stub your toe on the chair in the living room, it helps tremendously to yell out an expletive or two and vigorously rub the area? I may not be able to discuss the basis for such language in this paper, but we will explore the analgesic response to rubbing that toe, in addition to the mechanism of pain and alternative treatments such as acupuncture and transcutaneous electrical nerve stimulation.
Institute of Medicine Report from the Committee on Advancing Pain Research, Care and Education. (2011). Relieving Pain in America A Blueprint for Transforming Prevention, Care, Education and Research. Retrieved from http://books.nap.edu/openbook.php?records_13172
Assessing and managing pain is an inevitable part of nursing and the care of patients. Incomplete relief of pain remains prevalent despite years of research due to barriers such as lack of kn...
Almost all patients who have lost a limb due to an organ amputation, paralysis, or were born with inherited birth deficiency would undergo a mysterious phenomenon called phantom limb. Within this syndrome, patients would have a perception of their missing limb and would receive sensations from it. Limb loss could be due to many factors, such as congenital deficiencies, spinal cord injuries, and amputation of a limb. Although phantom limb sensation and phantom limb pain are strongly correlated, they should be differentiated. Phantom limb sensation is experienced by almost all biological and accidental amputees. On the other side, phantom limb pain is almost exclusively experienced as a result of an amputation.
After surgical joint replacement patients need pain management and analgesia because there is an increased amount of pain and stimuli that are usually not painful suddenly become bothersome (Scholz & Yaksh, 2010). For rehabilitation of the joint to occur, the patient must undergo physiotherapy. This therapy includes strengthening the joint and its surrounding muscles. If an intolerable amount of pain is present, the time for recovery could be prolonged and even chronic complications may result. The natural progression is that the amount and intensity of the pain perceived varies from patient to patient but as the incisions heal the pain intensity gradually declines (Scholz & Yaksh, 2010). “However, some patients experience deep pain or pain referred to the dermatomes that correspond to the operated organ, which persists for months or even years” (Scholz & Yaksh, 2010 p. 512). In the literature a clear distinction is not made in the description of post-operative pain. For instance post-operative pain could occur as a result of aggravation of the affected area by exercise, friction, or some other manipulation that occurs in the post-operative and recovery period (Scholz & Yaksh, 2010). Scholz and Yaksh (2010) ask “are the mechanisms responsible for sustained pain the same as those underlying acute postsurgical pain, or does, in this subgroup of patients, the trauma associated with the surgical intervention provoke different changes in sensory processing?” (Scholz & Yaksh, 2010 p.511)” The post-operative pain that is under examination in this paper is that which is produced as result of the acute joint rehabilitation process. The goal of this project is t...
Pain is something most people want to get rid of. It would be shocking if a person would want pain or create their own pain. Sounds outrageous, right? The millions of Americans suffering with diseases and conditions, from chronic pain to cancer, all want their pain to simply disappear. But, most people are aware that some treatment options and pharmaceuticals don’t always work. As a result, they are forced to live with their conditions or diseases for long amounts of time, sometimes even leading to their death. Other times, treatment options and pharmaceuticals that don’t medically have any pain-relieving or curing effect do work. In turn, patients who suffered with cancer or post-tooth extraction pain are relieved with nothing but a
For example, phantom pain is a well-known phenomenon in medicine. When people lose a limb, they will often feel painful spasms in parts that no longer exist. Although neuroscience is still developing, scientists assume sensory conflict is responsible for this phenomenon (Blakeslee, 1995b). The brain remembers the nerves going to the missing limb and their previous function, so it can issue orders through those nerves. However, the nerves will not get feedback from the muscles in the non-existent limb, so the brain stops the movement forcibly (Blakeslee, 1995b). Over time, the brain makes new nervous pathways and adapts to the new geography of the body (Blakeslee, 1995b), so the person's perception changes and phantom pain no longer persists.
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...
Jackson, M.A. & Simpson, K. H. (2006). Chronic Back Pain. Continuing Education in Anaethesia, Critical Care and Pain, 6(4), 152-155. http://dx.doi: 10.1093/bjaceaccp/mkl029
Wunderlich, R. P., Peters, E. J., Bosma, J., & Armstrong, D. G. (1998). Pathophysiology and treatment of painful diabetic neuropathy of the lower extremity. Southern Medical Journal, 91, 894-898.
The previous insert from William Lee Adams’ article, Amputee Wannabes, describes a 33-year-old man’s wish for amputation of his foot. There was nothing physically or medically wrong with this limb; John only stated that he did not feel comfortable with his own body and felt as though his foot was not a part of him. John’s leg was amputated above the knee, and he went on to describe that the operation resolved his anxiety and allowed him to be at ease in his own body (Adams, 2007).