scholarly journals Phantom Limb Pain: Mechanisms and Treatment Approaches

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Bishnu Subedi ◽  
George T. Grossberg
Keyword(s):  
Neuropathic Pain ◽  
Specific Treatment ◽  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Phantom Pain ◽  
Limb Pain ◽  
Pain Mechanisms ◽  
Treatment Approaches ◽  
The Past

The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral and central neural changes involving cortical reorganization. More recently, the role of mirror neurons in the brain has been proposed in the generation of phantom pain. A wide variety of treatment approaches have been employed, but mechanism-based specific treatment guidelines are yet to evolve. Phantom limb pain is considered a neuropathic pain, and most treatment recommendations are based on recommendations for neuropathic pain syndromes. Mirror therapy, a relatively recently proposed therapy for phantom limb pain, has mixed results in randomized controlled trials. Most successful treatment outcomes include multidisciplinary measures. This paper attempts to review and summarize recent research relative to the proposed mechanisms of and treatments for phantom limb pain.

scholarly journals Efferent retargeting in above-knee amputees is positively related to phantom limb pain

2020 ◽  
Author(s):  
Amanda S. Therrien ◽  
Cortney Howard ◽  
Laurel J. Buxbaum
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Thigh Muscle ◽  
Emg Activity ◽  
Phantom Pain ◽  
Limb Pain ◽  
Lower Limb Amputees

AbstractMany individuals who undergo limb amputation experience persistent phantom limb pain (PLP). The underlying mechanism of PLP is unknown, but the phenomenon has been associated with reorganization in sensorimotor cortex following amputation. The traditional view is that cortical reorganization degrades the missing limb’s representation. However, recent work suggests that an amputated limb’s cortical representation remains intact and that reorganization reflects a retargeting of efferent projections to residual muscles proximal to the amputation site. Evidence of retargeting has only been shown in individuals with upper limb amputations, and the relationship of retargeting to PLP is controversial. This study assessed retargeting and its relationship to PLP in 10 individuals with lower limb amputations. We recorded electromyographic (EMG) activity in a residual thigh muscle (vastus lateralis, VL) in patients with above-knee amputations during cyclical movements of the foot. VL activity on the amputated side was compared to that recorded on patients’ intact side while they moved their phantom and intact feet, respectively. VL activity in the patient group was also compared to VL activity from a sample of 9 control participants with no amputation. We show that phantom foot movement is associated with greater VL activity in the amputated leg than that seen in the intact leg as well as that exhibited by controls. The magnitude of residual VL activity was also positively related to ratings of PLP. These results provide the first support for retargeting in lower limb amputees and suggest that retargeting is related to the experience of phantom pain.New and NoteworthyPrevious work has only examined retargeting in upper limb amputees. This study provides evidence for retargeting in lower limb amputees and suggests that retargeting is related to phantom limb pain.

Cortical reorganization in phantom limb pain changes after regional anesthesia of the amputated limb

1996 ◽  
Author(s):  
P. Montoya ◽  
N. Birbaumer ◽  
W. Lutzenberger ◽  
H. Flor ◽  
W. Grodd ◽  
...  
Keyword(s):  
Regional Anesthesia ◽  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Limb Pain

Analysis of cortical reorganization (CR) of the patients with phantom-limb pain and the mechanism of motor cortex stimulation

2007 ◽  
Vol 58 ◽  
pp. S29
Author(s):  
Youichi Saitoh ◽  
Takufumi Yanagisawa ◽  
Satoru Oshino ◽  
Masayuki Hirata ◽  
Tetsu Goto ◽  
...  
Keyword(s):  
Motor Cortex ◽  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Motor Cortex Stimulation ◽  
Limb Pain

An Experimental Study of Atypical Phantom Pain

1965 ◽  
Vol 111 (481) ◽  
pp. 1185-1187 ◽  
Author(s):  
I. Pilowsky ◽  
A. Kaufman
Keyword(s):  
Experimental Study ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Phantom Pain ◽  
Limb Pain ◽  
Emotional Factors ◽  
Psychological Mechanism

A number of writers have drawn attention to the importance of emotional factors in phantom limb pain (Kolb, 1950, 1952; Simmel, 1956; Russell, 1959; Von Hagen, 1963). Kolb (1950, 1952) reported an association between the discussion of certain emotionally loaded topics and accesses of pain in the phantom. Stengel (1965), in his Maudsley Lecture, discussed the role played in these experiences by the psychological mechanism of identification with others. He briefly referred to the patient whom we have studied.

scholarly journals Effects of Regional Anesthesia on Phantom Limb Pain Are Mirrored in Changes in Cortical Reorganization

1997 ◽  
Vol 17 (14) ◽  
pp. 5503-5508 ◽  
Author(s):  
Niels Birbaumer ◽  
Werner Lutzenberger ◽  
Pedro Montoya ◽  
Wolfgang Larbig ◽  
Klaus Unertl ◽  
...  
Keyword(s):  
Regional Anesthesia ◽  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Limb Pain

Phantom Limb Pain

2018 ◽  
Author(s):  
Kenneth D. Candido ◽  
Teresa M. Kusper ◽  
Alexei Lissounov ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Alternative Therapy ◽  
Phantom Limb Pain ◽  
Body Part ◽  
Phantom Limb ◽  
Treatment Modalities ◽  
Phantom Pain ◽  
Limb Pain ◽  
Surgical Interventions ◽  
Neurologic Sequelae ◽  
The 19Th Century

Post-amputation pain (PAP) has challenged clinicians for centuries. The first written record of this perplexing condition came from the 16th-century French military surgeon Ambrose Paré. The term phantom limb pain (PLP) was coined by Silas Weir Mitchell, who provided a comprehensive description of the condition during the 19th century. Since that time, the understanding of PLP has greatly expanded; however, our knowledge of the exact mechanisms underlying it is still very deficient. Amputation of a body part can result in one sequela or more than one neurologic sequelae occurring concurrently: phantom sensation, phantom pain, and stump pain. The incidence and prevalence vary across the spectrum of these syndromes. A myriad of treatment modalities are employed in an attempt to terminate PLP, including pharmacotherapy, injections, alternative therapy, surgical interventions, and neuromodulation. Despite an extensive search for effective therapeutic options, PLP remains a highly challenging and debilitating condition.

Cortical Reorganization and Phantom Limb Pain in Traumatic Amputees and Subjects with Congenital Limb Atrophy

NeuroImage ◽  
1998 ◽  
Vol 7 (4) ◽  
pp. S481 ◽  
Author(s):  
P. Montoya ◽  
K. Ritter ◽  
E. Huse ◽  
S. Töpfner ◽  
C. Fritsch ◽  
...  
Keyword(s):  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Limb Pain ◽  
Congenital Limb

Phantom Limb Pain Responds to Distant Skin Magnets: Support for the Functional Existence of Acupuncture Meridians

1998 ◽  
Vol 16 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Timö Töysä
Keyword(s):  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Leg Pain ◽  
Phantom Pain ◽  
Limb Pain ◽  
Stopping Treatment

Phantom leg pain in 10 patients was treated with skin magnets to the ipsilateral superior ends, on the thorax, of the leg Yin-meridians (KI.27, LR.14 and SP.21). The majority of patients reported relief of phantom pain while skin magnets were in situ, but in general this benefit was lost soon after stopping treatment. In two cases the method appeared more effective than morphine, and in a few patients it seemed to have some prophylactic benefit.

The effect of opioids on phantom limb pain and cortical reorganization

Pain ◽  
2001 ◽  
Vol 90 (1) ◽  
pp. 47-55 ◽  
Author(s):  
Ellena Huse ◽  
Wolfgang Larbig ◽  
Herta Flor ◽  
Niels Birbaumer
Keyword(s):  
Phantom Limb Pain ◽  
Cortical Reorganization ◽  
Phantom Limb ◽  
Limb Pain
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