The phantom limb is a phenomenon that arises in patients who have undergone an amputation procedure, but who continue to have the sensation that the absent limb is attached and present. Although it is most often reported in cases regarding the loss of a limb, it is also known to occur following the loss of other body parts, such as the eyes and tongue (Flor, 2002).
This perception is separated into three distinct sensations. The first is pain in the residual limb, which refers to pain felt in the physically remaining portion of the limb at the site of amputation, most common directly following the procedure. The second, and almost invariably reported experience of patients, is phantom sensation, referring to any sensation of the absent limb’s presence, including tingling, temperature, touch and itching, but not including pain. It can be so vivid that the patient attempts to use the absent limb, and frequently includes the feeling of telescoping, where the phantom limb is perceived to retract into the residual limb. Lastly, the third distinction is phantom pain, which are those sensations felt in the absent limb that the patient describes as painful (Hill, 1999).
Current research believes that phantom limb is related to a reorganization of the somatosensory cortex, thalamus, and parietal cortex. The somatosensory cortex is associated with the perception and memory of pain, and sufferers of chronic back pain have shown a relationship between their experience of pain and an over representation of that particular area in the somatosensory cortex. In cases where portions of the cortex have been removed, patients report the cessation of the sensation of pain in the absent limb, and transversely, patients who have had the cortex stimulated reported an onset of phantom pain, suggesting the absent limb may be overly represented in the somatosensory cortex (Flor, 2002).
The Research paper on Phantom Limb Pain
... will experience not only sensation, but also the similar emotion. To relate this to phantom limb pain, a patient will enable to ... and non painful referred phantom sensations are parallel to perceptual reorganisational processes in the somatosensory cortex. This lead to the ... an extradural procedure where stimulation of the cortex responding to the upper limb is more feasible than stimulation of ...
Activity in the thalamus is indicative of continued response to the presence of the absent limb, and upon stimulation evokes a sensational response from the phantom, showing that the corresponding area has been reorganized after the loss. This cannot be solely attributed to a memory experience, as there are many instances of patients who were born without a limb reporting phantom sensation, and they would have no ability to form such memories (Cotterill, 2000).
Research also shows that the parietal cortex may be influential in the phantom limb, as the parietal cortex is responsible for the production and maintenance of the body schema. Other disorders relating to confusion of ownership or realities of the body, such as somatoparaphrenia or asomatognosia, have been shown to relate to a disruption in the parietal cortex, and the phantom limb is consistent with this time of disconnect between the physical body and the mind’s body template (Giummarra, Gibson, Georgiou-Karistianis, & Bradshaw, 2007).
Specific studies to determine causation of phantom pain have uncovered that peripheral nerve injury associated with amputation results in a loss of inhibitory neurons, and therefore a hyperexcitable spinal cord. Furthermore, studies have also shown that many patients exhibit a change in nociceptor fibres, which are now expressed by Ab fibres instead of being expressed in combination with Ad and C fibres. This is due to the degeneration of C fibres following peripheral damage, resulting in compensatory production of Ab fibres, and over-excitation of pain reception (Flor, 2002).
The Term Paper on Phantom Limb Phenomena Brain Cortex Amputated
For more than a hundred years, physicians have published accounts of people who perceive an amputated arm or leg as if it were still there. Many amputees feel burning, cramping, or shooting pains in these phantom limbs. Doctors explained this by saying that the patients went through a denial period due to the trauma of loosing a body-part. Experts have discovered in the last decade that the ...
While there is currently no proven effective treatment for phantom sensation, few
patients who report sensation are looking for intervention, and actually phantom sensation can often aid in the ability to use a prosthesis (Giummarra, Gibson, Georgiou-Kartistanis, & Bradshaw, 2007).
Phantom pain however is often reported to have a negative effect on the patient’s ability to function effectively, and most surgical and medication treatments have proven ineffective. Treatment for phantom pain associated with proprioreception, often described as “clenching spasms,” has recently been introduced with the use of mirror imaging. A subject is given a divided box that has space on one side for the remaining limb, and a space on the opposite side for the absent limb that is covered so that if a limb were inside it would be concealed. Next to the remaining limb is a mirror, which projects an image of the limb in such a way as to form the image of there being two opposite limbs. The subject is then told to clench the remaining limb to match the sensation felt in the phantom and then, watching the mirror image limb, relax both limbs simultaneously. Many subjects report an alleviation of discomfort in the phantom following this exercise (Brodie, Whyte, & Niven, 2007).
As far as future research of phantom limbs is concerned, I believe that research
should further investigate the neuropathic and physical etiologies of phantom sensation
and pain. Since to date there has only been one type of effective treatment introduced for
one type of phantom pain, other pain sensations remain ineffectually treated, and those
who report these pains describe them as chronic and an impediment on their ability to
effectively function in life. I feel that the best way alleviate this suffering is to find it at
its source instead of continuing to attempt surgical and pharmacological regiments that
have yet to offer real comfort.
Brodie, E.E., Whyte, A., & Niven, C.A. (2007).
Analgesia through the looking-glass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation and movement. European Journal of Pain, 11, 428-436.
The Term Paper on Living Through the Pain of Ankylosing Spondylitis
As I sit next to my sister, Natalie, she seems saddened as she tells the story that started her difficult journey of dealing with a lifelong disease. As she describes it, “At the young age of 13, when my girlfriends were thinking about an upcoming 1950s-genre sock hop, I found myself in a Milwaukee back brace to treat a curvature of my spine called scoliosis. The brace keeps the spine virtually ...
This article is a follow up study of the mirror image treatment initially proposed by Ramachandran for alleviating phantom pain. The researchers extend the study to include subjects with phantom legs, as opposed to the previous work done with phantom arms. This study also introduces a control group, which was lacking in the original study. The researchers had subjects stand in a mirror image box, with the phantom limb concealed on one side while the remaining limb remained visible, but juxtaposed to a mirror, which projected the image of a second limb. They were then asked to watch the mirror image limb, and align this limb with their remaining limb. The majority of patients then reported an alleviation of “clenching spasms,” a type of phantom pain.
Flor, H. (2002).
Phantom-limb pain: Characteristics, causes, and treatments. The Lancet, 182-189.
In this article, the author attempts to provide a summary of etiological research into phantom limbs. It starts off with a breakdown of the believed neurological structures involved and associated with the sensation of phantom pain, and describes some of the testing in animal subjects that thus far provide evidence of the various structures’ relations to the sensation. The author also goes into discussion regarding the discourse about the impact of psychological factors on the onset of phantom sensations, most especially phantom pain, and states that even though there is evidence of biological and neuropathic associative variables, stress and other environmental factors can bring on or exacerbate periods of phantom pain.
Hill, A. (1999).
Phantom limb pain: A review of the literature on attributes and potential mechanisms. Journal of Pain and Symptom Management, 17(2) 125-142.
This review article serves as an overview of literature regarding the detailing of the phantom limb experience. It begins by distinguishing between pain in the residual limb, phantom sensation, and phantom pain, then goes into explanation of what the sensational experience of each of these feelings are as reported by patients and described by researchers. It also details criticisms of research of this topic, including bias subject pool, as most who seek treatment for phantom limb do so for pain and not sensation. It then goes into various forms of measurement for quantifying the experience of pain, such as the McGill Pain Questionnaire. It concludes by looking into some of the early theories and postulations as to what the potential causes of the phantom limb could be, but as it is a review of earlier studies in the field, the author’s final conclusions are that continuing research into causality would be necessary, as theories of the time left too many variables unaccounted for.
The Research paper on Au Bon Pain Case Study
Business Strategy: Au Bon Pain (ABP) is an upscale French Bakery chain restaurant that competes with other fast food restaurants. They would like to go from a “Cycle of Failure” to differentiating themselves from their competitors by improving their customer experience. Alignment: Au Bon Pain wanted to differentiate themselves from other fast food chains by increasing the customer experience so ...
Works Cited
Brodie, E.E., Whyte, A., & Niven, C.A. (2007).
Analgesia through the looking-glass? A randomized controlled trial investigating the effect of viewing a ‘virtual’ limb upon phantom limb pain, sensation and movement. European Journal of Pain, 11, 428-436.
Cotterill, R.M.J. (2000).
Cooperation of the basal ganglia, cerebellum, sensory serbrum and hippocampus: Possible implications for cognition, consciousness, intelligence, and creativity. Progress in Neurobiology. 64, 1-33.
Flor, H. (2002).
Phantom-limb pain: Characteristics, causes, and treatments. The Lancet, 1, 182-189.
Giummarra, M.J., Gibson, S.J., Georgiou-Karistianis, N., & Bradshaw, J.L. (2007).
Central mechanisms in phantom limb perception: The past, present and future. Brain Research Reviews, 54, 219-232.
Hill, A. (1999).
Phantom limb pain: A review of the literature on attributes and potential mechanisms. Journal of Pain and Symptom Management, 17(2) 125-142.
