Phantom Pain Provides Lessons and Solutions for All Types of Chronic Pain
Losing a limb is a very traumatic event. Not only is the actual act of physically losing the limb traumatic, but there is also psychological trauma too. During these times of warfare and conflict around the world, many adults and children are living a life as an amputee and upwards of 80% of them will also be living with chronic pain as a result of losing that limb.
There are three different types of pain experienced by an amputee. First, the pain can be directly coming from the severed nerve. Second, the pain can also be coming from the residual limb. Finally, the most common type of pain is phantom limb pain. Phantom pain is a painful sensation perceived in the missing portion of the amputated limb. Phantom pain is not to be confused with phantom sensation which is a vivid non-painful experience in the missing limb.
The treatment of phantom limb pain is difficult because this type of nerve pain is often not responsive to traditional medications. Thus, non-traditional mental exercises that stimulate the brain in different ways are often suggested and consistently successful. One exercise is called "Phantom Exercise". This means that the individual is visualizing imagined movements of the missing limb. This will activate pathways in the brain and help to reorganize the brain. Another mental exercise used to treat phantom limb pain is progressive muscle relaxation. This mindful body survey systematically relaxes each muscle group from head to toe. Finally, mirror therapy and mental imagery are mind-body therapies that attempt to fool the brain into thinking the missing limb is still there. All of the mental exercises may seem a bit foolish but study after study show a reduction in pain intensity when an amputee consistently participates in such therapies.
Because the brain is the primary origin of pain and the focus of treatment, phantom limb pain is a valuable model for all types of conditions that result in chronic pain. Phantom limb pain challenges the assumption that pain comes from the exact location of the actual experience. Obviously that cannot be the case when the limb is actually missing. The role that the brain has in creating chronic pain not only in amputees but in all people that live with painful conditions cannot be ignored. Because of the brain’s powerful influence in the pain experience, all people with chronic pain will likely benefit from some type of mental exercises to combat the pain in the brain whether that therapy is in the form of relaxation techniques like guided imagery or in the form of mindful movement. By reorganizing and desensitizing the brain, mental exercises are powerful pain relievers for not only amputees but all individuals with chronic pain.
Brunelli, Stefano; Morone, Giovanni; et al; Efficacy of Progressive Muscle Relaxation, Mental Imagery, and Phantom Exercise on Phantom Limb: a randomized controlled trial; Archives of Physical Medicine and Rehabilitation; 2015; 96:181-7
Another Article of Interest:
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.