International Association for the Study of Pain (IASP) - An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
- Relates to any sensation that hurts or causes discomforts of any sort.
- Motivates withdrawal from damage or potentially damaging situations
Phantom Pain
Phantom Pain is a pain perception that an individual experiences relating to a limb or organ that is physically no longer part of the body.
• Most commonly occur following the amputation of a limb
• Can also occur following removal of breast , penis, eye or an internal organ.
• The pain can range from tingling sensations to severe sharp, stabbing pains.
• The patient can often experience other various sensations such as
o Feling that the phatom limb is behaving normally like sitting with knees bent
o Sensations of movement (Moving foot)
o Sensation of touch, temperature, pressure and itchiness. Many complain of feeling heat, tingling and itch.
• Said to be triggered by weather changes, pressure on remaining part of limb or emotional stress
Causes
- After an amputation, areas of spinal cord and brain lose input from the missing limb
- Hence the brain may re-map that part of the body’s sensory circuitry to another part of the body.
- Hence the amputated area is referred to a normal area and when the normal area is touched, it is as though the amputated limb is being touched as well.
- Other factors which are believed to contribute are damaged nerve endings, scar tissue at site of amputation, and physical memory or pre amputation in the affected area.
Treatment Without medication
- Wrap the stump in a warm soft fabric such as a towel. This helps increase circulation which may prevent phantom pain
- Mentally exercise the limb that is not there in the area that is painful
- Mentally relax the missing limb and your stump
- Tighten the muscles in the stump and release slowly
- Keep diary of when phantom pain is felt and when it is most severe to try and find any common causes
- Mirror box therapy allows for illusions of movement and touch in a phantom limb. The ability to move the phantom limb had shown to alleviate their pain.
- Wrap the stump in a warm soft fabric such as a towel. This helps increase circulation which may prevent phantom pain
- Mentally exercise the limb that is not there in the area that is painful
- Mentally relax the missing limb and your stump
- Tighten the muscles in the stump and release slowly
- Keep diary of when phantom pain is felt and when it is most severe to try and find any common causes
- Mirror box therapy allows for illusions of movement and touch in a phantom limb. The ability to move the phantom limb had shown to alleviate their pain.
Drugs
- Antidepressants often can relieve pain caused by damaged nerves.
o Examples include amitriptyline and nortirptyline which work by modifying chemical messengers that relay pain signals. They also help you sleep which relieves the phantom pain
- Anticonvulsants (Epilepsy drugs)
o Examples include Gabapentin and Carbamazepine which work by quieting damaged nerves to slow or prevent uncontrolled pain signals
- Narcotics
o Examples include codeine and morphine where it needs to be taken in appropriate doses under doctor’s direction.
- Antidepressants often can relieve pain caused by damaged nerves.
o Examples include amitriptyline and nortirptyline which work by modifying chemical messengers that relay pain signals. They also help you sleep which relieves the phantom pain
- Anticonvulsants (Epilepsy drugs)
o Examples include Gabapentin and Carbamazepine which work by quieting damaged nerves to slow or prevent uncontrolled pain signals
- Narcotics
o Examples include codeine and morphine where it needs to be taken in appropriate doses under doctor’s direction.
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