Phantom Pain
What is phantom pain?
Phantom pain occurs when someone feels pain in a body part that is no longer there. For example, if I had my left arm amputated in the past, phantom pain would be pain that I currently experience in my no-longer-there left hand. Scientists are still developing an understanding of what causes phantom pain. Currently, it’s believed there are many factors that contribute to this experience, including nervous system (brain, spinal cord, nerves) activity, psychological perception, and residual damage at the site of an amputation.
* There’s also something called phantom sensation, which is exactly what it sounds like. It’s when someone feels sensation on a part of the body that is no longer there.
* Residual limb pain is a little different. This pain occurs at the site of an amputation and is usually caused by things like nerve damage or entrapment leftover from surgery or from the original condition that led to amputation.
Photo by ShotPot: https://www.pexels.com/photo/man-in-black-t-shirt-and-black-shorts-doing-wall-climbing-4045669/
Can people feel phantom pain or sensation without amputation or loss of body parts?
This kind of gets into a grey area. Some researchers have successfully worked on producing similar pain and sensations in people with no history of amputation. This was done using a screen and a paintbrush and you can read more about it in the extra resources at the bottom of this blog post. I also linked an interesting video with a rubber hand experiment that gets at the same concept. The participants perceived sensation and pain on their own body part when it was actually a fake or non-existent body part being touched. However, the definition for phantom pain is specific to “a body part that’s no longer there,” indicating that someone would have to have and then lose a body part for the sensation to be classified as phantom pain. Science and language are always evolving, though, so it may count depending on who you’re talking to!
There’s also mixed evidence about whether or not people who were born with 1 leg or arm feel phantom sensations, so I think this one is still a bit up in the air, too.
How do physical therapists help?
I think it’s rare for physical therapists to treat someone just because they’re experiencing phantom sensations. I’m not going to count it out, though, because PTs are very knowledgeable when it comes to pain and if pain is limiting your movement and ability to participate in functional activities, then it’s in their wheelhouse as far as knowledge goes. What I’ve seen more often is PTs treating people in the first few months after a surgery, where phantom pain is addressed as part of the rehabilitation package. After amputation, appropriate recovery is important for individuals to maintain enough range of motion to qualify for prosthetics, learn how to care for the surgical wound at home, make any necessary modifications to activities, and manage pain.
When it comes to phantom pain specifically, physical therapists may talk with you before surgery to discuss what this is and what to expect moving forward. After surgery, your PT may help you with strategies to manage body awareness and emotional stress that might trigger the feeling of phantom pain. They may also use electrical stimulation, massage, movement imagery training, desensitization techniques, or mirror box therapy.
If you have any experience with this topic, I’d love to hear about it in the comments below! If you’d like to learn more, try one of these websites:
Cleveland Clinic - Phantom Limb Pain
Science Daily - Scientists create phantom sensations in non-amputees
