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Phantom Pain
Rebecca Brightwell, Farm Again Co-Director

The word phantom means something that you can feel but cannot see. After a part of the body, like an arm or leg is amputated by an accident or from surgery, the person sometimes feels that the arm or leg is still there. This is called phantom sensation. If the person has pain as though the arm or leg is still there, it is called phantom pain. Phantom limb pain may occur because the brain
sends signals to a missing limb as if it were still there but doesn't get feedback and keeps resending and amplifying the signals.

Pain PositionsMany individuals with amputations have a sensation that they are able to ‘move’ their missing limbs voluntarily but others experience the missing limb as ‘paralyzed’ in a painfully awkward position. The illustration to the left shows some of the positions that have been reported.

Is it possible to get relief from phantom pain without using medications? Some doctors and researchers believe so.  New approaches, based on a better understanding of the brain’s role in pain, are opening the way to innovative treatments.

Dr. V.S. Ramachandran, a researcher at the University of California, San Diego, devised a seemingly simple experiment to explore phantom pain. One of Ramachandran's patients complained that he was suffering from an excruciating cramping in his phantom arm. He felt that his phantom hand was clenched so tightly, he could feel his fingernails digging into his phantom palm. Ramachandran came up with an unusual treatment. He placed a mirror in a cardboard box and instructed the patient to place his existing hand inside the box, next to the mirror. When the patient looked down at the mirror, the reflection of his existing hand stood in as a visual replacement of his phantom limb. The patient was told to imagine that the reflection was in fact the lost limb, and to practice clenching and unclenching his hand while looking in the mirror.

mirrorboxdrTo the patient's surprise — and Ramachandran's — the illusion worked. After two weeks, the patient's pain vanished, along with his perception of a phantom arm. Dr. Ramachandran was recently interviewed by NPR to explain mirror therapy.   Click here to listen to the interview (Courtesy of NPR).

Mirror Therapy is now being adopted by many doctors to combat phantom pain. It can also be used to aide people who have had a stroke and other types of pain conditions.

Phantom PainUniversity of Manchester professors are taking this idea and are working on a virtual reality system for phantom pain.  The system uses specially developed software; off-the-shelf components including a standard PC and an Nvidia graphics card; and standard VR gear including a head-mounted display, a data glove, and electromagnetic trackers, said lecturer Steve Pettifer. So far, he noted, they haven’t built the system to work with a data sock for lower-limb amputees. Amputees put on the display and move the one arm they have, triggering a virtual 3D display of a torso that still has the missing limb. The image of the limb moves exactly the way the user is moving the real arm, Pettifer said. Technicians enhance the effect by configuring the system so that the body and clothing look like that of the user, he explained. This use of VR may work by dampening the brain signals to the missing limb that cause the phantom pain, according to Murray. Five patients participated in limited tests for several months, and four reported less phantom pain, saying they got longer relief after a greater number of sessions, said Murray. The researchers want to conduct further research with additional patients as time and money allow. For example, they want to determine whether treatment is more effective immediately following an amputation, what type of amputations the system is best for, whether treatments must be ongoing, or whether they eventually become unnecessary. (Photo courtesy of the The University of Manchester)  


Instructions to Make and Use A Mirror Therapy Box

End the Pain Project   (Request their ETPP Kit)

Web Sites of Interest

Amputee Coalition of America

The War Amps

Recommended YouTube Videos
Phantoms of the Brain (Part One)
Visit YouTube for other sections of this BBC Special (search terms: Phantoms In The Brain)


Part Two


Disclaimer: The information listed does not represent an endorsement by AgrAbility in Georgia and is provided only as an introduction to the topic of Phantom Pain. Contact a physician prior to starting any type of health treatments.