Phantom Limb Pain Essay

Phantom limb pain is defined as “pain perceived by the region of the body no longer present” (Subedi & Grossberg, 2011, p.1). This type of pain can be described as “shooting, severe burning, ischemic or crushing in nature or severe from…the limb being in a hyper-extended or unnatural position.” (Chapman, 2010, p. 35). Phantom limb sensation is the “nonpainful sensations experienced in the body part that no longer exist…phantom sensations are touch and pressure-like sensations.” (Subedi & Grossberg, 2011, p.1). In 2005, there were 1.6 million people in the United States who underwent limb amputation for various reasons. Among the most common are trauma, cancer, vascular issues, and congenital limb problems. Due to the current conflict in Iraq and Afghanistan, …show more content…
The peripheral mechanism occurs after nerves are severed at the site of the amputation, causing neuronal and tissue injury. The proximal portion of the nerve then forms neuromas, abnormal sprouting of nerves, which have increased numbers of sodium channels, leading to hyper-excitability and random neural discharges. (Subedi & Grossberg, 2011). Inflammatory mediators and enzymes also sensitize the nociceptors and stimulate A delta and C fibers, nerves that carry the pain signals. A constant influx of these mediators and enzymes cause the nerves to respond to lower levels of these chemicals, leading to an increased number of action potentials and thus an increased sensation of pain (Chapman, 2010). It has been postulated, “repeated stimulation of peripheral nociceptors produced changes in the dorsal horn neurons of the spinal cord... Epidural analgesia/anesthesia might ameliorate phantom limb pain by preventing excessive simulation of the dorsal horn neurons before and immediately after lower-limb amputation” (Ong et al, 2005, p. 603). This may contribute to decreasing the risk for postoperative phantom limb