Phantom pain is experienced by 60% to 80% of patients following limb amputation but is only severe in about 5% to 10% of cases. The mechanisms underlying pain in amputees are not fully understood, but factors in both the peripheral and central nervous system play a role. Treatment of phantom pain is not successful; a recent study on prevention of phantom pain showed negative results. The future...

Using functional MRI, we investigated 14 upper limb amputees and seven healthy controls during the execution of hand and lip movements and imagined movements of the phantom limb or left hand. Only patients with phantom limb pain showed a shift of the lip representation into the deafferented primary motor and somatosensory hand areas during lip movements. Displacement of the lip representation i...

Three case histories are presented in which amputees with acute or chronic phantom limb pain and phantom limb sensation were treated with Western medical acupuncture, needling the asymptomatic intact limb. Two out of the three cases reported complete relief of their phantom limb pain and phantom limb sensation. Acupuncture was successful in treating phantom phenomena in two of these cases, but ...

In humans, limb amputation or brachial plexus avulsion (BPA) often results in phantom pain sensation. Actively observing movements made by a substitute of the injured limb can reduce phantom pain, Proc. R. Soc. London B Biol. Sci. 263, 377-386). The neural basis of phantom limb sensation and its amelioration remains unclear. Here, we studied the effects of visuomotor training on motor cortex (M...

Recent findings suggest that major misunderstandings concerning the prevalence, characteristics, etiology, and treatment effectiveness of phantom pain have led to the widespread mismanagement of amputees throughout the history of modern medicine. For years it has been believed that phantom pain is relatively rare, is of unknown etiology, and probably has a psychological basis. Research results ...

The vast amount of research over the past decades has significantly added to our knowledge of phantom limb pain. Multiple factors including site of amputation or presence of preamputation pain have been found to have a positive correlation with the development of phantom limb pain. The paradigms of proposed mechanisms have shifted over the past years from the psychogenic theory to peripheral an...

This chapter is supported by Grant MT-12052 and a research scholarship from the Medical Research Council of Canada. After an amputation many patients awake from the anesthesia feeling certain that the operation has not been performed. They feel the lost limb so vividly that only when they reach out to touch it, or peer under the bed sheets to see it, do they realize it has been cut off. This ph...

Phantom limb phenomena were correlated with psychophysiological measures of peripheral sympathetic nervous system activity measured at the amputation stump and contralateral limb. Amputees were assigned to one of three groups depending on whether they reported phantom limb pain, non-painful phantom limb sensations, or no phantom limb at all. Skin conductance and skin temperature were recorded c...

Recent neuroscientific evidence has revealed that the adult brain is capable of substantial plastic change in areas such as the primary somatosensory cortex that were formerly thought to be modifiable only during early experience. We discuss research on phantom limb pain as well as chronic back pain that revealed functional reorganization in both the somatosensory and the motor system in these ...