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Handbook of Pain and Palliative Care pp 419–434Cite as

Phantom Limb Pain

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Abstract

Chronic phantom limb pain is a common occurrence after the amputation of an extremity, often causing a considerable level of suffering for years or decades after an accidental injury or an operation. Due to its intractable nature and multilayered working mechanisms, it has proven to be a challenge for both practitioners and researchers. Studies have linked this type of chronic pain to alterations in the peripheral nervous system, the spinal cord, the brainstem, the thalamus, and the cortex. Mechanisms that contribute to the elicitation and perpetuation of chronic phantom limb pain may be the formation of neuroma, central sensitization, cortical reorganization, and pain memory. The tendency of developing phantom limb pain after limb amputation seems to be connected to perceptual illusions, such as integrating the mirror image of a limb or a rubber hand into one’s own body representation. These findings have led to novel forms of treatment, such as mirror therapy, imagery training, or the application of virtual reality. Other promising treatments include pharmacological approaches before and after amputation, sensory discrimination, central stimulation, the use of myoelectric prostheses, and the combination of medication and behavioral approaches.

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Acknowledgment

The completion of this chapter was supported by European Research Council Advanced Grant PHANTOMMIND awarded to HF.

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Authors and Affiliations

  1. Department of Psychology, Florida State University, Tallahassee, FL, USA

    Jens Foell PhD

  2. Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany

    Herta Flor PhD

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  1. Jens Foell PhD
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  2. Herta Flor PhD
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Correspondence to Jens Foell PhD .

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  1. Bethesda, MD, USA

    Rhonda J. Moore

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Foell, J., Flor, H. (2018). Phantom Limb Pain. In: Moore, R. (eds) Handbook of Pain and Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-95369-4_22

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