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Phantom Limb Pain

  • Jens FoellEmail author
  • Herta Flor
Chapter

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.

Notes

Acknowledgment

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

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of PsychologyFlorida State UniversityTallahasseeUSA
  2. 2.Department of Cognitive and Clinical Neuroscience, Central Institute of Mental HealthUniversity of HeidelbergMannheimGermany

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