The Role of the Sympathetic Nervous System in Phantom Pain

Abstract

Recently, Sherman and Arena (1992) have argued that phantom limb pain is not a unitary syndrome but a symptom class, with each class subserved by different etiological mechanisms. For example, one class of phantom limb pain that is characterized by a cramping quality is associated with electromyographic (EMG) spike activity in muscles of the stump, whereas burning phantom limb pain shows no such association (Sherman & Arena, 1992). Katz and Melzack (1990) have identified a class of phantom limb pain that resembles in quality and location a pain experienced in the limb before amputation. Although the precise physiological mechanisms that underlie these somatosensory pain memories are unknown, the presence of pre-amputation pain clearly is a necessary condition for these pain memories to develop.