Central Nervous System Correlates and Mechanisms of Phantom Pain

Abstract

A striking property of phantom limb pain is the presence of a pain that existed in a limb prior to its amputation (Melzack, 1971). This class of phantom limb pain is characterized by the persistence or recurrence of a previous pain, has the same qualities of sensation, and is experienced in the same region of the limb as the preamputation pain (Katz & Melzack, 1990). Case studies of amputees have revealed pain “memories” of painful diabetic foot ulcers, bedsores, gangrene, corns, blisters, ingrown toenails, cuts and deep tissue injuries, and damage to joints and bony structures. As well, the phantom limb may assume the same painful posture as that of the real limb prior to amputation, especially if the arm or leg had been immobilized for a prolonged period. Appendix I provides an annotated bibliography of the literature, in chronological order, of reports of pain memories.