Is phantom pain experienced by amputees neurological?
Phantom pain
The neurological basis and mechanisms for phantom limb pain are all derived from experimental theories and observations. Little is known about the true mechanism causing phantom pains, and many theories highly overlap. Historically, phantom pains were thought to originate from neuromas located at the stump tip. Traumatic neuromas, or non-tumor nerve injuries, often arise from surgeries and result from the abnormal growth of injured nerve fibers. Although stump neuromas contribute to phantom pains, they are not the sole cause. This is because patients with congenital limb deficiency can sometimes, although rarely, experience phantom pains. This suggests that there is a central representation of the limb responsible for painful sensations. Currently, theories are based on altered neurological pathways and cortical reorganization.
Somatosensory rehabilitation of pain
Sometimes, the hypoaesthetic territory is masked by a patch of skin which is painful to touch and is therefore not accessible. Since 1979, this stimulus induced pain is to be called allodynia in medicine. The original definition comes from Merksey and Bogduk (1994) “pain due to a stimulus which does not normally provoke pain”. In such situations, while doing the diagnostic testing of axonal lesions at the first occupational or physical therapy session, the two point discrimination test is impossible, because it induces pain.“This conflict between hypersensitivity and hypoaesthesia is commonly seen in the clinical setting in patients with CRPS”.