When a person loses an arm or a leg, it involves, not only a shock to the physical body, but a tremendous amount of stress on an emotional and psychological basis. Depression, anger, and fear can set in as the injured person begins to cope with the loss of a limb and the resulting change in body image, as well as uncertainties of the future. Physical therapy needs to be accompanied by emotional support as the patient recovers.

One mysterious but very common consequence of limb loss is the occurrence of "phantom pain," ranging from an odd sensation to sometimes severe pain seemingly coming from an arm or leg which is no longer there. The phenomenon has existed for as long as human beings have been surviving wounds involving amputation. Only recently has the medical community begun to understand the reasons behind this event.

Once thought to be strictly a psychological problem, most doctors and researchers now believe that the pain is neurological in origin. It's possible that nerve cells in the brain adapt to the amputation by "rewiring" themselves to cope with the loss of the limb. The pain may be reflective of pain that existed in the limb prior to amputation, and may be a saved memory of the pain that is somehow triggered after the amputation. Other possible causes include blood clots which damage nerve cells, new growth of nerve cells at the site of the amputation, and poorly fitting prosthetic devices. Triggers can include changes in the barometric pressure, some kind of impact on the part of the limb remaining, even physical and emotional fatigue.

Treatment of phantom pain can include medications ranging from mild to very strong to deal with the physical pain, medications aimed at dealing with accompanying mood disorders such as depression, and a number of physical treatments and coping techniques including nerve stimulation, biofeedback, and acupuncture. In cases where pain has existed in the affected individual's limb prior to amputation, giving medication to alleviate the pain before the limb is amputated actually lowers the incidence of post-amputation phantom pain. Also, applying certain pain medications such as Calcitonin or Ketamine directly after the amputation may prevent phantom pain from developing in the future. In severe cases, additional surgeries, either on the stump, the brain, or the spinal cord, may provide relief.

Of course, a patient using a prosthetic device needs to make sure the artificial limb is not the source of pain. Someone experiencing phantom pain after exercise or use of the artificial limb needs to inform his or her physical therapist or doctor; it's possible that an adjustment in the prosthetic device can eliminate or minimize the pain.

Aldene Fredenburg is a freelance writer living in southwestern New Hampshire. She has written numerous articles for local and regional newspapers and for a number of Internet websites, including Tips and Topics. She expresses her opinions periodically on her blog, http://beyondagendas.blogspot.com She may be reached at amfredenburg@yahoo.com