Phantom sensation, phantom pain, and stump pain

Abstract

Phantom sensation, phantom pain, and stump pain have been known since antiquity. For millenia, sensations in the missing body part were thought to be of psychic origin. During this century the psychic explanations have gradually given way to physiological explanations. However, these have been tenuous hypotheses that have poorly explained the reported symptoms. This history is reviewed here. It is now believed that phantom pain probably originated in the pain transmitting neurons of the dorsal horn. This has led to significant advances in the treatment of this disorder. It is now thought that phantom sensation is best explained as a sensory emgram or a part of the neuomatrix as purposed in 1989 by Melzack. This hypothesis is in agreement with newer theories of brain function. The differential diagnosis and treatment of stump pain are also reviewed. There is no current treatment for phantom sensation. The treatment of phantom pain and stump pain must be part of a more comprehensive rehabilitation program aimed at restoration of function in all spheres of the individual's life. Discussion of the role of "phantom" sensation and pain in the spinal cord injured is also presented.