Experiencing pain in the void
Imagine this: You have just been through a terrible bike accident. You are being taken to the hospital and on the way, you suffer significant blood loss in your legs. As soon as you reach the hospital you were given morphine and anesthesia to help with the pain. You passed out after this and woke up after 6 hours.
As soon as you wake up you feel terrible pain in your right leg. You call for the doctor and the doctor is a little shocked by your experience. Because it's strange that there is pain, because your right leg has been amputated 3 hours ago.
Well, I hope no one ever has to go through this in their life but what you just read is actually true. But the question arises if your leg is not there how come the pain?
Phantom Pain. It is defined as painful sensations perceived as originating from the missing limb. These pains can happen at any time in your life and are recurrent. Scientists once believed this post-amputation phenomenon was a psychological issue. But experts later recognized that these are real sensations, originating from the spinal cord and the brain.
The pain was first recognized in 1551 by French military surgeon Ambroise Paré. He recorded the first documentation of phantom limb pain when he reported that, "For the patients, long after the amputation is made, say that they still feel pain in the amputated part".
It’s interesting to note that till now we don’t know for sure why this happens. But most studies say that it’s all a mix of neurons that are actually creating this illusioned pain. Because the disappearance of your limb doesn’t necessarily mean that your neurons linking to will also disappear. The limb area is still in the brain, but now the brain is confused.
This confusion can cause something called "smudging" in the brain, where the pathways of the amputated limb merge with areas of the brain next to it.
Almost 80% of amputees suffer through this pain mostly right after the leg has been amputated. The experience of phantom limb pain lies along a spectrum of severity. Some cases of extreme severity, which is around 10-20% have also resulted in the patients committing suicide because this can affect them mentally as well.
Nearly 75% of individuals experience the phantom as soon as the anesthesia wears off, and the remaining 25% of patients experience phantoms within a few days or weeks. Of those experiencing innocuous sensations, a majority of patients also report distinct painful sensations.
So how does one get out of it?
Well, as mentioned most of these 80% cases will just die out by taking in some sort of medication like beta-blockers, painkillers, opioids, etc. However, the complexity of diagnosing the origin discourages healthcare systems from actively treating the condition. Even today, several healthcare providers settle to ‘treating’ phantom limb pain by merely educating the patient about the syndrome and the several treatments available regardless of their effectiveness.
The sad part is that most of the people who go through this, don’t usually admit it. The reason: they are afraid of being considered psychotic by others.
In a unique time like this, the emotional impact caused by social distance and isolation has actually been shown to exacerbate the symptoms of PLP, so knowing how to deal with fear and stress is essential these days.