Monday, November 5, 2007

Phantom pain – the great leveler

Some time ago, one of my undergraduate pain science students came up to me after a lecture on phantom limb pain and said “but it is not real pain is it?”

Hopefully later lectures fixed the misconception and you wouldn’t want to tell the amputee that its not real pain!

Phantom pain is worth reflecting on from time to time. If there was a surgeon mad enough to perform a ‘lumbarspinectomy’ for chronic low back pain, the glaring evidence is that the pain would still be there in the hole in the back and made worse by stress and movements. Yet we jiggle and zap it, poke needles into the area and take medications which are supposed to find their way to the area and pathological process in the spine.

Clinicians should tell the patient about phantom pains. It provides a gateway to education about the role of the brain in pain. And it is worth remembering that many soldiers who returned from world war two with amputations and pain were told that it is impossible to have pain in fresh air.

Tell us your phantom stories…

Image from Butler DS, Moseley GL, 2003 Explain Pain, NOI Publications, Adelaide