Although doctors know something about the situations in which phantom
pain occurs, they don't know exactly the cause of the pain. Researchers
have suggested several theories.
Many doctors once thought that phantom pain was a psychological rather
than a physical problem. They believed that pain resulted from a
person's unwillingness or inability to accept the loss of a limb, or
from a person's being overly concerned about the loss. Later research
found that psychological distress is not the sole cause of phantom pain
and may not be involved at all.
Causes of phantom pain may include:
Some researchers have found that people who had pain in a limb
before amputation are likely to experience phantom pain afterward.
This connection may be strongest in the period of time immediately
Blood clot in
the amputated limb.
People who had surgery because of a blood clot in the amputated limb
report phantom pain and discomfort both before and after
rehabilitation more often than do people who had amputations for
other reasons. Researchers think this may occur because the clot
reduces the amount of oxygen available to the limb, damaging it.
Remaining tissue that was damaged may take longer to heal than
healthy tissue or may never heal, resulting in prolonged pain.
Pain that occurred intermittently but was not present immediately
before an amputation may influence whether phantom pain develops.
Pain related to gangrene or other infections prior to the amputation
also may be more likely to result in phantom pain after surgery.
Certain injuries such as nerve roots being torn away from your
spinal cord (root avulsion) and damage to your nerve networks
(plexus) also increase your risk of phantom pain.
researchers learned more about how the brain can "rewire" itself after
trauma such as surgery, some theorized that people experience phantom
limb sensation in an upper limb when a different part of the body, such
as the face, is stimulated. One research team found that the amount of
brain rewiring is directly proportional to the degree of phantom limb
pain. They found more rewiring in people with phantom pain symptoms than
in people without symptoms.
Screening and diagnosis
There's no medical test to diagnose phantom pain. Among the information
that doctors use to diagnose phantom pain are the signs and symptoms and
the circumstances (such as trauma or surgery) that occurred before the