Phantom pain

Discussion in 'Biology & Genetics' started by Orleander, Jul 14, 2007.

  1. Orleander OH JOY!!!! Valued Senior Member

    If an adult loses a limb, they feel like its still there. They even try and scratch an itch on that missing limb.

    Do very young children do the same thing? I mean, at what age does the brain get used to having it there?
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  3. Orleander OH JOY!!!! Valued Senior Member

    well, I was just thinking about my Mom being deaf. The nerves to make her hear never got used, so they didn't develop or get hard wired to hear. Even though they were there in perfect condition, they didn't work.

    If a baby loses a leg they never used, would they ever feel phantom pain? Did their brain have time to hard wire its usefulness?
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  5. Billy T Use Sugar Cane Alcohol car Fuel Valued Senior Member

    I do not know for sure, but think they may both have a phantom leg and even phantom (but very real) pain in it.

    Quite a lot of what it is to be human is hard wired in our brains. I suspect that the observation of others, with two legs, may be sufficient to activate the recognition that two legs is "normal" even in a baby born without one, and cause the existence of the phantom leg limb.

    Answer to this question is surely known, but I WILL NOT SEARCH FOR IT. I have several papers on phantom pain / limbs and have read many more, but do not recall this question being answered. Phantom limbs and pain is one of many facts that is easily explained by my theory* of how perception works. (And how the "mirror cure" for pain in the phantom limb (due to phantom finger nails digging into the phantom hand, usually). My theory would weakly predict that the baby could create a phantom leg.
    *See for novel view of how human perception, including our perception of our own bodies, works. In addition to phantom limbs its opposite, the strange denial of ones real limbs (even half of your entire body in the usual case) as being part of "your" body is easily explained by my theory and thus one of the many strong supports for it. (This condition is a frequent result of some types of partial strokes. - Usually called "unilateral neglect.")
    Last edited by a moderator: Jul 15, 2007
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  7. Orleander OH JOY!!!! Valued Senior Member

    Umm, you have papers and theories on it and yet you don't know how to spell it? phantom.
  8. Billy T Use Sugar Cane Alcohol car Fuel Valued Senior Member

    My spelling is poor and I am dyslexic. - I am more concerned with ideas than with form. My typing is worse. Usually I do a spell check soon after posting, but as it was apporaching mid night I had to rush off to near by Ruby Tuesday before it closed (now in USA for annual month visit with my grand children but at airport motel).
  9. valich Registered Senior Member

    As usually Billy, this is an excellent reply. The existence of phantom pain is hardwired. This we know. But what are you talking about, about some "mirror cure" for pain in the phantom limb? There is no cure. Billy, if you can help me with this please try. As you may or may not know from previous posts, the upper right quadrant of my torso is paralyzed from a motorcyle accident that caused root avulsion in C5-T1. The scenario is that nerve pain sets in within three months, and it did. I've been fighting chronic back and phantom nerve pain for fifteen years. There is a new medication on the market that just came out two years ago that has done wonders for relief of this intense pain. After the accident the pain was so intense that I underwent a dorsal root entrance zone (DREZ) lamenectomy with a 60% chance of success and a 10% chance of being quadrapalegic. Blain Nashold of Duke University Medical Center went in and caudurized the nerves and that took away about 50% of the initial pain - the guy saved my life. Still, the phantom nerve pain - causalgia, intense burning and stinging sensation, pins-and-neddles - is something I have to deal with on a daily basis. I have no idea what you are talking about: "phantom finger nails digging into the phantom hand, usually." I have sensation in my arm but not my forearm yet I always can feel that it is there - 100%.
  10. Orleander OH JOY!!!! Valued Senior Member

    If it is hard wired into the brain, is it done before birth? Or after the child realizes they have hands and feet. Or when the child actually starts using them?
  11. Billy T Use Sugar Cane Alcohol car Fuel Valued Senior Member

    Your pain is trama pain, not phantom pain and certainly not pain in a phantom limb.

    For many of the persons who have lost an arm, the missing arm is perceived as just as real as the arm they actually do have. They of course consciously know it is not there, but what they intellectually know has nothing to do with what they experience / perceive. The owners of a phantom limbs usually have little control over the limb. For example, one man´s phantom arm extended straight out from the body. If he thought about it, he could go thru and open door way, walking straight, but rarely did so. Instead he automatically twisted his body to avoid banging the absent arm into the wall / door frame.

    In a significant, but minor fraction of the cases of pahntom arm, the phantom hand is clinched into a very tight fist and the phantom finger nails are digging into the palm causing pain. As in your case, all sorts of things have been tried to ease this pain, mainly phycholgical things, suggestions and in most cases with very little success. Then the mirror cure was invented and it works in many cases. Here is how it is done:

    There is vertical mirror about 3 or 4 feet tall and at least a foot wide. (Often you can see them for sale cheap in a drug store etc.) The mirror is edge on to the patient with the mirror side turned to the real / existing arm and the real arm is hanging down in front of it. Normally the real arm and mirror are inside a larger box which is black on the inside but has some small lamp in it so that that when the patient looks into the box (on the mirror side) he sees his existing arm and its mirror image. (I.e. he see a right and left arm, right and left hand etc.) Before placing his real arm in front of the mirror, he is instructed to clench his real fist just the way the phantom fist is clenched,even causing some pain in the real palm. Then as he watches both the real and images with clenched fists, he is told to slowly unclench both his hands, the real one and the phantom one. He see the image of the clenched fist slowly open and he experiences the phantom hand un-clenching!

    I read about this at least 15 years ago. I do not know any stastistics as to how often it works. I think it may only ease the pain in some cases on the first try, but after being repeated may give complete relief of the phantom pain.

    As my theory of all perception is that it is not the real world, but a real time simulation of the real world, which is perceived this is not only easily understood, but to be expected. Humans are very visual creatures. When the patients retinal image is that of his phantom arm and he sees the clinched hand slowing unclinch, that is what he experience because evolution has made us make a real time simulation which is normally very faithful to the real world.

    Unfortunaltely, your problem is quite different from phantom finger nails cutting into a phantom hand. You have experienced real trama. I forget the correct erms, but it is quite common that when a sensory nerve is cut (or crushed) that a ball like structure forms at the proximal end of the cut nerve (the distal end dies) (Perhaps term for this ball is neuronoma, or something like that?) This ball can become very sensitive and the impulses it produces are often interpreted as painfull.

    I hesitate to make any suggestions to you, but will tell two thing I would at least experiment with.

    Pain is very complex process with huge mental interpretation component. Thus, if some manuevers of your torso cause the pain to intensify, I would do some thing (perhaps masterbate) which is very pleasurable and in Pavloff style, also near the intense pleasure period, also do the manuever that intensifies the pain. - idea being to get the brain to corelate that now pain intensifying movement with pleasure not pain. - there are sadists who do get pleasure from thing that most of us would process as pain, you know.

    The other thing I might try is to use some mild shocks*, but acupuncture is probably muich safer, as your injury is thorasic and we do not want to throw the heart in fibulations. In this case, the idea is that a significant change in the pulse characgteristics that are now interpreted as pain may cause a different interpretation. If you do anything with electricity, be sure to control the current path to keep it far from your heart. Don´t try this is you are not sure you can control the internal current paths. Stick to acupuncture.
    * Bi-polar pulse trains with less than 50% on time. Each pulse being about 0.5 ms duration and then off so get about 16 pulse pairs (+ AND -) per second. Current well limited to less than 1ma. Electrodes only a cm OR LESS apart over the T1 or higher region on your back / neck. Obviously some one is aiding you apply them. Expect nothing immeditate, and only uses for 2 or less minutes a few times each day. If noting better in 10 days, quit
    Last edited by a moderator: Jul 17, 2007
  12. valich Registered Senior Member

    I have no idea what you're talking about regarding this "mirrage image" cure but it sounds like a bunch of bunk to me. Regarding my root avulsion pain, it is documented that when root avulsion occurs, a severe pain syndrome sets in within about three months, and it did. Since it is root avulsion, you can't talk about the distal or proximal end of the nerve because there is no nerve left. This "ball like structure," if such a thing exists, and I've never heard of this on any nerve injury either, would definitely not apply in my case. This is why they went in and cautarized those particular nerves in the spinal cord. If he had slipped, I could be quadrapalegic. The result was a 50% reduction in the pain but I still experience severe burning, and sometimes lighting bolt shooting spike pain running down my arm and all I can do is grit my teeth for a couple/few seconds. I don't think root avulsion is classified as a trauma pain. I say phantom pain because all my nerves, both motor and sensory, are now cut/severed/avulsed that lead to that limb. The best explanation that I ever received from a neurologist is that it is like a short-circuit - the nerves still fire but the action potential has no where to go.

    Yes, "distraction therapy" does help, but your suggestion of "masturbation" is an insult to my integrity. I do use distraction therapy, but at a much more respectable socially-acceptable level. I certainly have no time to masturbate, and I am morally against this and other egotistic self-indulgence, self-enjoyment serve-no-end, purposeless activities. I believe in life-long-learning, knowledge and education. I am a Naturalist, a Biologist, a striving Paleontologist, an ESL teacher, and an author, and I am very busy with many intellectual activities that will definitely take up the rest of my life and then some.
  13. Billy T Use Sugar Cane Alcohol car Fuel Valued Senior Member

    Sorry I did not get back to your sooner. (I forgot about this thread.)

    I am not trying to change your moral values (I never do if the practice is not injurous to others.) but I do not think you should attact (degrade) others whose morals do pemit masterbation. There is little question that in some cases masterbation is useful to society in that it provides a relief to what Freud called "sexual tensions" when other reliefs are not available and without this relief injury to others does sometimes occur.

    Asfar as your pain is concerned it is properly called

    Neurogenic Pain
    "Pain initiated or caused by a primary lesion, dysfunction, or transitory perturbation in the peripheral or central nervous system."

    This quote from the international body defining pain types. See:

    For the widely accepted definitions of various types.

    Please reread the discription I gave of how the use of a vertical mirror has been used to relieve the phantom pain* of a (non existent) clenched fist with the non existent finger nails digging painfully into the non existent palm.

    If after a re-read you still do not understand, I think I can find the journal reference where this cure is first described. (I know I still have a Xerox of the article but it is some where in a stack of Xeroxs about a meter high.)

    I spent many hours working on chronic pain with doctors at Johns Hopkins Hospital. (I even hold a patent on a special needle that enables them to insert electrodes on the dura of the spinal cord with relatively minor surgery. (Just stick the needle in thru a lamina joint.)

    The problem I solved for them was that the cable from the electodes would not permit the insertion needle to be slipped back out if the other (non electrode) end already had a connector attached. Thus, the doctor used a soldering iron at the end of the operation to add the connector after the needle was pulled out leaving the electrode cable in place.

    My patented needle was a little larger and made in two pieces both "U" shaped I.e. a U and a u which with one inverted and inserted into the other to form a O or closed needle to confine the cable with well made, tested connector already attached.

    I.e. the cable was initially layed sideways into the u and then the U was placed over the u, thus confining the cable within the needle. After the electrode was inserted, my needle was slid back until it was entirely outside of the body and then the U and u were separated to free (side ways) the needle from the cable with no problem caused by the pre-existence of the connector attached to the cable.
    *Note that "phantom pain" is not amoung the couple of dozen of different pain types that are defined. - It is obviously a "phantom pain" if it is in a "phantom limb" so no definition is needed to distinguish it from pains in the real body. Perhaps "pain in the phantom" would be more precise, but that is not used as too long. (For readers unfamiliar with phantom limbs they are just as real emotionally and psychologically to people who have phantoms as their real existing limbs. Often they have little control over the phantom. I.e they can not "unclench the fist" that is causing the pain. The pain is certainly real even if the limb is not.

    Also I do not dispute the validity of the terms your doctor has used. They may be well understood by other doctors.

    You are not correct when you say: "you can't talk about the distal or proximal end of the nerve because there is no nerve left." If that were the case you would not have pain. In fact some experimental work has been done to totally remove the nerve with a injection of a toxin in it. Then it dies all the way back into the brain. Your injured nerves still exist and the end inside the brain is stil able to stimulate other brain cells and produce your pain.

    All pain is created only in the brain from unusual neural impulses coming to it from the nerves that extend outside of the brain.

    It is strange, but true, that the injury to the brain itself (alone) never casuses any pain. Doctor routinely cut deep in the brain, remove sections of it, stick stiff electrodes down into the deep interior parts etc. all without causing any pain. Usually while talking with the patient and making the patient speak back, tell the doctor various things etc. as the doctors slowly proceed to do what they think may help the patient (typically he has spreading eplipse, proper term instead of "spreading" is "kindling" like starting a fire,which is in some sense exactly what is happening as the excesive electrical activity of brain cells spreads). I.e. they are trying to avoid destroying some of his more obvious abilities as this is likely to result in a law suit against the doctor.

    I have been in the OR at JHH and watched a fully conscious lady's brain be probed and stimulated electrically without her feeling any pain. She had only a local (topical) pain killer applied to scalp. - some form of novicane, I think, like your dentist might use. (Just watching, I suffered much more than she did!)
    Last edited by a moderator: Aug 20, 2007
  14. ccdickey Registered Member

    Valich, I too have a brachial nerve plexus injury resulting in the paralysis of my left upper torso. I have the same pain as you and for the past 15 years have dealt with the pain. It has been only about 2 years since I’ve taken or done anything about the pain. I read that you found a new medication. Would you let me know what it is? I am currently taking Hydricodone (sp). I’ve tried several non narcotic medications but non have really helped. On another note, I just was referred to a Doctor that may be able to get movement back in my arm. I did some researching on the internet and found an article that talks about the surgery.
  15. invert_nexus Ze do caixao Valued Senior Member

    Old thread, I know. But, to anyone interested, the 'mirror cure' was discovered by V.S. Ramachandran and is not 'a bunch of bunk'. The conclusion drawn from the success of the mirror box is that there is a learned component to both paralysis and phantom pain.

    These people who suffer phantom pain are generally those who suffered nerve pain and paralysis prior to amputation. Amputation was seen as a final means to cure the pain, unfortunately the pain continued as the mind had already learned it quite sufficiently. Without any feedback from an actual limb, the sufferer was unable to revamp his learned body image and thus still felt the paralyzed limb. After spending time with the mirror box, the body image is relearned. Not only is the pain cured, but the phantom limb first becomes mobile then finally disappears altogether. This is generally seen as a great relief by those afllicted.
  16. Billy T Use Sugar Cane Alcohol car Fuel Valued Senior Member

    Thanks for the ref. I had again forgotten this old thread, so did not dig out my X-erox to Ramachandran's original paper. I also want to note that all perception has a "learned component."
    I think it was Locke, who first put forth the idea that humans come with a "blank slate" - that is now known not to be entirely true, but certainly all perception is strongly influenced by prior experience. For example, when you see an object, such as a chair, you perceive many things, sometimes called their "affordances" - In the case of a chair it "affords" the opportunity sitting upon it, or making a fire with it, etc.. Or a candle is perceived differently by one who has never seen one before than by one who has and knows what it affords.

    I have dozens of facts that support my POV about the mechanism of perception and tend to contradict the accepted POV. My POV is a "crackpot's POV" as I do not accept the standard POV of cognitive scientist that perception "emerge" following many stages of "neural transformations" of sensory input data.

    I contend that humans (and probably some other species) construct a "real time simulation" of the world they can sense and it is this real time simulation that is perceived, not any "emergent" transform of neural data. I agree that the sensory input is processed by neurons to extract many well known "characteristic" such as color, motion, position, shape, orientation etc. to name a few of about 15 known to be separated and sent to physically separate regions of the brain (Color to V5, motion to V3, position, shape and orientation are mainly in V1 & V2) These separated features, as far as is known, are never rejoined anywhere in the brain to allow you to perceive a round yellow tennis ball moving over the net.

    I think that the "deconstruction into features" is done to update the simulation more accurately and quickly, just as a airline pilot uses a "check list" of details, not some integrated overview to make sure the plane is ok.

    For example, only the position of the moving tennis ball needs to be constantly "corrected," not its color or shape, in the real time simulation. That position is perceived where the tennis ball actually is, not where it was earlier in time by the neural delays associated with the diffusion of neural transmitters across synaptic gaps (that can be up to 1/3 of a second delay, but usually is only about 0.1 seconds or so)

    If the standard POV were correct (no projection ahead to make a REAL-TIME simulation) then a fast game of ping-pong would not be possible if perception of the ball's position had to "emerge" after several neural delays in stages of processing in V1, V2, V3 and later regions.

    Phantom limbs, especially when manipulated during the mirror cure, are strong support for my POV as in this case there is no change in the neural inputs coming to the "sensory cortex" as there is in the case of a real limb moving. There are only neural changes in the "visual cortex" associated with the moving image in the mirror. How could they "emerge" as perceived moving limb when they do not even exist as tactile inputs? Clearly, this perception is internally generated, not "emergent," nor only "remembered" as then it could not move responsively as the image of the still existing limb is moving in the mirror.

    More and three stronger proofs that the standard emergent POV is simply wrong at:
    Last edited by a moderator: Mar 11, 2008
  17. Experience Registered Member

    Dear valich - For a "Senior Registered User", you have no qualifications to enter into the discussion! Are you speaking from the stance of some antiquated church-like organision? One that preaches Adam and Eve and the Immaculate Conception?

    Many years ago, I was in severve pain for weeks so I know the only thing to relieve my pain was to masturbate. It was either this (because conventional painkillers did not work) or suicide. The pain eventually subsided after a few weeks.

    Butter wouldnt melt in your mouth because we all know you deny masturbation: he who cast the first stone....

    Hopefully people who have read your comment also read mine.
  18. Billy T Use Sugar Cane Alcohol car Fuel Valued Senior Member

    Welcome to sciforums, Experience:

    Now that Experience revived this thread again I re-read my last post replying to invert_nexus. It mainly pointed out that Phantom limbs cannot be easily understood with the accepted “emergent” theory of perception, (There is no neural input from the absent limb for brain to process and then “emerge as our perception”) but are very easily understand in my Real Time Simulation model of perception as all perceptions come from the world we simulate not from transformations of sensory impulses. They only guide the simulation to keep it an accurate (except for illusions, a phantom limb being one) representation of the external world.

    In this post I want to comment that there is much more to phantom limb than pain. It is a very real, fully experienced limb to the victim or owner of it. Usually, it is in a fixed position and normally he has little control over it. They of course consciously know that they have lost the limb, but it does not seem that way to them – perceptually it is still there. For example, one man’s phantom limb stuck straight out from the side of his body. When he quickly went thru doorways without thinking, he automatically twisted his torso so it would not hit the wall.

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