Phantom pain is a perception that an individual experiences relating to a limb or an organ that is not physically part of the body. Limb loss is a result of either removal by amputation or congenital limb deficiency. Sensations are recorded most frequently following the amputation of an arm or a leg, but may also occur following the removal of a breast, tooth, or an internal organ. Phantom limb pain is the feeling of pain in an absent limb or a portion of a limb.
The pain sensation varies from individual to individual. Phantom limb sensation is any sensory phenomenon except pain which is felt at an absent limb or a portion of the limb.How using a mirror can relieve phantom pain
Some experience some level of this phantom pain and feeling in the missing limb for the rest of their lives. The term "phantom limb" was first coined by American neurologist Silas Weir Mitchell in Symptoms include: Onset within the first few days of amputation. Comes and goes or is continuous. Often affects the part of the limb farthest from the body, such as the foot of an amputated leg. May be described as shooting, stabbing, boring, squeezing, throbbing or burning.
Sometimes feels as if the phantom part is forced into an uncomfortable position. May be triggered by pressure on the remaining part of the limb or emotional stress. The neurological basis and mechanisms for phantom limb pain are all derived from experimental theories and observations. Little is known about the true mechanism causing phantom pains, and many theories highly overlap.
Historically, phantom pains were thought to originate from neuromas located at the stump tip. Traumatic neuromas, or non-tumor nerve injuries, often arise from surgeries and result from the abnormal growth of injured nerve fibers.
Although stump neuromas contribute to phantom pains, they are not the sole cause. This is because patients with congenital limb deficiency can sometimes, although rarely, experience phantom pains. This suggests that there is a central representation of the limb responsible for painful sensations. Neuromas formed from injured nerve endings at the stump site are able to fire abnormal action potentialsand were historically thought to be the main cause of phantom limb pain.
Although neuromas are able to contribute to phantom pain, pain is not completely eliminated when peripheral nerves are treated with conduction blocking agents. The peripheral nervous system is thought to have at most a modulation effect on phantom limb pain. In addition to peripheral mechanisms, spinal mechanisms are thought to have an influencing role in phantom pains.
Peripheral nerve injury can lead to the degeneration of C fibers in the dorsal horn of the spinal cord, and terminating A fibers may subsequently branch into the same lamina.I've definitely had this happen, and I've also pinched or scratched somewhere only to make it tingle or itch somewhere else.
I wonder if that ties in with how accupuncture and accupressure use one point in the body to affect another point. I'm also sure you are not the only crazy person. It is maybe possible that the itch is there on two places but only one is noticed by the brain until that itch is gone. And if all of this is wrong then you are just crazy. It's on the underside of my knee, above the carf muscle.
However the itch feels as though it's inside my leg, rather than on the surface of my skin. It also feels as though it's moving around a point, rather than on a specific point. Errr, not sure how to put this, does anyone get that sharp needle like pain around their rear exit passage I know quite a lot of people that said they've had it a few times, but I've never known why in that particular spot, and what's the cause.
Is it just because it's quite sensitive around that area?
I really seem to be lowering the tone today. Not worried about it at all It really makes you want to wiggle your bum around in an attempt to get rid of it. I'll see if I can find anything on it. LOL, I don't even want to go in to the problems a velcro-vindaloo would cause. It started about a month ago, and itches about once a day. I cant remember the details fully but its some kinda thing that blocks too many messages going through at once Taping the tooth picks to the ruler.
This was all done at school, we were testing the sensitivity of the inside and outside of our forearms It's down to convergence. There are 31 pairs of spinal nerves. Each pair of spinal nerves innervate a limited area of the body called a dermatome see image: from Kalat, The equivalent segmentation is also found in the motor system muscles. These are called myotomes. This pattern of innervation is left over from when we were segmented worms.
Anyway, long story short, the afferent nerves converge on their way to the brain. They enter the dorsal horn of the spinal cord and converge on projection neurons. These send information up the spine to the thalamus where they converge further. Occasionally, hyperstimulation of one point in a dermatome can trigger a convergent neurone in such a way that the brain interprets the signal as coming from another area served by the same convergent neurone.
A similar phenomenon is responsible for referred pain. In this case, stimulation of deeper nerves can result in sensation apparently from surface nerves in the same dermatome. The brain is unused to recieving sensory information from internal organs they are innervated, but comparitively poorly.
So, when some internal region gets irritated say, the diaphragmthe brain interprets the signal as having come from an area of skin innervated by the same convergent neuron becuase generally, the source of the signal is more commonly skin and those pathways are more strongly reinforced. In the case of diaphragmatic irritation, the sensation appears to come from the point of the shoulder. Another example is the sharp pain in the left arm and wrist during a heart attack, although nothing happens in those areas to cause the pain, but the brain is unused to recieving sensory information from the heart.
Thankfully no I actually can't remember the last time I felt that sensation Over a year ago, my ex-fiance and I started to feel like bugs crawling on our body. We first thought we had ticks, fleas, bed bugs etc etc.NCBI Bookshelf.
Carstens E, Akiyama T, editors. Itch: Mechanisms and Treatment. Dermatologists are increasingly aware that some cases of unexplained chronic itch are caused by underlying neurological disease, and some now seek neurological care for these patients, but few neurologists feel prepared to help.
This overview is intended both to guide clinicians and to suggest research topics. The fragmented literature attests to the current rudimentary state of awareness about neuropathic itch.
The epistemology of neuropathic itch NI is based on that of neuropathic pain, which has so far worked well, no doubt because most peripheral itch neurons are a subset of peripheral pain neurons. NI is thus defined as perception of itch in the absence of pruritogenic stimuli formerly known to dermatologists as pruritus sine materia.
In other words, there is uncoupling of the stimulus-response curve for itch sensation since dysfunction or disease of itch-signaling neurons is causing them to fire without cause. At a practical level, NI can only be diagnosed after dermatological and systemic causes have been excluded, so dermatological evaluation should usually precede referral to a neurologist. From the neurological perspective, NI is primarily a modality-specific sensory hallucination, and the literature on other types of sensory hallucinations, e.
The requirement for a structural abnormality is problematic because in many patients, the causal lesions can often be hard to localize, meaning that they therefore no longer qualify as having neuropathic pain Jensen et al. As is typical in neurology, discovering the anatomical pathways for normal itch sensation has been aided by studying patients with neurological diseases or injuries that caused their itch.
The relevant methods include localization by neurological examination, imaging Chapter 24and rarely, anatomical or surgical pathology. Studying patients has demonstrated that NI is caused by lesions that specifically affect itch neurons, just as other neurological symptoms reflect the functions of the specific neurons damaged. As always, the cause of the lesion is less important than its location. A stroke, tumor, or multiple sclerosis plaque in the same brain region will generate similar signs and symptoms.
As imaging methods advance, it should improve our understanding of the pathways and mechanisms of NI. Better visualization of white matter tracts is particularly relevant for network disorders such as NI.
For instance, applying 7T magnetic resonance imaging MRI to the spinal cord of a patient with NI after cavernous hemangioma see below suggested the hypothesis that his late-onset central itch might be triggered by delayed white matter degeneration Cohen-Adad et al.
Peripheral nervous system PNS lesions appear to be the most common causes of NI, most likely because these are more common than injuries to the well-protected central nervous system CNS. Neuropathological study shows clearly that injury to specific neurons is necessary to produce itch, namely, to the subset of sensory small fibers that encode itch signals, which includes C-fiber and A-delta primary afferents with various transduction patterns Chapter 9.
Neuropathic itch is caused by the same type of neurological injuries and diseases that cause neuropathic pain as well. Many patients present with pain alone, or pain plus itch, but some report only itch, for unknown reasons. Lesions that primarily affect motor neurons, amyotrophic lateral sclerosis, for instance, are not associated with NI.Posted on: Aug 16, PM. Since then and especially today which is why I'm writing I have had phantom itching on my sides under my armpits.
Those areas are numb so I can't ever get that itching feeing to go away. It seems like it's really deep in my body. Has anyone else experienced this? Sometimes too I get it where my breasts used to be but mostly on my sides. Will it ever stop??!! Aug 16, PM Moderators wrote:. We're sure you'll be joined by some others here soon who can share their personal experience with this, but in the meantime you may be interested in reading the main Breastcancer.
Me too! I just had lumpectomy, augst last year, and the itching just really makes me wild sometimes. My bofriend said he would stick the backscratcher down my throat to scatch the itch from the inside. It does feel really deep, doesnt it?
I wonder how many women deal with this too, or how they relieve it. Aug 16, PM BayouBabe wrote:. I have this myself, but never told anyone. Thought I was nuts!
Glad to hear it is not just me. Have not found a solution yet; hope others have and share! Aug 16, PM Lily55 wrote:. Aug 16, PM del4 wrote:. I got it near the incisions for a long time. But it wasn't "phantom" - darn, it really itched. Sometimes feel a sense of irritation under where the breast would have been, along the rib cage, not often, but annoying. I use calandula oil or cream and it seems to sooth both problems. Aug 17, PM geroNP23 wrote:. It's on my right side, bottom axillary area Just wanted to let you know you weren't alone Aug 18, AM DocBabs wrote:.
Oh yes I'm 2 years out and mostly my right breast itches so much at times it's awful. It seems to be getting worse! Scratching really doesn't relieve it but strangely enough, when I'm showering if I use an exfoliating soap on that breast it seems to give me the most relief.
I think it's just something we'll have to live with. I am going to take the Mods advice and pop over to the site they suggest. Aug 18, AM Ariom wrote:. I brought it up with my Surgeon last week, he said it is very common, and should resolve before the first year is over.
Neurological Itches and Why Scratching Doesn't Help
I sure hope so! Aug 18, AM Ukkate wrote:.I've recently developed an itch in my right breast. The problem? It isn't there anymore! Is this like the phantom pain that amputees experience? Has anyone else had this issue. It's really tough to get rid of an itch that you can't scratch. What's with this anyway? Those nerves were cut and damaged so there's no feeling there. Everh now and then though it just itches. Are the nerves repairing or it is a phantom itch? I just saw my onc 2 weeks ago and it wasn't doing it then, but I'll see my surgeon in 10 days and will check with him.
In the meantime, just wondering if nayone else has had this issue. During rads and still now, I am getting sharp little pains on both sides that go away fairly quickly. I had bilateral mastectomy but rads only on the right. The RO said it is just the tissue getting feeling back. That may be what is happening. Still check with the surgeon. I would imagine it is just the nerve endings and everything repairing itself.
I had a strange feeling for awhile. I am not sure it was like an itch, but, I certainly felt something going on. I can't remember what it was exactly, but I do remember telling my surgeon at an appt. It is incredible what these damaged nerves and my brain are communticating to my conscious brain. You would think I have been beaten on a daily basis sometimes, yet, and that I am bruised, numb, etc. But yet there is nothing physically wrong with me, other than those rotten nerves and my brain communicating what they "think" is happening.
I always came in with a list of questions for my surgeon and she came to expect it. On one of my last appts, I didn't come in with a list and she said she was surprised. I had lumpectomies on both sides -- on the right side, the incision was made right around the aereola like a sideways smiley face :-and I have no feeling in or around that nipple. But yes, I still get itches there, try to scratch, and can't even feel myself scratching!
It's strange and irritating, but doesn't happen very often or for very long, so I've never worried about it. I never thought to ask my surgeon about it, as it's no more than a weird, occasional nuisance for me. Traci, I'm so glad you said that!! I sit here at night scratching away and I can't feel it at all. Meanwhile it's still itching!! It's like scratching a body part that is asleep. It's been driving me and my hubby crazy! I had a lumpectomy also but the scar is underneath.
My whole breast itches!!In a famous case ina woman with itching caused by shingles on her head scratched so furiously that she went through her skull and into her right forebrain.
Although aside from the itch she was neurologically and psychiatrically well, she needed to be physically restrained to prevent injuring herself further. In a seeming paradox, a skin biopsy of the itching area showed almost no nerve fibers in the affected region.
Where did this terrible itch come from? Despite its universality, itching has been relatively poorly investigated compared to pain or other sensations.
This definition is not completely satisfactory, however, since there are itches for which scratching provides no benefit. The original purpose of itch may have been to protect the skin from harmful agents by causing us to scratch the culprit away. Like all sensations, itch can also result from misfiring in the nervous system. In such cases, the skin needn't be directly involved, and scratching may do little to relieve the chronic itch.
It used to be believed that itch was just low-intensity pain. We now know this view to be wrong.
This specific pathway is triggered by histamine release. That all being said, the lines of information for pain and itch, while separate, do interconnect and communicate in the spinal cord. This may explain the inexorable desire to scratch an itch. Also, if pain is firing, it may inhibit or mask the activity of the itch pathway. The intriguing relationship between itch and pain can be seen in the use of some opioidswhich may cause itching when inhibiting pain.
In some cases of chronic itch, the normal cross-talk between pain and itch pathways in the spine does not exist. There is some evidence for each of these arguments, and the true nature of chronic itch that does not respond to scratching is likely some combination of those mechanisms.
While itching is classically thought of as a problem with the skin, some problems of the nervous system have also been described as causing itch. Examples include brachioradial pruritis and post-herpetic neuralgia.
That Crazy Itch You Just Can’t Satisfy
In other cases, small sensations may lead to a pattern of signals which is incorrectly decoded by the brain as being an itch. Chronic neurological itches are difficult to treat.
Typical avenues like oral antihistamines e.Itching, pain, and crawling sensations on the skin can take a mental and physical toll. Treating these MS symptoms often requires trial and error. Virtually all symptoms of multiple sclerosis MS are a result of the damage MS does to the brain and spinal cord. The sensation of burning pain caused by MS can occur anywhere on the body but is particularly common on the legs and tends to be a constant pain.
The legs can also be sensitive to the touch and feel cold. Brad Mann, who formerly blogged for Everyday Healthhas progressive relapsing MS and says he experiences uncomfortable skin sensations daily, including painful numbness in his fingertips and feet. If none of these drugs adequately controls the pain, a pain specialist may need to be involved in the care team to offer other alternatives.
When MS causes an itchy feeling, there is generally no sign of irritation on the skin such as a rash or bug bite. Topical skin creams are often not helpful with MS-related itching. However, Nicholas says there are that can be helpful, such as antiepileptic medications, Lidocaine patches, and possibly antihistamines although they are sedating.
However, this is a difficult symptom to treat, she notes. Managing the discomfort of his various symptoms is a challenge for Mann. While anticonvulsant medications provide some relief, he uses other strategies to help, such as applying ice and heat to areas of his body and using electrodes on the nerve receptors to distract his body from painful sensations.
Antidepressants such as Pamelor nortriptylineElavil amitriptylineand Cymbalta duloxetine. These drugs can also cause drowsiness.
Lidocaine patches used to treat severe pain in a localized area. Nicholas warns that most insurance companies cover one patch a day, and since the patches are small, that is usually not enough to treat a large area of pain. Capsaicin creamwhich can cause temporary burning or stinging where applied but which can, over time, block painful sensations.
Itching Associated With MS When MS causes an itchy feeling, there is generally no sign of irritation on the skin such as a rash or bug bite.
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