Some people develop phantom pain after an amputation while others do not. Is phantom limb pain psychological or physiological? Which treatment is more effective acupuncture or mirror therapy?
The pathophysiological mechanisms behind the phantom pain limb are still not much clear and in research. The proposed mechanism include peripheral, central and psychological factors. The following article may help you. https://www.sciencedirect.com/science/article/pii/S2256208713000850
Mohadese,
When an amputation is performed under anesthesia and a central neuraxial technique is performed (Spinal), the incidence of phantom limb pain is reduced. Therefore, the main component would be physiological (altered nerve transmission). The disease (pathophysiogy) leading to the surgical amputation plays an important factor. If the patient was experiencing intense pain prior to the amputation, the pain pathways would be induced and hyperactive. Another factor has to due with the amount of exogenous opioids the paitent had been receiving (dynorphin production). First and second order neuron activity contributes to the majority of phantom limb pain but psychological stress can be a significant contributor. One must treat both aspects to provide the patient with the best outcome.
Regards,
Christopher
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