Neuropathic Pain " Phantom Pain
by Jonathan Blood Smyth
All the information which comes into our sensory system such
as feelings like touch and pain is transmitted up to the
sensory cortex of the brain, where the parts of the body
have specific parts of the cortex dedicated to them. The
diagram which results when the body parts are illustrated
against the sensory cortex is called the homunculus, in
which certain parts such as the lips and hands have much
larger areas of brain devoted to them than average. This is
because the importance for daily life of those areas is
greater and more information is required from them to figure
out what's going on.
In an acute injury the injured part goes through an
inflammatory process, with the soup of irritating chemicals
waking up normally silent pain nerves and a stream of nerves
impulses making their way upwards. These enter the spinal
cord and pass the messages on to the next stage nerves,
which become highly stimulated by the incoming impulse
streams as they start to amplify the incoming pain levels.
This increases and passes on higher pain intensities up to
the brain, forcing us to take corrective actions.
To feel any pain our higher brain areas such as our sensory
cortex and our conscious interpreting minds must receive the
pain impulses as pain is not present until it gets right
through. No pain is imaginary but the brain builds a virtual
feeling reality in order to interpret the world and be able
to respond, a virtual reality involving sight, touch and
pain. It's vital to understand the concept that the brain is
what makes the reality of the pain and not the injured,
damaged or abnormal body part.
Amputation causes a much greater disruption of the body's
systems than appears obvious on the surface as it is not
just the ligaments, muscles and bones which are surgically
cut. The nerves which travel down the limb are also cut
across and this has profound repercussions as the nervous
system does not appreciate it when input from the body is
cut off. When the constant streams of information coming in
are cut off the nervous system reacts in abnormal ways which
can cause unpleasant pain syndromes which are hard to treat.
When normal incoming impulses are blocked from reaching the
second stage spinal cord nerves these nerves overreact by
becoming highly irritable and increasingly active. Due to
the nerve transection and the complete loss of sensory input
the second stage nerves start to go into business on their
own, firing off pain signals without any incoming
stimulation. As the sensory areas in the brain for the leg
or other amputated part are still present, when they receive
the spontaneous inputs from the overexcited second stage
nerves they interpret them as pain in the area where the
nerve used to come from originally.
Phantom pain is the name given to pain which is present in a
part which does not exist any longer. It is a common
consequence of amputation with a high proportion of amputees
reporting a pain problem which can come on over weeks and
months. This pain can be very troubling, more troubling than
most typical pains, due to its unpleasant nature which can
be very sharp or deep and throbbing. Phantom pain is an
example of neuropathic pain, a pain generated by the nervous
system rather than by current injury to bodily tissues as in
normal pain.
Drug treatment of phantom pain is difficult as the morphine
chemicals such as morphine, fentanyl, tramadol and codeine
are often not very effective. The nerve treatment agents
such as amitriptyline, gabapentin and pregabalin are used
against neuropathic pain with some effectiveness. Other
treatments include transcutaneous electrical nerve
stimulation (TENS), an electrode based stimulation treatment
which can be self-managed. Cognitive therapy may also be
useful to start to cope with what can be a long term
problem.
Phantom pain can be an intractable, serious problem for
anyone with an amputation, and having significant pain
before the amputation may make the likelihood of phantom
pain greater. A multidisciplinary approach involving a pain
clinic is most likely to be helpful. - 15668
Jonathan Blood Smyth is a Superintendent
(http://www.thephysiotherapysite.co.uk) Physiotherapist at
an NHS hospital in the South-West of the UK. He specialises
in orthopaedic conditions and looking after joint
replacements as well as managing chronic pain. Visit the
website he edits if you are looking for
(http://www.thephysiotherapysite.co.uk/physiotherapy/physiotherapists/uk/london)
physiotherapists in London.
---------------------------------
New Unique Article!
Title: Neuropathic Pain " Phantom Pain
Author: Jonathan Blood Smyth
Email: david.ravech@googlemail.com
Keywords: Back pain,injury management,sciatica,Piriformis Syndrome,pain management,sciatica,back injury,back pain relief,Frozen Shoulder,Alternative medicine,physiotherapists,physiotherapy,Health,physical fitness,advice
Word Count: 688
Category: Health & Fitness:Alternative Medicine
---------------------------------
---------------------------------------------------
You are receiving this because you signed up for it on 2008-10-17 from IP
To fine-tune your selection of which articles to receive, just login here:
http://www.uniquearticlewizard.com/bloggers/
using your username: Robert
To unsubscribe please use the following link:
http://www.uniquearticlewizard.com/unsubscribe.php?mail=obetdos.tipsreviews@blogger.com&code=d1aa0d3361d9faa085f2a7d42a589d4a
---------------------------------------------------
0 comments
Post a Comment