PAIN AND YOUR BRAIN - introducing phantom pain

The ability of the brain to change, to rewire itself and find new pathways, is called neuroplasticity.  In many situations, such as after a stroke, this can be a blessing. The brain can recruit new areas to facilitate relearning lost capabilities, such as using ones hand and arm again after a stroke has affected the area of the brain responsible for those movements.


However, when it relates to how we perceive pain, it can be a major disadvantage. To quote Norman Doidge, the Canadian author of “The Brain that changes itself” and my inspiration for this article, “There are  a whole host of haunting pains that torment us for reasons we do not understand and that arrive from we know not where - pains without return address”.


Silas Mitchell was an American doctor who looked after the wounded soldiers at Gettysburg in 1863. In those days, prior to antibiotics, it was common for any wound to become infected and eventually gangrenous. Therefore many amputations were performed, to prevent gangrene from spreading and killing the affected soldier.  It wasn't long before the amputees started reporting that their amputated limbs had returned to haunt them. Dr Mitchell became fascinated at how common this phenomenon was and initially called the experiences “sensory ghosts” but later changed this to the phrase “phantom limbs”.


Lord Nelson was the first famous person to have the experience of phantom limb pain recorded, after he lost his right arm in an attack on Santa Cruz de Tenerife in 1797. It was the last British attack on Santa Cruz with devastating losses to Britain, including Nelson’s arm, which reminded him for the rest of his life of his epic failure! He decided that the presence of this phantom limb was proof for the existence of the soul - with his reasoning being, that if his arm could apparently exist after its amputation, then the whole person would be able to exist, even after death of the entire body.


One of the most famous people with phantom pains was Douglas Bader a Royal Airforce fighter ace, who lost both his legs whilst performing acrobatics in the early 1930s. Having almost died, he repeated his flight training, passed his check flights and requested reinstatement as a pilot. Despite there being no regulations applicable to his situation, he was retired against his will for medical reasons. Once World War ll broke out he was accepted back into the RAAF and flew many missions including taking part in the Battle of Britain. He was shot down and taken prisoner and remained a POW until he was liberated at the end of the war, despite making many breakout attempts, once after the Germans allowed a spare prosthesis to be flown in for him! He describes being plagued by itchy feet for years after the loss of his legs!


Phantom pains are actually one of only many very strange pains and sensations that have troubled or tortured people for thousands of years and which, until recently have baffled doctors, due to there being no obvious cause in the body. So how do you cure a pain in an organ that isn't even there?