*Photos illustrating the phantom limb phenomenon and how a mirror can create the illusion of two limbs again. Photo credits: Department of Defense (left); The New Yorker (right).

Phantom Limb Syndrome. The very name conjures spooky nights spent around the camp fire. But this is no ghost story: Phantom Limb Syndrome is a condition that affects people who’ve suffered the loss of a limb and yet can still “feel” the missing body part. 

We asked Anna Kulidjian, MD, assistant clinical professor at the UC San Diego School of Medicine’s Department of Orthopaedic Surgery and chief of Orthopaedic Oncology at UC San Diego Health System about this strange phenomenon.

Question:  What is Phantom Limb Syndrome?

Answer:  Phantom Limb Syndrome occurs after a limb is removed due to surgery or trauma but the patient feels as if the missing limb is still there. They feel as if they can move it and control it. Sometimes, if the limb was lost after experiencing painful or traumatic circumstances, they can still feel pain in the limb although it’s gone. It’s often reported in veterans. 70 percent of patients with an amputation experience the sensation, though at around two years, the feeling disappears or greatly diminishes in most. Interestingly, phantom sensations occur not only with limbs but even with a loss of an eye or even organs.

Q:  What type of injuries/patients do you see this happening to?

A:  I deal with patients who have threatened limbs due to tumors of the bone or soft tissue and occasionally due to a major trauma or infection which has set in and become chronic. In the last decade, we have learned new techniques to salvage limbs while removing tumors around the vital structures. Occasionally, we still need to amputate if the tumor involves the blood vessels and nerves, which cannot be bypassed. If the limb was painful before the surgery, I warn patients that pain may remain after, and we try to aggressively treat the pain even prior to surgery in the hopes that sensation of discomfort will be diminished.  I spend a great deal of time with my patients who are at risk to help them develop coping strategies when the sensation “hits.”  Typically, the pain or feeling is intermittent.  One strategy we use to help patients overcome pain is to retrain or “trick” the brain into associating the feeling with something else. Patients know the pain may come but when it does they immediately engage in an activity that will distract them and refocus the sensation. Some patients go for walks; one of my patients calls her daughters and they go shopping.  Through humor and support, most patients can beat the problems associated with the sensation.

Q:  Does this syndrome stay with them forever or just a short time period after the limb is removed?

A:  Most patients with appropriate interventions improve and essentially stop feeling the limb. Occasionally, stress or illness can bring the sensation back.  Overall, with early intervention, most patients will improve.

*Editor’s Note: Vilayanur S. Ramachandran, PhD, professor of psychology and director of the Center for Brain and Cognition at UC San Diego, is broadly credited for developing the mirror box treatment for phantom limb syndrome and for deepening understanding of its underlying neurological and physiological bases. In 2009, the New Yorker published an excellent profile of Ramachandran and his work. You can read a synopsis here: http://www.newyorker.com/reporting/2009/05/11/090511fa_fact_colapinto.

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