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When Royal Navy officer and British national hero Lord Nelson lost his arm in battle in 1797, he considered his "phantom limb pain" to be "direct proof of the existence of the soul." Regardless of your spiritual leanings, you have to admit that being able to "feel" an arm or leg that isn't there is a pretty extraordinary thing. Phantom limb syndrome following the loss of a limb involves way more than just "sensing" phantom pain: there are plenty of fascinating accounts in the medical literature that reveal the phantom limb phenomenon as further evidence of the extraordinary power of the human mind (or soul, if you're into that).
While you recover after losing a limb, you might experience a number of "phantom" sensations, depending on how the limb was lost. Your phantom limb may wave involuntarily, or even "retain" the "memory" of a wedding ring or wristwatch. There's even a chance you could lose both arms and still experience arthritis in your "phantom hands" in the winter. You could even lose the phantom after decades, only to regain it by rubbing on your stump, "releasing" it like a genie from a bottle. Read on for a detailed look into what the phantom limb phenomenon is all about.
The chances of experiencing a so-called "phantom limb" after losing a real limb are extraordinarily high: Dr. V.S. Ramachandran—the man Richard Dawkins calls "The Marco Polo of Neuroscience"—writes in Brain: A Journal of Neurologythat "between 90 and 98% of all patients experience a vivid phantom" almost immediately after losing a limb. In 75% of these cases, the phantom returns after the anesthetic wears off. In the remaining 25%, the phantom's return is delayed for as long as a few weeks.
Ramachandran says patients with phantom limbs "experience an amputated extremity as still present, and in some cases also experience pain or cramping." And that's only the beginning. . .
Sometimes Just a "Phantom Hand" Will "Dangle from the Stump"
In a phenomenon known as "telescoping," some patients experience a "fading" of the phantom limb until it is nothing but a hand, "dangling from the stump." This occurs in roughly 50% of cases, according to Dr. Ramachandran. Why does the brain allow the rest of the phantom limb to fade?
One theory is that the hand is "over-represented" in the somatosensory cortex, the main sensory receptive area in the brain for the sense of touch, which is called "cortical magnification." The lack of visual feedback from a phantom arm creates a "sensory conflict" that the brain deals with by "fading" it out, leaving the "over-represented" hands behind.
Phantom limb sensations may only last "for a few day or weeks, then gradually fade from consciousness," but they could also last for years. In about 30% of cases, the sensations last for decades. There are even fringe cases of phantoms lasting 44 and 57 years.
Kids don't seem to experience phantom limbs nearly as frequently as adults. A 1962 study showed that only 61% of child amputees between 4 and 6 and 75% between 6 and 8 reported the phantoms (compare that to the 90-98% of adults). Once they're more than 8 years old, kids seem to report them just as frequently as adults.
Why? Experts think it may be because there has not been enough time "for the body image to consolidate" in younger kids.
Rubbing the Stump Can Bring Back a Lost Phantom Limb
Once lost, the sensation of a phantom limb can be "recalled" through "intense concentration or sometimes merely by rubbing the stump." Weir Mitchell in 1872 was also able to "revive" a phantom limb by applying "faradic stimulation" (a form of low-frequency electrical stimulation) to the stump of an above-knee amputee.
These findings could help explain why the "widespread clinical opinion," according to Dr. Ramachandran, is that neuromas (aka "pinched nerves") are the "primary cause of phantom limbs." Ramachandran argues that it's more complicated than that, especially considering that people born without limbs also experience phantoms.
Phantom limbs can sometimes assume awkward or even painful poses against the will of the amputee. These may range from the relatively benign, such as your phantom arm twisted behind your head after you wake up in the morning, to the god-awful, such as the report of a soldier that lost his arm to a grenade. The grenade went off in his hand, rendering his phantom hand in a "permanently clenched and painful posture."
