Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Alerts
  • Advertising/recruitment
  • Subscribe
  • Contact
  • Current Issue
  • Past Issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • Conversations with Giants in Medicine
    • Author's Takes
  • Reviews
    • View all reviews ...
    • Tumor Microenvironment (Mar 2021)
    • 100th Anniversary of Insulin's Discovery (Jan 2021)
    • Hypoxia-inducible factors in disease pathophysiology and therapeutics (Oct 2020)
    • Latency in Infectious Disease (Jul 2020)
    • Immunotherapy in Hematological Cancers (Apr 2020)
    • Big Data's Future in Medicine (Feb 2020)
    • Mechanisms Underlying the Metabolic Syndrome (Oct 2019)
    • View all review series ...
  • Viewpoint
  • Collections
    • In-Press Preview
    • Commentaries
    • Concise Communication
    • Editorials
    • Viewpoint
    • Top read articles
  • Clinical Medicine
  • JCI This Month
    • Current issue
    • Past issues

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • Conversations with Giants in Medicine
  • Author's Takes
  • In-Press Preview
  • Commentaries
  • Concise Communication
  • Editorials
  • Viewpoint
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Alerts
  • Advertising/recruitment
  • Subscribe
  • Contact
A review of current theories and treatments for phantom limb pain
Kassondra L. Collins, … , Robert S. Waters, Jack W. Tsao
Kassondra L. Collins, … , Robert S. Waters, Jack W. Tsao
Published June 1, 2018
Citation Information: J Clin Invest. 2018;128(6):2168-2176. https://doi.org/10.1172/JCI94003.
View: Text | PDF
Review

A review of current theories and treatments for phantom limb pain

  • Text
  • PDF
Abstract

Following amputation, most amputees still report feeling the missing limb and often describe these feelings as excruciatingly painful. Phantom limb sensations (PLS) are useful while controlling a prosthesis; however, phantom limb pain (PLP) is a debilitating condition that drastically hinders quality of life. Although such experiences have been reported since the early 16th century, the etiology remains unknown. Debate continues regarding the roles of the central and peripheral nervous systems. Currently, the most posited mechanistic theories rely on neuronal network reorganization; however, greater consideration should be given to the role of the dorsal root ganglion within the peripheral nervous system. This Review provides an overview of the proposed mechanistic theories as well as an overview of various treatments for PLP.

Authors

Kassondra L. Collins, Hannah G. Russell, Patrick J. Schumacher, Katherine E. Robinson-Freeman, Ellen C. O’Conor, Kyla D. Gibney, Olivia Yambem, Robert W. Dykes, Robert S. Waters, Jack W. Tsao

×

Figure 2

Proposed peripheral contributions to PLS and PLP.

Options: View larger image (or click on image) Download as PowerPoint
Proposed peripheral contributions to PLS and PLP.
The dorsal root fibers...
The dorsal root fibers of the DRG split into lateral and medial divisions (38). The lateral division sections contain most of the unmyelinated and small myelinated axons and specifically carry pain and temperature information. The medial division sections of the dorsal root fibers (not shown) contain mostly myelinated axons that convey sensory information from the skin, muscles, and joints, such as touch, pressure, proprioception, and vibration (38). When an injury occurs to the nerves, neurons in the DRG increase their nociceptive signaling through increases in neuronal excitability and the creation of ectopic discharges (25). The resulting aberrant signaling through the spinothalamic tract may produce PLP.

Copyright © 2021 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts