Scientists have come up with a radical way to treat phantom limb pain. By recognizing the central nervous system and motor response involved, the scientists used augmented reality, virtual reality, machine learning and serious gaming as a way to treat the condition. The results showed that these techniques significantly improved all areas of phantom limb pain.
Patients who suffered from upper limb amputation were recruited in three clinics spread in Sweden and one clinic based in Slovenia. Patients received 12 sessions of phantom motor execution using machine learning, augmented and virtual reality, and serious gaming. phantom limb pain was analyzed based on differences in intensity, frequency, duration, quality, and intrusion before and after treatment based on different pain measuring techniques, scales and indexes. Follow-up interviews were also conducted at 1, 3, and 6 months after the last session had ended. Variation in medication and prostheses were also analyzed.
Between the period of Sept 15, 2014, and April 10, 2015, 14 patients with intractable chronic phantom limb pain were recruited. Conventional treatments had failed for these patients. After 12 sessions, patients showed massively significant improvements in all areas of phantom limb pain. It decreased from pre-treatment to the last treatment session by 47% for weighted pain distribution, 32% for the numeric rating scale, and 51% for the pain rating index. The numeric rating scale score for phantom limb pain intrusion in simple daily activities of living and sleeping was reduced by 43% and 61% respectively.
Two of four patients who were on medication reduced drug intake by 81%. There was an absolute reduction of 1300 mg of gabapentin drug and a 33% absolute reduction of 75 mg of pregabalin drug, both of which are strong painkillers and used extensively in the treatment of phantom limb pain. These improvements were luckily not short-lived and continued for 6 months after the last treatment had ended.
These results show the significant importance in motor execution of the phantom limb as a treatment for phantom limb pain. Promotion of phantom motor execution helped by machine learning, augmented and virtual reality, and gaming is non-invasive, does not involve any drugs or medications, rather keeps the patient engaged without revealing any side-effects at the current moment.
Motor execution is the process by which brain and spinal cord communicate signals to muscles and limbs across the body to produce motor movement. Therefore, these technologies improved motor execution in patients who suffered from phantom limb pain.
Phantom limb pain happens when a person who has lost his limbs feels pain in that region where his limbs used to be. This is an actual phenomenon that is felt by amputees from time to time. It most often occurs after surgical removal of the affected body part. It has been estimated that 80% of the amputee population feels this pain. The person can feel a variety of different sensations from pain, pressure, heat sensitivity, feeling cold, twitching and even itching. These sensations are caused by nerve endings at the injury site. These nerve endings continue to send signals to the brain to register pain, as a memory of the limb being there.
The length of time and duration for which a person may feel pain differs due to a person’s perceived pain and its threshold. It can last anywhere from seconds to minutes, hours and in very extreme cases even days. The occurrence of phantom limb pain is highest during the first six months, but continues to decline over the years. Despite this decline, a person might still feel pain sensations from time to time.
Medical Conditions That Can Cause Phantom Limb Pain
Certain medical conditions such as diabetes can increase the risk of a person being amputated. In extreme cases diabetes can cause peripheral artery disease (PAD). This condition causes blood vessels restriction, reducing blood flow to lower parts of the body, particularly feet and legs. It may also lead to peripheral neuropathy, which leads to loss of feeling physical pain.
So when a person gets injured, cut or has an ulcer, they would not feel it. The injury would grow, as a result of putting pressure on it and not treating it immediately. Moreover, restricted blood flow fails to fight the infection effectively as white blood cells supply becomes limited. As a result, the injury spreads, causing massive tissue damage to such an extent that amputation remains the only option to prevent the infection from reaching other parts of the body.
73,000 Americans who suffered from diabetes and were over the age of 20 had amputations in 2010. There are nearly 2 million people living with limb loss and approximately 185,000 amputations occur in the US each year. In 2009, hospital expenses for amputations cost more than $8.3 billion. Nearly half of the individuals who have an amputation due to vascular disease will die within 5 years. This is higher than the five-year mortality rates for breast cancer, colon cancer and prostate cancer. For these reasons alone, the scientists thought it was necessary to make use of significant technological advances to help ease the pain of these individuals. Moreover, the ongoing war on terrorism has resulted in millions of deaths and injuries. Quite a lot of these severe injuries result in amputation.
Unfortunately, there are no guaranteed treatment techniques to cure this condition. Doctors might prescribe narcotics to treat the pain, but such strong painkillers can lead to addiction. Other treatments include drugs that intercept brain and spinal cord signals in order to decrease pain sensitivity. Certain non-medical techniques such as relaxation therapy, heat massage, physical therapy and muscle massage can be used as well. One could hope for best outcome when non-medical and medical therapies are combined.