Banishing phantom pain

Banishing
phantom pain
People with phantom pain
were until recently thought to be
mentally ill or faking their pain, which
had been stigmatised as a psychological
disorder. But functional magnetic
resonance imaging (fMRI) has shown
that the condition is driven mainly by
functional and structural changes in
the brain, specifically in the areas that
generate pain.
These changes are also associated
with the severity of phantom pain:
the greater the changes, the greater
the pain. We also now know that the
changes can be reversed with simple
treatment that provides pain relief.
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In 2018, Limakatso, an assistant
lecturer and PhD candidate in the
University of Cape Town (UCT) Chronic
Pain Management Unit, along with
Parker, his supervisor, completed a
trial investigating the effectiveness
of graded motor imagery (GMI)
for reducing phantom limb pain
in amputees. GMI is a three-step
intervention that involves exercises
and activities to activate the areas of
the brain controlling movement of the
amputated limb.
The treatment was initially developed
by researchers in Australia. However,
this study was the first in Africa and only
the second in the world – and it worked.
“It’s a huge development in pain
management,” Limakatso said. “Often
pharmacological alternatives don’t work
– and medication is expensive – and
neither does surgery.”
What’s more, Limakatso is now
able to show, via the GMI programme
and the results, that the brain is the
generator of phantom pain.
“We need to inform patients and
healthcare practitioners that it can be
easily assessed and managed using the
graded motor imagery programme.
And that this treatment is affordable,
accessible and effective.”
PHOTOGRAPH: MICHAEL HAMMOND
Katleho Limakatso and
Associate Professor
Romy Parker are
studying phantom pain:
a debilitating condition
affecting seven out
of 10 amputees in
the aftermath of
cardiovascular disease,
like diabetes, and
trauma. Their recent
research adds to
evidence that phantom
pain is real and simple
treatment can help.

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