VR Cures Amputees' Phantom Limb Pain

An anonymous reader writes, "Scientists have developed a virtual world like Second Life where real-life amputees have their limbs restored. The experience can cure patients of the perception of pain in their missing limbs. From the article: 'The machine is designed to combat phantom limb pain (PLP) — a sensation of pain experienced by an amputee that appears to originate in the missing limb. Intriguingly, researchers have discovered that if a person's brain can be tricked into believing they can see and move a "phantom limb," this motion reduces the perception of pain in PLP.' The graphics used by the computer look very crude, almost comically so, but apparently the system works."

Comments

If this really works...

[dada21]

...what kind of VR would they use for John Bobbitt, and would the pro-family values conservatives approve of that form of medical "service?"

Re:If this really works...

[Fozzyuw]

...what kind of VR would they use for John Bobbitt

The only thing that popped into my mind is... why is Bobbitt the first thing on your mind, to associate it with this article?

visualization

[lawpoop]

"...the graphics used by the computer look very crude, almost comically so, but apparently the system works."

Could this also be accomplished by hypnosis and visualization? If useful, that would reduce the cost -- namely the expensive electronics.

Re:visualization

[kfg]

Could this also be accomplished by hypnosis and visualization?

They tried that first. Works sort of, for some people. About as well as it does for sea sickness, another area where unpleasant feelings are caused by a discontinuity in what the brain "knows" and what it "sees" ( your ear "sees" you are in motion, your eyes see you are not. This does not compute and smoke pours out of your ears; and your dinner out of your stomach).

The problem is one of creating a harmonic whole of the input of all the senses. You either need to shut down the "offending" sense, or supply it with input that compliments the input to the other senses.

This particular technique focuses on supplying complimentary input. As noted elsewhere in the thread, yes, this can be done without the expensive electronics.

Simply use the old standbys of the illusionist; smoke and mirrors.

Of course mirrors are not free, electronics are getting cheaper; and many of the necessary componants of the system are already found in people's homes these days (just as for mirrors. Just because you take them for granted does not mean they are not technology).

There's also the fact that people likely find this thing fun. Something not to be overlooked in any therapy strategy, even if it costs a few extra bucks.

KFG

Re:visualization

[Puff of Logic]

Actually, it can be done with a cardboard box and a mirror. If I recall correctly, V.S. Ramachandran detailed performing precisely the same technique in his book Phantoms of the Brain for patients who had a phantom hand that was painfully clenched into a tight fist.

In essence, he had the box and the mirror positioned such that the patient would insert his good arm into the box and have the amputated arm stump occluded. Obviously, a reflected image of the unamputated limb would appear in the mirror to the patient, who was then instructed to position the "phantom limb" such that it superimposed the mirror image. This done, the patient was then instructed to repeatedly clench and declench both hands.

Obviously only one hand was real, but the correlation between what the brain felt was happening and what the eyes reported was happening was sufficient to fool the brain into believing that the phantom fist had been unclenched and thus the phantom limb pain was eliminated. I believe that Ramachandran reported excellent success with this ingenious medical hack.

Re:visualization

[cp.tar]

They tried that first. Works sort of, for some people. About as well as it does for sea sickness, another area where unpleasant feelings are caused by a discontinuity in what the brain "knows" and what it "sees" ( your ear "sees" you are in motion, your eyes see you are not. This does not compute and smoke pours out of your ears; and your dinner out of your stomach).

That is supposed to be a poison-rejecting mechanism, actually - evidently, some poisons make you feel as if you were moving, although you're not; this is the mechanism which recognizes (or "recognizes") such behaviour and reacts accordingly - by forcing the poison out the same way it supposedly came in by.

Mirrors in a Box

[MBCook]

I once saw something about this on TV years and years ago. People might feel a phantom limb with a fist grasped so tightly it hurt (like the fingernails in the palm and everything). It was supposed to be horrible (and I'm sure it was).

The report was on a doctor who had developed a box that the patient stuck their real arm in and using mirrors they could see both arms (obviously just a reflection). By having the patient put their "arms" in clenched and talking to them and having them relax them and thinking about unclenching the fist, it would work. The pain would go away because their brain "saw" that the first was unclenched where as before they couldn't see that. I don't know how long it worked, if it needed to be re-done every six months or whatever, but this isn't out of the blue.

Very interesting problem, phantom limb syndrome.

Re:Mirrors in a Box

[mendaliv]

Sounds like someone's trying to build a better mousetrap.

I can see very little to no advantage of this over the mirrors in a box method that you describe... the therapist speaking to the patient could be done with a recording, or with practice the patient could learn to accomplish this themselves through meditation. So the entire argument that this VR method is better because it can be done in the patient's home is largely invalid. A box with mirrors and a tape deck is going to be significantly cheaper than a VR headset, glove and computer.

The only advantage that I might entertain is that if the person is a multiple amputee (i.e., no arms or no legs or something like that), then maybe you could substitute movement from some other body part (i.e., head and neck, or facial twitches) to cause limb movement in the VR environment, where a series of mirrors would not permit this.

Re:Mirrors in a Box

[itchy92]

The doctor is V.S. Ramachandran, and his work is fascinating. His book on phantom limb syndrome and other psychological conditions is called _Phantoms_in_the_Brain_, and it's thoroughly enjoyable; an easy read (especially if you have no previous exposure to the field), but not so dumbed down as to insult your intelligence. He frequently uses very simple approaches to diagnosing and studying these cases.

His newer book is called _A_Brief_Tour_of_Human_Consciousness_, which deals with some of the same issues, but also introduces his more recent studies.

/Not a shill
//Just a fan of brain disorders
///that doesn't sound right

2nd life

[glen]

The graphics used by the computer look very crude, almost comically so...

Wow, it really is like second life.

How available is this?

[waif69]

I RTFA, and saw no reference to availability. This doesn't seem to be very expensive, in medical cost comparatively. Anyone have experience with this technology, here?

Cool, but...

[TheSHAD0W]

...Can we throw in some cacodemons and a grenade launcher to spice up the rehab sessions?

what about double amputees?

[maddogsparky]

Lots of posters are mentioning the mirror trick. Unfortunately, that won't work with some double amputees (i.e. portions of both arms or both legs amputated). This seems like it might help in these cases if they have some way to provide input corresponding to the phantom limb.

HeAdOn: VR

[RipTides9x]

VR: Attach it directly to your forehead
VR: Attach it directly to your forehead
VR: Attach it directly to your forehead

Now available without a prescription.

Will it work for people...

[p00ked]

who lost their genitalia in an unfortunate smelting accident?

The Phantom Menace

[Narril Duskwalker]

"The graphics used by the computer look very crude, almost comically so, but apparently the system works."

Seems like helping to battle this phantom menace would be a good project for ILM to get involved with. Just leave JarJar out of it this time ;)

Hypnosis?

[msimm]

Have you ever been hypnotized? I have. 1) The number of people likely to be responsive to hypnotic suggestion is relatively small 2) the number of people susceptible to a typical induced hypnotic state is relatively small.

Hypnosis seemed fascinating to me when I was young but when I had the opportunity to experience it (or rather, not) I found out that it isn't uncommon for people to not automagically achieve a hypnotic state.

Not that I'm trying to dismiss your idea altogether, just had an interesting experience with hypnosis.

What I'd find more interesting is visualization or (quasi-)mediation. A lot of the practices that hypno-therapists use are remarkably similar to meditation practices including the use of visualization technics that seemed to me fairly esoteric (white light, breathing through feet, etc).

Re:Hypnosis?

[msimm]

I've been left with the distinct impression that hypnosis is the western answer to guided meditation and really is more a pseudo-science with a Barnum & Bailey air of mystery.

Honestly I don't see much difference myself, aside from the fact that western hypnosis seems to be a hodge-podge of tradition practices dressed up to be more palatable to modern science. Maybe its easier on the western constitution to say hypnotherapist then monk. It certainly sounds less new-agey, but I suspect there's more to meditation and culturally we are probably simply playing semantic games.

FWIW, while I was undergoing hypnotherapy my therapist did incorporation more contemporary tools such as subliminal sound and habit replacement (I was seeing the therapist to quite smoking). Not that I ever ended up achieving much of a suggestive state (smoked for about 5 years after).

Overall it was interesting and was nice to throw a little light on some of my misconceptions (the therapist became a good friend and we talked about his training and the results a bit).

But then...

[Quiet_Desperation]

...you jack out of the system, and your limb is gone again. Sounds kind of depressing. I think I'd rather just take an Advil. I mean, the *pain* is real so a pain killer should do something.

Re:What if...???

[nido]

Donna Eden talks about treating phantom limb pain in Energy Medicine.

Unbearable Phantom Pain A good-looking man who had lost both of his legs in Vietnam was brought to me in a wheelchair. No one had been able to help with the pain at the end of where his right foot had been. He vividly recalled the scene of stepping on a land mine and watching the bones and flesh of his right foot explode into pieces. The pain he now had was massive. The sensations were so similar to the original shock that he could never get relief from the traumatic memories. The relentless pain also led to terrible nightmares. His left foor wasn't as painful. It sometimes itched, but it was a mild discomfort compared with the area of his right foot.

As he sat there with his friend, he cried and said, "The pain is so excruciating, and the way it keeps me tied to my past is so bad, that I sometimes think of taking a gun to my head." I could see the energy still there in both of his absent legs, and I could feel it with my hands. I followed the energy along his absent legs to the end of where his feet had been. It was palpable. My hand began to hurt terribly. I asked him if my hand was in the area of the worst pain, and it was. The most painful areas were at the sides of his feet, which happens to be at the end of the bladder meridian. I said to him, "This may sound crazy to you, but I believe I can hold some points in midair hwere your feet were and help you."

I moved my hands to the ends of his legs, where his feet had been, and held the points on the bladder meridian. As the two men watched thses strange conjurings, it must have seemed to them that I was just holding air. But I was not! I felt and saw the meridian lines as strongly as if his legs were still there. At first it was painful for him to have me touch the area of his absent right foot. After a couple of minutes, he reported that not only was the foot being relieved of the pain, but another chronic pain in his back, just above his waist, was also lifting. Interestingly, that area is also goverened by the bladder meridian.

His kidney and liver meridians were also involved, and I held those points as well. ... By the time I had finished holding his liver points, he was pain free. I showed the friend, who lived with him, how to hold points and which points to hold. The man and his friend never returned, but on my invitation they called me about once a month. The friend told me that after the session, the manbegan to lift out of his deep depression. While the phantom pain would return every now and then, they knew how to deal with it.

-pg 31-32

I'm sure someone will come along and scoff - "haha, meridians, quackery". Whatever. Western science has established that Accupuncture works well. Western science knows that bodies generate mild electric fields - never impulses, etc. Western science knows that there is electrical behavior when bones are broken, and has devices to apply electric fields to speed healing thereof. The body's energy systems are all closely associated with physical systems - each of the chakras corresponds with a gland: thymus, pituitary, etc. Energetic approaches to health really shouldn't be such a streach, but in a medical system dominated by the rockefeller drug cartel I'm not surprised that affordable approaches such as Mrs. Eden's are suppressed and ridiculed.

While Donna does not take clients anymore (she started teaching when demand for her services became too great), her senior teaching assistants are all quite capable. She has a list on her website.

Your father might benefit from Osteopathic manipulation too.

Phantom Limb Sensation Is a Ton of Fun

[multiplexo]

Well, not really, the first thing I can remember from the day after my left leg was amputated (motorcycle v. pickup truck, pickup truck wins even if motorcycle has right of way) was an intense itching, like the worst case of athlete's foot ever, in the toes of my then newly up the chimney of a medical incinerator left foot. Over the next few months the phantom limb pains decreased in severity and frequency, although I still get them sometimes and they can leave me gasping for breath.

Neurologically this is kind of interesting and even somewhat cool. About 9 months after my leg was amputated I was out working in my yard clearing a drain during a rainstorm. I was standing in water up to mid calf and my right foot started to get cold because it was soaking wet. I kept mucking out the drain and then I noticed that my left foot, which is actually a cunningly crafted bit of carbon fiber from the folks at Otto Bock felt cold and wet too. It was the damnedest thing and it made me stop for a moment, it felt as if I had a left foot that was in a cold, thoroughly soaking wet sock inside of a thoroughly soaking wet boot. I finished mucking out the drain, went inside, changed into dry clothes and stuck my right foot into a tub of warm water. As my right foot warmed the sensation in my left foot gradually decreased. If I am wearing my prosthesis phantom limb pains feel as if they are coming from the ankle and/or foot of my left leg, if I'm not wearing the prosthesis they feel as if they are coming from the stump. Amputation, the gift that keeps on giving.

Why you can still feel pain in a missing limb

[sir_montag]

Doctors used to think that if you cut the nerve to something, you wouldn't feel anything from that area because your brain wouldn't get a signal from that area.

As it turns out, it's nowhere near that simple. You can't just transect a nerve to make someone with a really damaged body stop feeling pain in that area, and for the same reason, amputees still get sensations from limbs that aren't there and nerves that aren't connected to anything.

The brain doesn't recognize pain based on polling a nerve for pain signals and determining whether there's pain if the nerve is being triggered or if it is not being triggered. Rather, it's a contextual thing. The brain recognizes a certain kind of amalgamation of signals as pain, and the lack of pain as a different collection of signals.

So if you just cut the nerve, it doesn't feel a lack of pain - without any signal telling it that there's no pain, it just tends to try and match what input it can to the signals it previously had from that limb. This results in all sorts of strange sensations in a limb you don't even have! A lot of times, the brain will try and model sensory information on the closest thing to the absent limb - if you're missing your right leg, it checks input from the left as a guide to what it should be feeling.

Doctors used to think people were crazy for feeling pain in limbs that they didn't have. Now they know better. And much of this knowledge was gained from experiments that involved amputating limbs and digits from monkeys, so don't let anyone tell you there's no point to animal testing (they used anesthesia, so it wasn't too bad for the monkey).