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Exploring Phantom Limb Pain


A New Approach to Treating a Common Problem Among People with Amputations Shows Promise

In many ways, it defies logic - feeling pain where an arm or a leg used to be. But many of the almost 2 million people in the U.S. who have had an amputation experience this persistent sensation known as phantom limb pain. Current therapies fall short of bringing relief. Now MossRehab's research unit - Moss Rehabilitation Research Institute - is working on a potential solution using virtual reality technology.

"Like somebody took a wire out of the wall and touched you with it ... ."

MossRehab patient James Wolf describes phantom limb pain on WPVI TV

Most theories on the cause of phantom limb pain propose that the commands sent from the brain to the amputated limb fail to generate the sensory feedback signals that the brain expects. The mismatch between the expected and actual sensory feedback causes pain.

Based on this theory, Laurel Buxbaum, PsyD, associate director of Moss Rehabilitation Research Institute, and colleagues at the University of Pennsylvania – H. Branch Coslett, MD, Katherine Kuchenbecker, PhD, and Alex Miller – have developed a virtual reality approach to the treatment of lower limb phantom limb pain that seeks to improve the match between expected and actual feedback. 

How the Research Works

During the study, individuals with lower limb amputations wear a head-mounted display that provides a three-dimensional graphical view of a virtual environment.

When the user moves and rotates his or her head, the view changes appropriately. Patients engage in a number of game-like tasks that require movement of both legs, such as ‘scooting’ around a maze on a virtual chair or rappelling up a cliff by holding a virtual rope and pushing off with the legs.

Custom software and a motion tracking system generate an image of a moving figure with two complete legs.

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Pilot research conducted thus far with a small number of research subjects is promising. The system is easy to use, and appears to improve phantom limb pain. The project collaborators are currently seeking funding to enable them to test the VR system with a larger group of research participants.


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