Wednesday, May 8, 2013

Phantom Limb Pain: 1/2

Author and Christy Award nominee (two nominations!) Jocelyn Green joins us again this week for a two-part series on phantom limb pain.

As an added bonus, Jocelyn has graciously offered to give away a personalized copy of her latest novel, Widow of Gettysburg, to one commentor. To enter, leave a comment on any of her posts WITH your e-mail address. Must live in the USA. Winner drawn midnight, Saturday, May 11th, 2013 and announced here at Redwood's on May 12th, 2013.

Jocelyn has also graciously said she'll send you a signed bookplate if you have any of her novels and would like one. Again, MUST have your e-mail. 

You can view Jocelyn's previous posts at Redwood's here and here.

Welcome back, Jocelyn!

Though the phenomenon of phantom limb pain had been recorded long before the Civil War, it was Silas Weir Mitchell, a Philadelphia physician specializing in nerve injuries during the Civil War, who coined the term. Phantom limb pain, or PLP, occurs when a patient feels pain in an arm or leg that has been amputated. Mitchell studied PLP (or sensory hallucinations, as he also called them) in depth at the Turner’s Lane hospital in Philadelphia, dubbed the Stump Hospital because it focused on caring for amputees.

If a character in your story is an amputee, like one of my characters in Widow of Gettysburg, the following will be helpful to you.

What Mitchell Found

·         Almost every amputee at Turner’s Lane Hospital experienced PLP. 

·         Most of them came out of anesthesia feeling the presence of the amputated limb.

·         Those who did not immediately feel PLP usually felt it within three weeks.

·         Usually, the patients felt the missing hand/foot but not the section of limb directly beyond the stump.

       Mitchell wrote: “The patients describe themselves as knowing that they have a hand which is connected to a stump, and feel able to move it, but of the rest of the limb they are unconscious, and the subjective sensations which are so common are always referred to the hand or foot, and rarely to the continuity of the member.”

·         In about one-third of the leg cases, and in one-half of the arm amputations, the patient felt that the foot or hand is nearer to the trunk than the extremity of the limb.

·         The type of pain could be burning, itching, stabbing, or cramping.

·         Missing legs usually felt as though they are hanging straight down, while missing arms felt as though they were bent at the elbow or locked in the last position they were in prior to the operation.

·         Treatment of water dressings on the stump helped with burning sensations in some cases, but most efforts to relieve PLP were ineffectual.

·         Amputee veterans wrote to Mitchell decades after their operations and shared that in their dreams, they had all their limbs perfectly whole.
      Return Friday as Jocelyn finishes up her Civil War medical series.


A former military wife, Jocelyn Green authored, along with contributing writers, the award-winning Faith Deployed: Daily Encouragement for Military Wives and Faith Deployed . . . Again. Jocelyn also co-authored Stories of Faith and Couragefrom the Home Front, which inspired her first novel: Wedded to War. She loves Mexican food, Broadway musicals, Toblerone chocolate bars, the color red, and reading on her patio. Jocelyn lives with her husband Rob and two small children in Cedar Falls, Iowa.


  1. Amputation and phantom pain is an intriguing topic and thank you for including Dr. Mitchell’s findings. In earlier years, medical science did a great disservice to patients by explaining it as, “all in your head” or as a purely psychological phenomena. As to the abnormal sensations, phantom pain is the unpleasant sensory and emotional experience. The non-painful sensation of the missing part is called, “phantom sensation”. I read about applying cold towels as an early treatment for phantom pain in the 1800s. However, similar treatment is described in Scandinavian folklore. Parre, Napolian’s surgeon, reported that he could do in near painless amputation the battlefield when the temperature was about -19°F.
    Phantom pain is usually described in the missing limb but has also been reported after missing breast, teeth, and genitals. We are now learning that the same changes in the nervous system that caused the reporting of pain in the missing limb can I occur virtually anywhere in the body after trauma, pain, and cutting of nerves.
    Treatment for Phantom pain continues to be suboptimal. However there’s a growing body of evidence that in some cases the incidence and/or severity might be prevented.
    I would like to thank the author for bringing forth medically accurate information in her writings and wish her all the best of luck in future publications.
    Thom Bloomquist, MSN, CRNA,, FAAPM (Amputee Peer Visitor)
    Reference; Sherman, Richard A. “Phantom Pain”
    Plenum Press, New York, 1997

    1. Thanks so much for the info! I really appreciate your time in leaving it.