Full Title: Who Stole My Tail and Why Does It Itch? A Look at Phantom Limb Pain and Phantom Limb Sensation
Author: Jacqueline Miaso
Date of Publication: December 8, 2020
Research Paper Text:
Since 70 to 80% of human amputees report phantom sensations of some sort within six months of amputation, and most reporting it immediately after surgery, with pain ranging from “mild and infrequent to severe and chronic” per Nicole Cutler, L.Ac, MTCM, Dipl. Ac, in her article Bodywork Techniques for Phantom Pain, I think we can safely extrapolate that dogs may also experience this. Whether it is just for limbs, or also encompasses tail and ear docking, we have no way of knowing for sure. Humans, however, have reported it after losing not only an arm or leg, but also an eye or a breast.
Ms. Cutler also states that “new amputees tend to have frequent and intense sensations several times every day, often continuously for a few hours at a time. After a while, the sensations typically become less frequent, less intense…however, many amputees report that phantom pain never completely disappears.”
The Amputee Coalition of America describes phantom limb pain (PLP) as “ongoing painful sensations that seem to be coming from the part of the limb that is no longer there. The limb is gone but the pain is real.” And, according to Fairview.org, also reported by amputees is Phantom Limb Sensation – an itch, a tickle, or as if the missing limb is asleep. Most often it is mild and not painful. PLP however “may feel like a quick zing or flash up your limb. Or it may feel more like burning, twisting, cramping, or aching.”
Fortunately there are ways to alleviate the pain – one of which is massage. According to B-L Family Practice in South Carolina, “Many patients find that having the amputation site massaged can help alleviate phantom limb pain. Massage soothes the nerve endings in this area, helping them to relax and stop sending pain signals to your brain.” They recommend gentle pressure at the amputation site.
Moreover, since the dogs cannot tell us if they are having pain or sensations, performing massage as if they do will certainly cause no harm. And the deep relaxation that many dogs experience from massage can certainly aid in pain relief.
Reiki has proven helpful in humans as has Cranial-Sacral therapy with its gentle touch to increase cerebrospinal fluid circulation. With dog massage we are always working to increase the flow of body fluids especially along the spine. So it makes sense that these methods will help in pain relief in dogs especially since many experts believe the cause of phantom pain is generated from the spinal cord and brain as part of the neural circuitry. It is theorized that the area of the brain responsible for perceiving sensation begins to act abnormally and “thinks” the body part still exists. Neuromassage.co.uk states that “The massage therapy we offer can increase blood flow to and from the area of amputation helping to improve circulation. This can also aid in reducing phantom pain as poor blood circulation can be a contributing factor to phantom pain.”
The Massage Clinic at St. John’s Rehabilitation Hospital, Toronto, Canada, lists the following indicators for post-amputation massage therapy: “Reduce swelling, increase circulation, reduce muscle tightness and stiffness, reduce scar tissue tightness, reduce spasms, increase muscle length, decrease pain, decrease anxiety and stress, improve sleep (i.e. duration), increase state of relaxation.”
St. John’s further says that massage therapy may consist of the following: “massage applied directly to the amputated end (stump), to the muscles and soft tissues above the amputated area (the residual limb), or to soft tissues at the proximal end of the effected limb.” A more general massage can help as well with the goal of reducing stress and anxiety.
Compensatory structures (areas not directly associated with the amputated limb) need to also be considered for massage. We already know that a dog limping on his right front leg probably needs to have his left front leg thoroughly massaged because he will put more stress on it in order to take pressure off the injured or aching leg. This imbalance can lead to repetitive strain disorders in the unaffected limbs and needs to be addressed early on. Also common in people with lower limb loss is back and neck pain. Since dogs normally carry 60% of their body weight on their front legs, amputation of a front limb may cause even more back strain than a rear limb, so extra attention to the back may be even more important.
It is interesting that headaches are very commonly reported after amputation, with many possible causes. Massage therapy in humans has proven to help decrease the muscle tightness and soft tissue restriction and induce a relaxation effect which can manage, if not eliminate, headache symptoms. Since dogs stubbornly refuse to learn to talk to us (in our language), why not assume that they may have headaches for a while (especially if they shy away from contact with their heads), and pay extra attention to the entire head, including ears or ear stumps.
When initially researching this topic, one of my questions to myself was: How do we know if we’re helping ease phantom pain or sensation if we don’t know if the dog is experiencing it? Well, we don’t know for sure that dogs experience phantom limb pain or phantom limb sensation but based on how they have been used and misused extensively throughout history for various experiments because they so closely resemble us, I think we can assume that they do. Massage therapy has proven very effective for a large majority of humans post-amputation so why wouldn’t we try it for dogs. Since the majority of the painful PLP occurs soon after amputation, treatment should begin as soon as possible and continue as long as needed. In my massage practice with dogs, I have found they let me know which areas are still painful and which are better than the last time I saw them so if you “listen” to your dog you can learn how long to continue a specific massage method. After all, according to medicalmassagecenter.com “The evidence on mood improvement from amputee massage therapy is strong.”
And who doesn’t want their dog to be in a good mood!