We all get aches and pains from time to time. But imagine suffering pain in a body part that's not there.
It's called "phantom pain," It's very real and can be very painful.
It's something few people understand. To a certain degree, it's something even medical experts are only beginning to grasp.
There are a couple of kinds of cases.
Loss of a Limb
“As we grow, the limbs feed into these areas of the brain," he said. "So if one part is missing, you could still feel it."
Take, a person involved in a tragic car accident who loses an arm.
A person who has always known what it's like to have an arm knows nothing else. If they suffered pain in the arm before it was amputated, they can still feel that pain after the arm is gone, Iyengar said
According to studies, as many as 80 percent of people who've lost a limb experience this phenomenon. Part of the reason is that some of the nerves that were cut remain in the stump, the doctors said.
"The pain is real," he said. "It's not to be confused with pain in the stump. There's a real sensation of pain in the lost limb. There could be something going on in the periphery - the nerves are cut, so there might be some impulses still generated."
Those impulses have always gone out but now have nowhere to go to.
"The brain has a map of your whole body, so there's memory there. When you lose the limb, the memory is still there. Women who've had mastectomies can also have similar types of sensations," he said.
So treatments begin, but often times, they're the wrong treatments, Krug said.
"Most folks are treated incorrectly. The most frequent medications that are prescribed, studies say, are anti-inflammatory medications and narcotics. In my opinion, you have to manage it by targeting something else - targeting nerve pain. They actually have an effect on the nerve pain itself."
There are a variety of medications, such as those used to treat seizures, that can help. There are also electrical nerve stimulators that can help reduce the pain.
An awareness of the condition has helped lead to effective treatments, Iyengar said. But he also said there are topics in the field that researchers are just beginning to fully understand, such as "telescoping."
"As the brain begins to accept the loss of the limb, it shrinks the limb in the mind. That means the perception of where the hand is on the arm becomes shorter and shorter,” he said.
The hand feels closer and closer to the shoulder until it disappears, he said. It's difficult for those who haven't experienced it to understand but then there are people who can feel limbs they never had.
The Limb That Never Was
"If you are born without limbs, you can still feel the limbs as if they were present,” Iyengar said.
This is also because of the way that the brain is wired, he said.
"On the surface of the brain, there's a part that tells you what part of the brain controls what part of the body," he said.
Krug said these are called "phantom sensations," and they can be dangerous at times.
"Someone who doesn't have a leg needs to get up in the middle of the night to use the bathroom. They think they have their limb there - that doesn’t end well, of course," Krug said.
So, outside of prosthetics, how do you even begin to treat an issue that's physically not there?
"Virtual reality," Iyengar said. "It can make a huge difference."
A virtual reality essentially recreates reality.
"One treatment involves patients who were allowed to put their hand in a box that had a mirror. The mirror gives the illusion that both your hands are in. You move one and the perception that the brain gets is that the other is moving. You tell the patient to imagine it's moving like you'd want it to. You can trick the brain. It wards off the bad symptoms."
But it's a treatment that can take decades, and it isn't guaranteed.
"Many of these patients think they’re crazy," Krug said. "They're far from it."