After a sip of champagne or wine, Jim Martinson's toes start to tingle. When the barometric pressure drops, he feels an electrical storm throughout his legs. Thing is, Martinson is a double amputee. As a sergeant in Vietnam, a landmine detonated and blew him into the air, tore off his right leg and severed his left leg behind the knee. Doctors amputated both legs mid-thigh, but since waking from surgery, July 4, 1968, he's had sensation and pain in both legs.

This phantom pain can be daily excruciating or intermittent tingling, and is the same neuropathic pain that those with SCI describe as burning, shooting or stinging pain. In amputees, phantom pain or sensation manifests as a feeling that a limb is still there.

"I remember specifically when I'd lie on my stomach. It felt like my legs were behind me, up in the air. I'd have to look back to see if my legs were actually there or not," Martinson says. "The phantom pain is when you have shooters, hot pokers. It targets areas like a big toe or heel or ankle; mine is usually in the feet."

Martinson, of Puyallup, Wash., experiences phantom pain less frequently than he used to, but explains how the pain will shoot through the right leg for an entire day and work its way out the left leg the next day. He says it's like getting zapped with an electrical wire, and nothing will make it stop, not even rubbing the end of his stump. "Sometimes it hits so hard I feel like I'm having a heart attack," he says.

Martinson says there's "no rhyme or reason" to when phantom pain occurs. He now gets a tingling sensation that drives him nuts and has tried everything he can think of to stop the pain: massage, hot baths, cold baths, Advil, aspirin, prescription pain relievers; it sometimes helps to apply pressure or massage his sacroiliac.

"I just figure it's part of what goes on with me. If they lasted weeklong, I'd have surgery," he says. "Knock on wood, the episodes are getting further and further apart. I used to get them every other week -- now it's about once a month."

The Interactive Phantom
Martinson says his phantom pains sometimes start with just the mention of the subject. "Maybe there's a little bit in your head. I've had doctors tell me it was a figment of my imagination." But the same thing happened to 37-year-old Pam Hammersly, of Crystal River, Fla., a single amputee as a result of a motorcycle accident when she was 18. During our conversation, Hammersly several times said her stump tingled and was "shivering with awareness" with just the mention of phantom pain. Sounds mystical, but it makes sense, according to Dr. Howard T. Katz, physiatrist and owner of Gulf States Physical Medicine and Rehabilitation, in Jackson, Miss.

"Every single person with an amputation has some phantom sensation, and very commonly they have pain," explains Katz, who is also board certified in SCI medicine. "That pain is usually described as something to do with fire, biting fire ants, wasp stings or a burning feeling, which is consistent with neuropathic or neurogenic pain -- any pain from nerves."

Martin L. Buckner, certified prosthetist/orthotist of Buckner Labs, also of Jackson, says some people think that phantom pain/sensation is activated by electromagnetic fields, kind of like the vibrations you feel if you place your hand close to a neon sign. Buckner says there is a type of prosthesis that has an electrical sensing device that measures electrical activity on the outside of a limb in order to activate the artificial limb. In other words, those nerves are still sending signals.

"There's constant information being sent from the periphery or the extremity to the brain. In return, the brain is constantly sending information back," Katz says. "When that transmission is stopped because the nerve is cut, then the information is no longer getting to the brain and the brain starts to perceive that as a painful situation. We don't know exactly what causes this, but we believe it has to do with the fact that nerves are not made to be severed."

Stress, certain foods, alcohol and unrelieved pressure from sitting or lying too long in the same position can stimulate phantom pain. To relieve phantom pain or sensations, Katz prescribes anti-seizure drugs or anti-depressants. "They modulate the electricity," he says, adding that he sees best results with anti-seizure meds taken at bedtime. He also says people experience good results with relaxation techniques, hypnosis or holistic medicines.

"When someone comes to me with phantom pain, I first look for a neuroma," Katz explains. "Neuromas usually occur in traumatic amputations -- usually in war -- rather than surgical amputations." A neuroma is a bundle of nerves or benign tumor formed where the nerve is cut. It is extremely painful but can be removed and a smoother cut created in its place, or medicine can eliminate the pain.

Hammersly says she had "screaming horrific pain" the first few years after her accident. She uses guided visualization to let her mind relax to relieve the pain, which she says is a gentle awareness day-to-day but horrible during her menstrual cycle.

"Now I take Neurontin and the phantom is not as angry as it used to be," she says. "It helps if I press against my wheelchair and put pressure with a towel on my stump -- it affects the phantom. The phantom is very interactive!"