Deafferentation refers to any process that results in a loss of afferent input at the peripheral or central nervous system level. Phantom pain has been demonstrated to affect a significant number of people following a range of deafferentating conditions. These conditions include amputation, spinal cord injury, brachial plexus avulsion and even congenital aplasia and local anaesthesia. Despite the prevalence of phantom pain, little is known about its cause; indeed, it remains a contentious issue. This article discusses the major theories proposed and the evidence accumulated regarding each. A mixed mechanism is mooted, which combines pertinent elements from each theory, and the implications for occupational therapy are discussed.
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