Learned Pain

Radiolab has a great story on ‘learned pain’ (story 2 in this podcast, starts around minute 14:30). It describes an amputee and his persistent phantom pain from his previously debilitated arm. His arm was no longer there, yet the pain he used to feel in that arm persisted. His doctor— V.S. Ramashandran— suspected this pain was learned, and devised a successful method of unlearning pain felt in a non-existent limb. Ramashandran jokes: “This is the first example in the history of medicine of a successful amputation of a phantom limb.”

The notion of learned pain would not be unfamiliar to John E Sarno, M.D. He created a diagnosis, Tension Myositis Syndrome (TMS), and describes it in his book Healing Back Pain. His theory behind the persistence of the pain is a little different, but it shares the commonality of being first and foremost a problem of cognition, and he has had success in relieving the chronic pain of thousands of patients.
To consider this phenomenon as limited to amputees is to miss the lesson. Need we lose a limb in order to learn a pain response and continue to feel the pain long after the stimulus is removed? Might this provide insight that could provide lasting relief to chronic pain patients?