question: Why do paralysed people feel pain but not much, if at all, of anything else?
comment: They do also feel "ghost experiences" (thinking the limb still moves, etc). The limbs can't move but wherever the nervous impulses end still work and that's where there can be pain and other sensations.
passages: In June 2008, a team led by Professor Maria Fitzgerald of UCL Neuroscience, Physiology and Pharmacology published research showing that infants may be experiencing discomfort when their body movements, blood pressure and facial expressions show them to be pain free. 
   List of people with paraplegia
  
  This is a list of people who have or had paraplegia.
  
  BULLET::::- Deng Pufang, Chinese politician, son of Deng Xiaoping
  
  BULLET::::- Daniel Dias, a Brazilian Paralympic swimmer.
  
  BULLET::::- John Porter East, US politician who was partially paralyzed by polio in 1955
  
  BULLET::::- Frank Gardner (journalist), prominent BBC journalist who became paralysed after being shot six times at close range by an Al-Qaeda gunman in Saudi Arabia
  
  BULLET::::- Chuck Graham, United States politician injured in an automobile accident at age 16
  
  BULLET::::- Tanni Grey-Thompson, paralympian born with Spina Bifida
   Pain is common and may result from the inherent deficits associated with the condition, along with the numerous procedures children typically face. When children with cerebral palsy are in pain, they experience worse muscle spasms. Pain is associated with tight or shortened muscles, abnormal posture, stiff joints, unsuitable orthosis, etc. Hip migration or dislocation is a recognizable source of pain in CP children and especially in the adolescent population. Nevertheless, the adequate scoring and scaling of pain in CP children remains challenging. Pain in CP has a number of different causes, and different pains respond to different treatments.
   Paraplegia, the loss of sensation and voluntary motor control after serious spinal cord damage, may be accompanied by girdle pain at the level of the spinal cord damage, visceral pain evoked by a filling bladder or bowel, or, in five to ten per cent of paraplegics, phantom body pain in areas of complete sensory loss. This phantom body pain is initially described as burning or tingling, but may evolve into severe crushing or pinching pain, or the sensation of fire running down the legs or of a knife twisting in the flesh. Onset may be immediate or may not occur until years after the disabling injury. Surgical treatment rarely provides lasting relief.
   Kean begins the chapter with the sad tale of George Dedlow. George Dedlow had fought in the Civil War and in turn had both his arms and both his legs amputated for various reasons. These amputations brought on another neurological phenomenon: phantom limbs. George Dedlow, amongst millions of other war amputees, felt pain in limbs that he did not have.
   The ability to experience pain is essential for protection from injury, and recognition of the presence of injury. Episodic analgesia may occur under special circumstances, such as in the excitement of sport or war: a soldier on the battlefield may feel no pain for many hours from a traumatic amputation or other severe injury.
   A painful experience may change the motivation for normal behavioural responses. American bullfrogs learn to inhibit their high-priority, biologically adaptive righting reflex to avoid electric shock. After repeated exposure, they remain passively on their backs rather than exhibiting the normal, short-latency, righting response, thereby showing a trade-off in motivation.
  
  Section::::Research findings.:Cognitive ability and sentience.
  
  It has been argued that although a high cognitive capacity may indicate a greater likelihood of experiencing pain, it also gives these animals a greater ability to deal with this, leaving animals with a lower cognitive ability a greater problem in coping with pain.
   Peter Singer, a bioethicist and author of "Animal Liberation" published in 1975, suggested that consciousness is not necessarily the key issue: just because animals have smaller brains, or are ‘less conscious’, this does not mean that they are not capable of feeling pain.
   Section::::Experiencing pain.:Nociception.
  
  Nociception usually involves the transmission of a signal along a chain of nerve fibers from the site of a noxious stimulus at the periphery to the spinal cord and brain. This process evokes a reflex arc response generated at the spinal cord and not involving the brain, such as flinching or withdrawal of a limb. Nociception is found, in one form or another, across all major animal taxa. Nociception can be observed using modern imaging techniques; and a physiological and behavioral response to nociception can be detected.
  
  Section::::Experiencing pain.:Emotional pain.
   The prevalence of phantom pain in upper limb amputees is nearly 82%, and in lower limb amputees is 54%. One study found that eight days after amputation, 72% of patients had phantom limb pain, and six months later, 67% reported it. Some amputees experience continuous pain that varies in intensity or quality; others experience several bouts of pain per day, or it may reoccur less often. It is often described as shooting, crushing, burning or cramping. If the pain is continuous for a long period, parts of the intact body may become sensitized, so that touching them evokes pain in the phantom limb. Phantom limb pain may accompany urination or defecation.
   The second component is the experience of "pain" itself, or suffering – the internal, emotional interpretation of the nociceptive experience. This is when the withdrawn finger begins to hurt, moments after the withdrawal. Pain is therefore a private, emotional experience. Pain cannot be directly measured in other animals; responses to putatively painful stimuli can be measured, but not the experience itself. To address this problem when assessing the capacity of other species to experience pain, argument-by-analogy is used. This is based on the principle that if an animal responds to a stimulus in a similar way, it is likely to have had an analogous experience.
   There is no randomized study in medical literature that has studied the response with amputation of patients who have failed the above-mentioned therapies and who continue to be miserable. Nonetheless, there are reports that on average cite about half of the patients will have resolution of their pain, while half will develop phantom limb pain and/or pain at the amputation site. It is likely that as in any other chronic pain syndrome, the brain becomes chronically stimulated with pain, and late amputation may not work as well as it might be expected. In a survey of fifteen patients with CRPS Type 1, eleven responded that their life was better after amputation. Since this is the ultimate treatment of a painful extremity, it should be left as a last resort.
   For children with CP with limited movement and sensation, the risk of pressure sores increases. Pressure sores often occur on bony parts of the body. For example, pressure sores may occur when a child has limited feeling and movement of their lower body and uses a wheelchair; the tailbone bears weight when seated and can become vulnerable to pressure sores. The occupational therapist can educate the child, family, and caregivers about how to prevent pressure sores by monitoring the skin for areas of irritation, changing positions frequently, or using a tilt-in-space wheelchair.
  
  Section::::Occupational therapy.:Effect of cognitive and perceptual impairments.
   Peter Singer, a bioethicist and author of "Animal Liberation" published in 1975, suggested that consciousness is not necessarily the key issue: just because animals have smaller brains, or are ‘less conscious’ than humans, does not mean that they are not capable of feeling pain. He goes on further to argue that we do not assume newborn infants, people suffering from neurodegenerative brain diseases or people with learning disabilities experience less pain than we would.
   Severity depends on both the level at which the spinal cord is injured and the extent of the injury.
  
  An individual with an injury at C1 (the highest cervical vertebra, at the base of the skull) will probably lose function from the neck down and be ventilator-dependent. An individual with a C7 injury may lose function from the chest down but still retain use of the arms and much of the hands.
   Axillary nerve palsy patients present themselves with differing symptoms. For instance, some axillary nerve palsy patients complain that they cannot bend their arm at the elbow, however no other pain or discomfort exists. To further complicate diagnosis, onset of palsy can be delayed and may not be noticed until 12-24 hours after the trauma of shoulder region occurred. Therefore it is important to recognize the symptoms, but also to realize that different people have various combinations of them.
  
  Symptoms include:
  
  BULLET::::- cannot bend arm at the elbow
  
  BULLET::::- deficiency of deltoid muscle function
   BULLET::::- Rick Hansen, Canadian Paralympian who was paralyzed in a car crash at age 15
  
  BULLET::::- John Hockenberry, journalist and blogger
  
  BULLET::::- Paul Johnson (producer), American record producer and disc jockey who was shot accidentally
  
  BULLET::::- Sharry Konopski, model and actress injured in a car accident
  
  BULLET::::- Charles Krauthammer, conservative columnist and commentator
  
  BULLET::::- Boris Kustodiev, Russian painter who became paraplegic due to tuberculosis of the vertebral column.
  
  BULLET::::- James Langevin, US Congressman from Rhode Island who was shot accidentally at age 16.
  
  BULLET::::- Linda Laubenstein, American physician who was left paraplegic after a childhood polio infection
   While chronic progressive brachial monoplegia is uncommon, syringomyelia and tumors of the cervical cord or brachial plexus may be the cause. The onset of brachial plexus paralysis is usually explosive where pain is the initial feature. Pain localizes to the shoulder but may be more diffuse, or could be limited to the lower arm. Pain is severe and often described as sharp, stabbing, throbbing, or aching. The duration of pain, which is constant, varies from a span of several hours to 3 weeks. As the pain subsides, weakness usually appears. In addition, chronicle progressive weakness of one leg suggests a tumor of the spinal cord of the lumbar plexus. Fever is often the first symptom of lumbar plexus paralysis, followed by pain in one or both legs. The pain has an abrupt onset and may occur in a femoral or sciatic distribution. Weakness may develop concurrently with pain or be delayed for as long as 3 weeks. Furthermore, a monomeric form of spinal muscular atrophy, affecting only one leg or arm, should be considered when progressive weakness is not accompanied by sensory loss.
   There are two types of nerve fibre relevant to pain in amphibians. Group C nerve fibres are a type of sensory nerve fibre which lack a myelin sheath and have a small diameter, meaning they have a low nerve conduction velocity. The suffering associated with burns, toothaches, or crushing injury are caused by C fibre activity. A-delta fibres are another type of sensory nerve fibre, however, these are myelinated and therefore transmit impulses faster than non-myelinated C fibres. A-delta fibres carry cold, pressure and some pain signals, and are associated with acute pain that results in "pulling away" from noxious stimuli.
   Scientists have also proposed that in conjunction with argument-by-analogy, criteria of physiology or behavioural responses can be used to assess the possibility of non-human animals perceiving pain. The following is a table of criteria suggested by Sneddon "et al."
  
  Section::::Scientific statements.
  
  Several scientists have made statements indicating they believe amphibians can experience pain. For example, -
  
  After examining the morphology of the nervous system of vertebrates, Somme concluded "...most four-legged vertebrates have some state of consciousness..."
   Adults with CP are more likely to use medication to manage pain than active pain management methods.
   The extent of the injury is also important. A complete severing of the spinal cord will result in complete loss of function from that vertebra down. A partial severing or even bruising of the spinal cord results in varying degrees of mixed function and paralysis. A common misconception with tetraplegia is that the victim cannot move legs, arms or any of the major function; this is often not the case. Some individuals with tetraplegia can walk and use their hands, as though they did not have a spinal cord injury, while others may use wheelchairs and they can still have function of their arms and mild finger movement; again, that varies on the spinal cord damage.
   A group in Texas reported having observed a pattern in 2013 of one to four cases per year with similar polio-like characteristics.
  
  In 2014, the CDC Morbidity and Mortality Weekly Report and a CDC Clinician Outreach and Communication Activity (COCA) conference call, noted that many cases had neck, back, or extremity pain, but otherwise those affected generally had normal sensation in their limbs. A few participants in the conference call discussed whether pain, later abating, might precede the onset of paralysis.
   Section::::Causes.
  
  The correlation of notalgia paraesthetica localization with corresponding degenerative changes in the spine suggest that spinal nerve impingement may be a contributing cause. According to Plete and Massey, "The posterior rami of spinal nerves arising in T2 through T6 are unique in that they pursue a right-angle course through the multifidus spinae muscle, and this particular circumstance may predispose them to harm from otherwise innocuous insults of a varied nature." Patients may have other conditions that predispose them to peripheral neuropathies (nerve damage).
  
  The causes of this condition have not yet been completely defined. Patients are usually older persons.
   Pain is a complex mental state, with a distinct perceptual quality but also associated with suffering, which is an emotional state. Because of this complexity, the presence of pain in non-human animals cannot be determined unambiguously using observational methods, but the conclusion that animals experience pain is often inferred on the basis of likely presence of phenomenal consciousness which is deduced from comparative brain physiology as well as physical and behavioural reactions.
  
presuppositions: Paralyzed people only feel pain in missing limbs.
corrections: Paralyzed people feel ghost experiences in addition to pain where the nerve impulses end.
raw_presuppositions: Paralyzed people only feel pain in missing limbs. Paralyzed people can only feel pain.
raw_corrections: Paralyzed people feel ghost experiences in addition to pain where the nerve impulses end. Paralyzed people can feel ghost experiences in addition to pain.