Risk factors for post-amputation pain

2018 ◽  
Author(s):  
Tudor Phillips
Keyword(s):  
Older Patients ◽  
Clinical Characteristics ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Limb Pain ◽  
Experienced Pain ◽  
Stump Pain ◽  
Peripheral Pain

The landmark paper discussed in this chapter is ‘Immediate and long-term phantom limb pain in amputees: Incidence, clinical characteristics and relationship to pre-amputation limb pain’, published by Jensen et al. in 1985. This study examined a cohort of older patients undergoing limb amputation, and carefully related pre-amputation pain to the development and nature of phantom limb pain. The authors demonstrated that a third of patients experienced pain similar to the pre-amputated limb pain immediately after amputation; patients who had experienced pre-amputation pain were more likely to experience phantom limb pain in the first 6 months after the amputation; and persistent phantom limb pain was more likely in patients who experienced stump pain after amputation. The study had clear implications for pain management but, importantly, it also demonstrated that peripheral pain, in the form of pre-amputation and stump pain, was important in determining the development and maintenance of phantom limb pain.

Psychosocial predictors of long-term adjustment to lower-limb amputation and phantom limb pain

2004 ◽  
Vol 26 (14-15) ◽  
pp. 882-893 ◽  
Author(s):  
Marisol A Hanley ◽  
Mark P Jensen ◽  
Dawn M Ehde ◽  
Amy J Hoffman ◽  
David R Patterson ◽  
...  
Keyword(s):  
Lower Limb ◽  
Phantom Limb Pain ◽  
Lower Limb Amputation ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Psychosocial Predictors ◽  
Limb Pain

scholarly journals Trajectory of phantom limb pain relief using mirror therapy: Retrospective analysis of two studies

2017 ◽  
Vol 15 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Sarah C. Griffin ◽  
Sean Curran ◽  
Annie W.Y. Chan ◽  
Sacha B. Finn ◽  
Chris I. Baker ◽  
...  
Keyword(s):  
Pain Relief ◽  
Short Form ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Mcgill Pain Questionnaire ◽  
Mirror Therapy ◽  
Limb Pain ◽  
Experienced Pain ◽  
Pain Symptoms

AbstractBackground and purposeResearch indicates that mirror therapy reduces phantom limb pain (PLP). Objectives were to determine when mirror therapy works in those who respond to treatment, the relevance of baseline PLP to when pain relief occurs, and what pain symptoms respond to mirror therapy.MethodsData from two independent cohorts with unilateral lower limb amputation were analyzed for this study (n = 33). Mirror therapy consisted of 15-min sessions in which amputees performed synchronous movements of the phantom and intact legs/feet. PLP was measured using a visual analogue scale and the Short-Form McGill Pain Questionnaire.ResultsThe severity of PLP at the beginning of treatment predicted when pain relief occurred. Those with low baseline PLP experienced a reduction (p < 0.05) in PLP by session 7 of treatment, those with medium baseline PLP experienced pain relief by session 14 of treatment, and those with high baseline PLP experienced pain relief by session 21 of treatment. Mirror therapy reduced throbbing, shooting, stabbing, sharp, cramping, aching, tender, splitting, tiring/exhausting, and punishing-cruel pain symptoms.ConclusionThe degree of PLP at baseline predicts when mirror therapy relieves pain.ImplicationsThis article indicates that the degree of baseline PLP affects when mirror therapy relieves pain: relief occurs by session 7 in patients with low PLP but by session 21 in patients with high PLP. Clinicians should anticipate slower pain relief in patients who begin treatment with high levels of pain.

Chronic pain in lower limb amputees: Is there a correlation with the use of perioperative epidural or perineural analgesia?

2021 ◽  
pp. 1-10
Author(s):  
Benedetti Maria Grazia ◽  
De Santis Letizia ◽  
Mariani Giorgio ◽  
Donati Danilo ◽  
Bardelli Roberta ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Lower Limb ◽  
Phantom Limb Pain ◽  
Postal Survey ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Limb Pain ◽  
Simultaneous Use

BACKGROUND: Chronic pain is common in patients who undergo lower limb amputation. The use of epidural or perineural catheters seems to reduce acute pain after surgery but their effects in a longer follow up are unknown. OBJECTIVE: To evaluate the long-term prevalence of phantom limb sensation (PLS), phantom limb pain (PLP), and residual limb pain (RLP) and their correlation with perioperative use of epidural or perineural catheters. METHODS: Postal survey. Patients with trans-femoral, trans-tibial or hemi-pelvectomy amputation were asked to partake in the study. The Prosthetic Evaluation Questionnaire was used for the presence of chronic post-surgical pain. Presence of catheters was retrieved from medical notes. RESULTS: 57 patients at a mean of 4.4 years follow up were included. PLS was reported in 68.4%, PLP in 63.2 % and RLP in 54.4% of amputees. No correlation was identified between pain syndromes and the presence of individual catheters and the duration of their permanence. The simultaneous use of 2 catheters was related to a lesser presence of PLP. CONCLUSIONS: Data on prevalence of PLP, PLS and RLP are consistent with the literature. Favourable effects in PLP reduction in the long term follow up was related to the simultaneous use of two catheters.

Immediate and long-term phantom limb pain in amputees: Incidence, clinical characteristics and relationship to pre-amputation limb pain

Pain ◽  
1985 ◽  
Vol 21 (3) ◽  
pp. 267-278 ◽  
Author(s):  
Troels S. Jensen ◽  
Børge Krebs ◽  
Jørn Nielsen ◽  
Peter Rasmussen
Keyword(s):  
Clinical Characteristics ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain

Electrical stimulation of referred sensation area alleviates phantom limb pain

2021 ◽  
pp. 1-10
Author(s):  
Michihiro Osumi ◽  
Daisuke Shimizu ◽  
Yuki Nishi ◽  
Shu Morioka
Keyword(s):  
Electrical Stimulation ◽  
Single Case ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Long Term Effects ◽  
Limb Pain ◽  
Short Term ◽  
Analgesic Effects ◽  
Stimulation Of

Background: Patients with brachial plexus avulsion (BPA) usually experience phantom sensations and phantom limb pain (PLP) in the deafferented limb. It has been suggested that evoking the sensation of touch in the deafferented limb by stimulating referred sensation areas (RSAs) on the cheek or shoulder might alleviate PLP. However, feasible rehabilitation techniques using this approach have not been reported. Objective: The present study sought to examine the analgesic effects of simple electrical stimulation of RSAs in BPA patients with PLP. Methods: Study 1: Electrical stimulation of RSAs for 60 minutes was conducted for six BPA patients suffering from PLP to examine short-term analgesic effects. Study 2: A single case design experiment was conducted with two BPA patients to investigate whether electrical stimulation of RSAs was more effective for alleviating PLP than control electrical stimulation (electrical stimulation of sites on side opposite to the RSAs), and to elucidate the long-term effects of electrical stimulation of RSAs. Results: Study 1: Electrical stimulation of RSAs evoked phantom touch sensations in the deafferented limb, and significantly alleviated PLP (p <  0.05). Study 2: PLP was alleviated more after electrical stimulation on RSAs compared with control electrical stimulation (p <  0.05). However, the analgesic effects of electrical stimulation on RSAs were observed only in the short term, not in the long term (p >  0.05). Conclusions: Electrical stimulation of RSAs not only evoked phantom touch sensation but also alleviated PLP in the short term. The results indicate that electrical stimulation of RSAs may provide a useful practical rehabilitation technique for PLP. Future studies will be required to clarify the mechanisms underlying immediate PLP alleviation via electrical stimulation of RSAs.

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