Background: Chronic pain following limb amputations is now a recognized chronic pain syndrome usually described in a combination of phantom and stump pain.
Both stump and phantom pain continue to be significant treatment challenges. If
pharmacotherapy does not provide effective analgesia for stump pain, a clinician
has interventional options that frequently give only transient benefit, or have a high
chance of failure in the long run.
Methods: We selected 2 patients with primarily stump pain and difficulty tolerating the limb prosthesis. After a positive response to segmental nerve root blocks at
L4 and L5, pulsed radiofrequency (PRF) was performed to the dorsal root ganglia
(DRG).
Results: Both patients experienced 50% pain relief or better for 6 months. Each patient tolerated the prosthetic limb and could function at a higher level.
Conclusion: PRF treatment of the DRG at the L4 and L5 nerve root level may be a
therapeutic option for patients with peripherally mediated intractable stump pain. A
decrease in pain intensity and improved toleration of the limb prosthesis was appreciated in both patients.
Key words: Stump pain, dorsal root ganglia, pulsed radiofrequency