scholarly journals Psychological Factors Associated with Phantom Limb Pain: A Review of Recent Findings

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Xaver Fuchs ◽  
Herta Flor ◽  
Robin Bekrater-Bodmann
Keyword(s):  
Chronic Pain ◽  
Psychological Factors ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Body Perception ◽  
Limb Pain ◽  
Psychological Variables ◽  
Emotional Factors ◽  
Pain Symptoms

Phantom limb pain (PLP) is a common phenomenon occurring after the amputation of a limb and can be accompanied by serious suffering. Psychological factors have been shown to play an important role in other types of chronic pain, where they are pivotal in the acquisition and maintenance of pain symptoms. For PLP, however, the interaction between pain and psychological variables is less well documented. In this review, we summarize research on the role of emotional, motivational, cognitive, and perceptual factors in PLP. The reported findings indicate that emotional factors modulate PLP but might be less important compared to other types of chronic pain. Additional factors such as the amount of disability and adjustment to the amputation appear to also play a role. Bidirectional relationships between stress and PLP have been shown quite consistently, and the potential of stress and tension reduction in PLP treatment could be further exploited. Little is known about the role of cognitive variables such as attention or expectation. Catastrophizing seems to aggravate PLP and could be targeted in treatment. Body perception is altered in PLP and poses a potential target for novel mechanistic treatments. More research on psychological factors and their interactions in PLP is needed.

Persistent Phantom Limb Pain

1981 ◽  
Vol 53 (1) ◽  
pp. 135-138 ◽  
Author(s):  
Linda Dawson ◽  
Paul Arnold
Keyword(s):  
Psychological Factors ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain ◽  
Personal Problems ◽  
Phantom Limbs

The role of psychological factors in 10 patients with painful phantom limbs was investigated by means of a questionnaire and interviews. The hypotheses were that the severity of pain would be positively correlated with their present personal problems and attitudes and with experience of pain in the limb before amputation. The first hypothesis was confirmed but the second was not.

Origin of phantom limb pain: A dynamic network perspective

e-Neuroforum ◽  
2017 ◽  
Vol 23 (3) ◽  
Author(s):  
Herta Flor ◽  
Jamila Andoh
Keyword(s):  
Chronic Pain ◽  
Dynamic Network ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Phantom Pain ◽  
Limb Pain ◽  
Functional Changes ◽  
Frequency Of Use ◽  
Pain Symptoms

AbstractFunctional and structural plasticity in neural circuits may actively contribute to chronic pain. Changes in the central nervous system following limb amputation are one of the most remarkable evidences of brain plasticity.Such plastic changes result from combined sensorimotor deprivation with intense behavioral changes, including both acquisition of compensatory motor skills and coping with a chronic pain condition (phantom limb pain), which is a common consequence after amputation. This review aims to discuss the latest insights on functional changes and reorganization in nociceptive pathways, integrating analyses in human patients across several scales. Importantly, we address how functional changes interrelate with pain symptoms, not only locally within the primary somatosensory cortex but at a network-level including both spinal and cerebral areas of the nociceptive and pain networks. In addition, changes in the function of neurons and neural networks related to altered peripheral input are dynamic and influenced by psychological factors such as learning, prosthesis usage or frequency of use of the intact limb as well as comorbidity with anxiety and depression. We propose that both central and peripheral factors interact in a dynamic manner and create the phantom pain experience.

Fluoxetine in Phantom Limb Pain

1993 ◽  
Vol 163 (1) ◽  
pp. 105-106 ◽  
Author(s):  
Parsley Power-Smith ◽  
Douglas Turkington
Keyword(s):  
Chronic Pain ◽  
British Journal ◽  
Affective Disorder ◽  
Phantom Limb Pain ◽  
Complete Recovery ◽  
Phantom Limb ◽  
Limb Pain

Complete recovery of phantom limb pain of five years' duration occurred in a 71-year-old man following treatment with fluoxetine. There was no coexisting affective disorder. Further research is indicated in view of the postulated role of lowered central 5-hydroxy-tryptamine activity in the genesis and maintenance of chronic pain.British Journal of Psychiatry (1993), 163, 105–106

An Experimental Study of Atypical Phantom Pain

1965 ◽  
Vol 111 (481) ◽  
pp. 1185-1187 ◽  
Author(s):  
I. Pilowsky ◽  
A. Kaufman
Keyword(s):  
Experimental Study ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Phantom Pain ◽  
Limb Pain ◽  
Emotional Factors ◽  
Psychological Mechanism

A number of writers have drawn attention to the importance of emotional factors in phantom limb pain (Kolb, 1950, 1952; Simmel, 1956; Russell, 1959; Von Hagen, 1963). Kolb (1950, 1952) reported an association between the discussion of certain emotionally loaded topics and accesses of pain in the phantom. Stengel (1965), in his Maudsley Lecture, discussed the role played in these experiences by the psychological mechanism of identification with others. He briefly referred to the patient whom we have studied.

Psychological factors influencing chronic phantom limb pain: An analysis of the literature

Pain ◽  
1987 ◽  
Vol 28 (3) ◽  
pp. 285-295 ◽  
Author(s):  
Richard A. Sherman ◽  
Crystal J. Sherman ◽  
Glenda M. Bruno
Keyword(s):  
Psychological Factors ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain ◽  
Factors Influencing

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.

Psychological factors in spinal cord stimulation therapy: brief review and discussion

2006 ◽  
Vol 21 (6) ◽  
pp. 1-6 ◽  
Author(s):  
Daniel M. Doleys
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Spinal Cord Stimulation ◽  
Psychological Factors ◽  
Low Back ◽  
Psychological Variables ◽  
Psychological Screening ◽  
What Works ◽  
Made In

✓Since its introduction in 1967 by Shealy and colleagues, spinal cord stimulation (SCS) therapy has become an accepted approach to the treatment of certain types of chronic pain. Significant advances have been made in surgical technique, hardware technology, and the variety of disorders for which SCS has proven to be potentially beneficial. Despite these advancements, 25 to 50% of patients in whom a preimplantation trial screening yields successful results report loss of analgesia within 12 to 24 months of implantation, even in the presence of a functioning device. Psychological factors may play an important role in understanding this observation and improving the outcomes. In this article the author briefly reviews some of the data on psychological factors potentially involved in SCS. Research on patients with low-back and extremity pain was more heavily relied on because this is the population for which the most data exist. The discussion is divided into four sections: 1) role of psychological factors; 2) psychological screening and assessment; 3) patient selection and psychological screening; and 4) psychological variables and outcomes. To date, the data remain speculative. Although few definitive conclusions can be drawn, the cumulative existing experience does lend itself to some reasonable recommendations. As with all therapies for chronic pain, invasive or noninvasive, the criteria for success and an acceptable level of failure need to be established, but remain elusive. The emphasis herein is to try to take what works and make it work better.

scholarly journals Mirror therapy for phantom limb pain: Brain changes and the role of body representation

2013 ◽  
Vol 18 (5) ◽  
pp. 729-739 ◽  
Author(s):  
J. Foell ◽  
R. Bekrater-Bodmann ◽  
M. Diers ◽  
H. Flor
Keyword(s):  
Phantom Limb Pain ◽  
Body Representation ◽  
Phantom Limb ◽  
Mirror Therapy ◽  
Limb Pain ◽  
Brain Changes

scholarly journals Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Pain Following Amputation

2019 ◽  
Vol 184 (7-8) ◽  
pp. e267-e274 ◽  
Author(s):  
Steven P Cohen ◽  
Christopher A Gilmore ◽  
Richard L Rauck ◽  
Denise D Lester ◽  
Robert J Trainer ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Peripheral Nerve ◽  
Nerve Stimulation ◽  
Military Service ◽  
Phantom Limb Pain ◽  
Peripheral Nerve Stimulation ◽  
Service Members ◽  
Phantom Limb ◽  
Limb Pain ◽  
Military Service Members

Abstract Introduction Chronic pain and reduced function are significant problems for Military Service members and Veterans following amputation. Peripheral nerve stimulation (PNS) is a promising therapy, but PNS systems have traditionally been limited by invasiveness and complications. Recently, a novel percutaneous PNS system was developed to reduce the risk of complications and enable delivery of stimulation without surgery. Materials and Methods Percutaneous PNS was evaluated to determine if stimulation provides relief from residual and phantom limb pain following lower-extremity amputation. PNS leads were implanted percutaneously to deliver stimulation to the femoral and/or sciatic nerves. Patients received stimulation for up to 60 days followed by withdrawal of the leads. Results A review of recent studies and clinical reports found that a majority of patients (18/24, 75%) reported substantial (≥50%) clinically relevant relief of chronic post-amputation pain following up to 60 days of percutaneous PNS. Reductions in pain were frequently associated with reductions in disability and pain interference. Conclusions Percutaneous PNS can durably reduce pain, thereby enabling improvements in quality of life, function, and rehabilitation in individuals with residual or phantom limb pain following amputation. Percutaneous PNS may have additional benefit for Military Service members and Veterans with post-surgical or post-traumatic pain.

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