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

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.

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.

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.

The role of coping in adjustment to phantom limb pain

Pain ◽  
1995 ◽  
Vol 62 (1) ◽  
pp. 79-86 ◽  
Author(s):  
A. Hill ◽  
C. A. Niven ◽  
C. Knussen
Keyword(s):  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Limb Pain
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