Phantom Limb Pain

2016 ◽  
Author(s):  
George C Chang Chien ◽  
Alexander Bautista ◽  
Kenneth D. Candido
Keyword(s):  
Neuropathic Pain ◽  
Phantom Limb Pain ◽  
Underlying Mechanism ◽  
Interventional Therapy ◽  
The Body ◽  
Phantom Limb ◽  
Residual Limb ◽  
Mirror Therapy ◽  
Limb Pain ◽  
Residual Limb Pain

Phantom limb is a complex pain phenomenon that is perceived by patients after a limb has been amputated. Many patients have the persistent perception that the particular limb that was lost is still present. This phenomenon, which may be painful and nonpainful, may develop immediately after amputation or in years following the incident. This phenomenon should not be confused with residual limb pain, formerly described as “stump pain,” which is pain that resides in the residual limb attached to the body. Phantom limb pain (PLP) is described similarly to other neuropathic pain conditions as burning, gnawing, stabbing, pressure, aching, squeezing, and knifelike. PLP is associated with a myriad of symptoms and considered one of the most challenging chronic pain conditions. The underlying mechanism of this phenomenon can be supraspinal, spinal, and peripheral. PLP remains a very challenging condition to treat. The therapies are similar to those of any other neuropathic pain states. A multimodal approach that includes interventional therapy, pharmacotherapy, rehabilitation, surgery, and preemptive analgesia working together improves success.  Key words: Amputation, amputee, central sensitization, mirror therapy, neuropathic pain, phantom limb pain, residual limb pain

scholarly journals Phantom limb pain intensity is associated with generalized hyperalgesia

2019 ◽  
Author(s):  
Xaver Fuchs ◽  
Martin Diers ◽  
Jörg Trojan ◽  
Pinar Kirsch ◽  
Christopher Milde ◽  
...  
Keyword(s):  
Phantom Limb Pain ◽  
The Body ◽  
Phantom Limb ◽  
Limb Amputation ◽  
Sensory Threshold ◽  
Heat Pain ◽  
Residual Limb ◽  
Limb Pain ◽  
Somatosensory Sensitivity ◽  
Generalized Hyperalgesia

AbstractAfter limb amputation, most amputees suffer from phantom limb pain (PLP). The mechanisms underlying this condition are complex and insufficiently understood. Altered somatosensory sensitivity (either heightened or lowered) might contribute to PLP. Recent studies have tested this assumption but mainly focused on the residual limb. However, altered somatosensation in PLP might be generalized. In this study, we applied quantitative sensory testing to 37 unilateral upper-limb amputees (23 with PLP, 14 without PLP) and 19 healthy controls. We assessed thresholds to heat pain (HPT), pressure pain (PPT), warmth detection (WDT), and two-point discrimination (2PDT) at the residual limb, a homologous point and the thenar of the intact limb, and both corners of the mouth. We did not find significant differences in any of the thresholds between the groups. However, higher PLP intensity was significantly related to lower HPT at all measured body sites except for the residual limb. At the residual limb, lower HPT were observed in more distal amputations and in amputees showing a higher degree of prosthesis use. Although WDT did by itself not significantly correlate with PLP intensity at any of the body sites, multiple regression analysis showed the highest multiple correlations with PLP intensity for a combination of high WDT and low HPT at the corners of the mouth. In this model, the combination of HPT and WDT shared 58% of the variance with PLP intensity. Other factors of potential importance, especially residual limb pain, were not significantly associated to any sensory threshold. We conclude that the intensity, but not the presence of PLP is positively associated with higher heat pain sensitivity. Since this association was observed at various, distributed body sites, we suggest that central mechanisms might be underlying such generalized hyperalgesia.

scholarly journals Targeted muscle reinnervation in quadruple amputees: self-reported outcomes

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Emma-Leigh Rudduck ◽  
Frank Bruscino-Raiola ◽  
Margaret Angliss ◽  
Steven J Gray ◽  
David Lee Gow ◽  
...  
Keyword(s):  
Current Literature ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Residual Limb ◽  
Limb Pain ◽  
Targeted Muscle Reinnervation ◽  
Alfred Hospital ◽  
Muscle Reinnervation ◽  
Residual Limb Pain ◽  
Psychological Disabilities

Targeted muscle reinnervation (TMR) reduces pain and physical and psychological disabilities in amputees. We present the first two cases reported globally of quadruple amputees that underwent acute TMR. Each patient completed our novel ‘The Alfred Hospital Osteointegration Survey’ (TAHOS) for each limb at six, 12 and 24 months post amputation which evaluated aspects of prosthesis wear, neuroma-related residual limb pain (RLP), phantom limb pain (PLP) and overall function. Our findings that TMR reduced or eliminated RLP and PLP by 12 months and clinically improved prosthetic function in both quadruple amputees reflects the current literature for single and multiple limb amputees.

scholarly journals Protective and Risk Factors for Phantom Limb Pain and Residual Limb Pain Severity

Pain Practice ◽  
2020 ◽  
Vol 20 (6) ◽  
pp. 578-587
Author(s):  
Marionna Münger ◽  
Camila B. Pinto ◽  
Kevin Pacheco‐Barrios ◽  
Dante Duarte ◽  
Muhamed Enes Gunduz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Phantom Limb Pain ◽  
Pain Severity ◽  
Phantom Limb ◽  
Residual Limb ◽  
Limb Pain ◽  
Residual Limb Pain

scholarly journals Benchmarking Residual Limb Pain and Phantom Limb Pain in Amputees through a Patient-reported Outcomes Survey

2020 ◽  
Vol 8 (7) ◽  
pp. e2977
Author(s):  
Lauren M. Mioton ◽  
Gregory A. Dumanian ◽  
Megan E. Fracol ◽  
A. Vania Apkarian ◽  
Ian L. Valerio ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Phantom Limb Pain ◽  
Phantom Limb ◽  
Residual Limb ◽  
Limb Pain ◽  
Patient Reported ◽  
Residual Limb Pain

Residual limb pain: An evidence-based review

2020 ◽  
Vol 47 (3) ◽  
pp. 315-325
Author(s):  
Gary Stover ◽  
Nathan Prahlow
Keyword(s):  
United States ◽  
Treatment Options ◽  
Phantom Limb Pain ◽  
The United States ◽  
Phantom Limb ◽  
Evidence Based ◽  
Residual Limb ◽  
Limb Pain ◽  
Current Prevalence ◽  
Residual Limb Pain

Acquired limb loss, whether from accident or amputation, occurs with an incidence of greater than 175,000 per year in the United States. Current prevalence is estimated at greater than 1.5 million and is expected to double within 30 years. While many patients with amputations may have no significant pain or sensory issues after healing from the initial loss, one-quarter to one-half of patients may have ongoing difficulties with residual limb pain, phantom limb pain, or phantom limb sensation. This review explores the potential etiologies of those symptoms, as well as a variety of treatment options that a practitioner may consider when approaching this condition.

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