Phantom Limb Pain; Prevalence, Mechanisms and Associated Factors

Richardson, Cliff

doi:10.1007/978-0-387-87462-3_10

Cited by 10 publications

(13 citation statements)

References 92 publications

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Section: Discussionsupporting

confidence: 90%

“…Additionally, among atraumatic amputees, those with a vascular cause who often experienced extreme pain in the limb prior to amputation were more likely to experience PLP (Larbig et al, 2019;Streit et al, 2015). This is consistent with suggestions that pre-amputation pain might predispose amputees to PLP (Jensen et al, 1983;Nikolajsen et al, 1997;Ramachandran & Hirstein, 1998;Richardson 2009). Importantly, in the study by Larbig et al (2019) when assessing the duration of pre-amputation pain, they found that while acute pain 1 day prior to amputation was only weakly associated with ongoing PLP, having pain throughout the week prior to amputation or chronic pre-amputation pain were both strong predictors of PLP at 3 and 12 months postoperatively.…”

Section: Indication For Amputationsupporting

confidence: 81%

“…targeted muscle reinnervation) during this period. This supports propositions that majority of amputees will experience PLP or PLS (Streit et al, 2015), which may persist decades post-amputation (Resnik et al, 2019;Richardson 2009).…”

Section: Time Since Amputationsupporting

confidence: 80%

See 2 more Smart Citations

Prevalence and incidence of phantom limb pain, phantom limb sensations and telescoping in amputees: A systematic rapid review

Stankevicius

Wallwork

Summers

et al. 2020

European Journal of Pain

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Background and objective: This systematic, rapid review aimed to critically appraise and synthesize the recent literature (2014-2019) evaluating the incidence and prevalence of post-amputation phantom limb pain (PLP) and sensation (PLS). Databases and data treatment: Five databases (Medline, Embase, Emcare, PsychInfo, Web of Science) and Google Scholar were searched, with two independent reviewers completing eligibility screening, risk of bias assessment and data extraction. Results: The search identified 1,350 studies with 12 cross-sectional and 3 prospective studies included. Studies evaluated traumatic (n = 5), atraumatic (n = 4), and combined traumatic/atraumatic (n = 6) amputee populations, ranging from 1 month to 33 years post-amputation. Study heterogeneity prevented data pooling. The majority of studies had a high risk of bias, primarily due to limited generalizability. Three studies evaluated PLP incidence, ranging from 2.2% (atraumatic; 1 month) to 41% (combined; 3 months) and 82% (combined; 12 months). Only one study evaluated PLS/telescoping incidence. Across contrasting populations, PLP point prevalence was between 6.7%-88.1%, 1 to 3-month period prevalence was between 49%-93.5%, and lifetime prevalence was high at 76%-87%. Point prevalence of PLS was 32.4%-90%, period prevalence was 65% (1 month) and 56.9% (3 months), and lifetime prevalence was 87%. Telescoping was less prevalent, highest among traumatic amputees (24.6%) within a 1-month prevalence period. Variations in population type (e.g. amputation characteristics) and incidence and prevalence measures likely influence the large variability seen here. Conclusions: This review found that lifetime prevalence was the highest, with most individuals experiencing some type of phantom phenomena at some point post-amputation.

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Section: Discussionsupporting

confidence: 90%

Section: Indication For Amputationsupporting

confidence: 81%

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Prevalence and incidence of phantom limb pain, phantom limb sensations and telescoping in amputees: A systematic rapid review

Stankevicius

Wallwork

Summers

et al. 2020

European Journal of Pain

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“…Depression is a frequent response to such circumstances [2]. Pain from the residual limb or phantom limb (pain experienced as arising from the limb which has been amputated) may exacerbate feelings of depression [3]. One key challenge following limb loss is adjusting to a different body image [4].…”

mentioning

confidence: 99%

The experience of amputation and prosthesis use for adults: a metasynthesis

Murray

Forshaw

2012

Disability and Rehabilitation

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The findings provide a base from which to make suggestions regarding the provision of health rehabilitation services for this population. It is recommended that such services make greater use of psychological interventions and education, include patients' social support networks, use psychotherapy to support and develop positive coping strategies, and facilitate peer support from those who have already made positive adjustments to amputation and prosthesis use.

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“…5 However, this postulate does not fully explain neither the magnitude of pain patterns involved nor the presence of a contemporaneous stump pain, and the fact that the majority of the amputees wake up from the amputation with a picture of a phantom limb. Also, the treatment procedures based on this theory have been problematic.…”

Section: Discussionmentioning

confidence: 99%

Role of myofascial trigger points in post-amputation pain

Reiestad¹,

Kulkarni²

2013

Prosthetics &Amp; Orthotics International

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Background: Post-amputation pain is a multifactorial issue and thus necessitates multiple treatment strategies. Myofascial trigger points-related pain remains under diagnosed and hence not addressed. This study investigates causation and management. Objectives: To identify the presence and role of myofascial trigger points in post amputation pain. Study Design: Post-amputation pain clinic review and recruitment. Methods: Twenty one identified patients in the post-amputation pain clinic with myofascial trigger points were recruited, of which 13 were transtibial and eight transfemoral and all had phantom limb pain and stump pain. The trigger points were identified and injected with long-acting local anaesthetic on a weekly basis and patients were followed up on an ongoing basis. Results: There was significant resolution of pain on the Visual Analogue Scale in the majority of these patients within five weeks, though some of the transtibial cohort needed further eight injections on a weekly basis for resolution of the pain. Conclusion: Identification of myofascial trigger points in amputation stumps and their role in post-amputation pain, followed by appropriate intervention is an important facet of management of this complex chronic pain. Clinical relevanceMyofascial trigger points in amputation stumps can lead to ongoing chronic post-amputation pain and our results indicate that identification and intervention of these trigger points does lead to notable resolution of this pain.

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Phantom Limb Pain; Prevalence, Mechanisms and Associated Factors

Cited by 10 publications

References 92 publications

Prevalence and incidence of phantom limb pain, phantom limb sensations and telescoping in amputees: A systematic rapid review

Prevalence and incidence of phantom limb pain, phantom limb sensations and telescoping in amputees: A systematic rapid review

The experience of amputation and prosthesis use for adults: a metasynthesis

Role of myofascial trigger points in post-amputation pain

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