Treatment of Chronic Phantom Limb Pain Using a Trauma‐Focused Psychological Approach

Abstract

BACKGROUND: Chronic phantom limb pain (PLP) is a disabling chronic pain syndrome for which regular pain treatment is seldom effective. Pain memories resulting from long-lasting preamputation pain or pain flashbacks, which are part of a traumatic memory, are reported to be powerful elicitors of PLP.OBJECTIVE: To investigate whether a psychological treatment directed at processing the emotional and somatosensory memories associated with amputation reduces PLP.METHODS: Ten consecutive participants (six men and four women) with chronic PLP after leg amputation were treated with eye movement desensitization and reprocessing (EMDR). Pain intensity was assessed during a two-week period before and after treatment (mean number of sessions = 5.9), and at short- (three months) and long-term (mean 2.8 years) follow-up.RESULTS: Multivariate ANOVA for repeated measures revealed an overall time effect (F[2, 8]=6.7; P<0.02) for pain intensity. Pairwise comparison showed a significant decrease in mean pain score before and after treatment (P=0.00), which was maintained three months later. All but two participants improved and four were considered to be completely pain free at three months follow-up. Of the six participants available at long-term follow-up (mean 2.8 years), three were pain free and two had reduced pain intensity.CONCLUSIONS: These preliminary results suggest that, following a psychological intervention focused on trauma or pain-related memories, substantial long-term reduction of chronic PLP can be achieved. However, larger outcome studies are required.

A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing – a multicentre pilot trial

“…It may be speculated that given the similarities between phantom pain and tinnitus (De Ridder, Elgoyhen, Romo, & Langguth, 2011) and the effectiveness of eye movement desensitization and reprocessing (EMDR) in reducing phantom pain severity (De Roos et al, 2010; Schneider, Hofmann, Rost, & Shapiro, 2007) EMDR might also be an effective intervention for tinnitus distress. EMDR is an evidence-based psychological treatment that is frequently used and effective in post-traumatic stress disorder (PTSD) and its affiliated symptoms (Bisson et al, 2007; Bradley, Greene, Russ, Dutra, & Westen, 2005; Seidler & Wagner, 2006).…”

Comparison of Eye Movement Desensitization and Reprocessing (EMDR) and Duloxetine Treatment Outcomes in Women Patients with Somatic Symptom Disorder

“…The prospect of the AIP model includes EMDR therapy can result in completely elimination of the stressful somatic perception. The previous studies of EMDR have provided robust evidence empirically supporting the theoretical considerations of the AIP model that EMDR therapy for phantom limb pain which is assumed to be caused by the unprocessed painful memories containing the physical sensations during the time of the event indicate an excessive success rate as defined by almost complete elimination of the painful somatic sensations (de Roos et al, 2010;Russell, 2008;Schneider et al, 2008;Wilensky, 2006). Completed processing of the memory through is premised to include an integration and reconsolidation of the originally stored memory that results in alterations in emotions, beliefs and bodily sensations (Shapiro, 2001(Shapiro, , 2007Solomon & Shapiro, 2008).…”

EMDR Processing of Chronic Fatigue Syndrome

“…In the only two studies indicating EMDR therapy applications for phantom limb syndrome [15,16], the afflicted individuals are still experiencing pain intensities despite the amputation of the limbs. Similarly, the two clients in both case studies [1] are still experiencing symptoms of fatigue despite the clearing of the viral infection.…”