A Study on Relationship among Phantom Limb Pain (original) (raw)
Related papers
Phantom pain in bilateral upper limb amputation
Disability & Rehabilitation, 2009
Purpose. To alert health professionals on presence and extent of phantom pain and sensation following bilateral upper limb amputation. Methods. Of a total of 140 war-related bilateral upper limb amputees in Iran, 103 subjects were thoroughly examined in this cross-sectional study by a physical medicine specialist. The patients were questioned for the presence of phantom pain and sensations, and frequency and intensity of the feeling were recorded. Results. At 17.1 + 6.1 years after injury, 82.0% of the 103 amputees suffered from phantom sensation, including varying degrees of phantom limb pain in 53.9% of stumps. Phantom phenomena had a higher frequency in the right extremities, but this was not statistically significant (p 4 0.01). Of those amputees who had phantom pain or sensation, 51.2% reported that they 'always' had phantom limb sensation; and approximately one-fourth of the subjects (24.6%) 'always' had phantom pain. Among the stumps who reported phantom pain (N ¼ 112), the pain was excruciating (38.5%), distressing (34.9%) or discomforting (25.6%). A significant statistical relation between phantom limb sensation and level of amputation was observed (p 5 0.01). Conclusion. At this time there is no healing for phantom pain; medical and surgical modalities only bring temporary relief, and less than 1% of the respondents achieve permanent relief through different treatment methods.
Phantom pain and phantom sensations in upper limb amputees: an epidemiological study
Pain, 2000
Phantom pain in subjects with an amputated limb is a well-known problem. However, estimates of the prevalence of phantom pain differ considerably in the literature. Various factors associated with phantom pain have been described including pain before the amputation, gender, dominance, and time elapsed since the amputation. The purposes of this study were to determine prevalence and factors associated with phantom pain and phantom sensations in upper limb amputees in The Netherlands. Additionally, the relationship between phantom pain, phantom sensations and prosthesis use in upper limb amputees was investigated. One hundred twenty-four upper limb amputees participated in this study. Subjects were asked to fill out a self-developed questionnaire scoring the following items: date, side, level, and reason of amputation, duration of experienced pain before amputation, frequencies with which phantom sensations, phantom pain, and stump pain are experienced, amount of trouble and suffering experienced, respectively, related to these sensations, type of phantom sensations, medical treatment received for phantom pain and/or stump pain, and the effects of the treatment, self medication, and prosthesis use. The response rate was 80%. The prevalence of phantom pain was 51%, of phantom sensations 76% and of stump pain 49%; 48% of the subjects experienced phantom pain a few times per day or more; 64% experienced moderate to very much suffering from the phantom pain. A significant association was found between phantom pain and phantom sensations (relative risk 11.3) and between phantom pain and stump pain (relative risk 1.9). No other factors associated with phantom pain or phantom sensations could be determined. Only four patients received medical treatment for their phantom pain. Phantom pain is a common problem in upper limb amputees that causes considerable suffering for the subjects involved. Only a minority of subjects are treated for phantom pain. Further research is needed to determine factors associated with phantom pain.
Original article, 2022
Objective: To determine the prevalence of phantom limb pain and stump pain in amputees during first six months of amputation and to examine the intensity of phantom limb pain and stump pain with the passage of time. Methodology: It was cross sectional survey conducted from 16 th May to 30 th November 2019 at District Head Quarter hospital and Allied hospital Faisalabad during first six months of amputation. Total 80 patients including both gender and age ranging from 18-75 years were enrolled in the study. Data was collected using a questionnaire named "Phantom and stump pain questionnaire in amputees. And data was analyzed by using SPSS 20. Results: It was observed that 45 (56.25%) were males and 35 (43.75%) were females. In this study 22 (27.50%) patients were presented with upper limb amputation and 58 (72.50%) were with lower limb amputation. Findings of this study showed that the prevalence of phantom limb pain was 48 (60%) and stump pain was 52 (65%) and their intensity decreased with the passage of time because a negative correlation was found between two variables "duration since amputation and phantom pain" (r =-0.76, p = .000) and "duration since amputation and stump pain" (r =-0.49, p = .000). Stump pain was most common in traumatic cause of amputation and phantom limb pain was seen more in patient with amputation due to diabetes and peripheral vascular disease. Conclusion: It was concluded that phantom limb pain and stump pain appeared to be common in patients after upper and lower limb amputation during first six months of amputation and it was reported that the intensity of pain decreases gradually with the passage of time.
Phantom limb sensations and phantom limb pain in child and adolescent amputees
Pain, 1998
To provide a better understanding of the prevalence, correlates and quality of phantom sensations and phantom pain in child and adolescent amputees. Retrospective survey study. Recruitment through the War Amputations of Canada. Sixty child and adolescent amputees aged 8-18 years who were missing a limb due to a congenital limb deficiency (n = 27) or surgery/trauma (n = 33). Questionnaire to assess the occurrence and correlates of phantom sensations and phantom pain. Forty-two percent of the total sample reported phantom sensations; 7.4% of the congenital group and 69.7% of the surgical group (chi2 = 23.70 with 1 df, P < 0.01.) Twenty-nine percent of the total sample reported phantom pain; 3.7% of the congenital group and 48.5% of the surgical group (chi2 = 14.67, with 1 df, P < 0.01). Eighty-eight percent of the amputees with phantom pain had stump pain, while 35.3% had phantom pain that was similar to pre-operative pain and 76.5% experienced pains other than phantom pain (e.g. headaches). Amputees identified exercise, objects approaching the stump, cold weather and 'feeling nervous' as the primary triggers of phantom sensations and/or phantom pain. Less than half of the sample experienced phantom sensations and phantom pain; however, the loss of a limb due to surgery is associated with an increase in the likelihood of experiencing these phenomena.
Factors associated with phantom limb pain: a 31/2-year prospective study
Clinical Rehabilitation, 2010
Objective: To analyse the prevalence of phantom (limb) pain over time and to analyse factors associated with phantom (limb) pain in a prospective cohort of amputees. Design: A multicentre longitudinal study. Patients: One hundred and thirty-four patients scheduled for amputation were included. Methods: Patients filled in questionnaires before amputation, and postal questionnaires six months, 1½ years and 2½ years to a maximum of 3½ years after amputation. Preoperative assessment included patients' characteristics, date, side and level of, and reason for amputation. The follow-up questionnaires assessed the frequencies of the experienced phantom pain, prosthetic use and walking distance. The occurrence of phantom pain was defined as phantom pain a few times a day or more frequently. Results: Pre-and postoperative questionnaires were available filled in by 85 amputees (33 females and 52 males). The percentage of lower limb amputees with phantom pain was the highest at six months after amputation, and of upper limb amputees at 1½ years. In general, more women than men experienced phantom pain. One and a half years and 2½ years after amputation the highest percentages of the lower limb amputees used their prosthesis more than 4 hours a day (66%), after that time this percentage decreased to 60%. The results of the two-level logistic regression analysis to predict phantom pain show that phantom pain was less frequently present in men (odds ratio (OR) ¼ 0.12), in lower limb amputees (OR ¼ 0.14) and that it decreased in due course (OR ¼ 0.53 for 1 year). Conclusion: Protective factors for phantom pain are: being male, having a lower limb amputation and the time elapsed since amputation.
The International Journal of Psychiatry in Medicine, 1988
Phantom limb pain, which affects a majority of amputees, must be distinguished from phantom limb sensation, a universal consequence of limb amputation. Although the characteristics and time course of phantom limb pain are well described in the literature, no single theoretical approach can fully account for the contradictory aspects of this condition, thus its underlying mechanisms remain unclear. Theories concerning the etiology of phantom limb pain categorized as peripheral, central and psychological have given rise to a myriad of treatment approaches.
British Journal of Anaesthesia, 2001
d Phantom limb pain: Painful sensations referred to the absent limb. d Phantom limb sensation: Any sensation in the absent limb, except pain. d Stump pain: Pain localized in the stump. These elements often coexist in each patient and may be dif®cult to separate. Clinical aspects Incidence Early literature suggested that the incidence of phantom pain was as low as 2%. However, more recent studies report incidences of 60±80% (Table 1). The discrepancy in reported frequencies mainly occurred because early studies based prevalence rates on patients' request for pain treatment. This will substantially underestimate the problem of phantom pain as many amputees, at least in the past, were reluctant to report pain to health care providers. Sherman and Sherman (1983) reported that, although 61% of amputees with phantom pain had discussed the problem with their doctor, only 17% were offered treatment and a large proportion of the rest were told that they were mentally disturbed. 80 The occurrence of phantom pain seems to be independent of age in adults, gender and level, or side of amputation. 37 46 54 59 80 Phantom pain is less frequent in young children and congenital amputees. In a recent study of 60 child and adolescent amputees who were missing a limb because of congenital limb de®ciency (n=27) or surgery/ trauma (n=33), the incidence of phantom pain was 3.7% in the congenital group and 48.5% in the surgical group. 99 Some authors have suggested a relationship between
Stability of phantom limb phenomena after upper limb amputation: A longitudinal study
Neuroscience, 2008
Amputees may experience stump pain (SP), phantom limb (PL) sensations, pain, and/or a general awareness of the missing limb. The mechanisms underlying these perceptions could involve nervous system neuroplasticity and be reflected in altered sensory function of the residual limb. Since little is known about the progression of post-amputation sensory phenomena over time, we longitudinally evaluated the stability of, and relationships among: 1) subjective reports of PL sensations, pain, awareness, and SP, 2) stump tactile and tactile spatial acuity thresholds, and 3) use of a functional vs. a cosmetic prosthesis in 11 otherwise healthy individuals with recent unilateral, traumatic upper-extremity amputation. Subjects were evaluated within 6 months and at 1-3 years after amputation. Processing of tactile sensory information from the stump remained stable over the study time period. PL awareness was frequent, stable over time, intense, and occurred with or without PL sensations. Functional prosthetic use correlated with stable vividness of PL awareness whereas subjects who used a cosmetic prosthesis had less vivid PL awareness at follow-up. Initial SP correlated with follow-up SP, the initial PL pain correlated with follow-up PL pain but neither initial nor follow-up SP appear to be related to follow-up PL pain after accounting for initial PL pain intensity. Neither limb temperature nor prosthesis-use correlated with the initial vs. follow-up change in PL pain intensity. These data provide evidence that PL pain described 1-3 years after an amputation is not related in any simple way to peripheral sensory function, SP, or limb temperature; and PL awareness but not PL pain may be influenced by the frequent use of a functional prosthesis.