Ból kończyny resztkowej
Epidemiologia

Ból kończyny resztkowej (RLP) jest istotnym powikłaniem po amputacji, dotykającym około 60% pacjentów, z częstością występowania zmieniającą się w czasie: 50% w 1. tygodniu, 11% w 1. miesiącu, a następnie stabilizującą się na poziomie 22-27% od 3 miesięcy do 2 lat po zabiegu. Czynniki ryzyka obejmują wyższy poziom amputacji, intensywny ból przedoperacyjny, etiologię amputacji (najwyższe nasilenie po amputacjach nowotworowych), starszy wiek oraz palenie tytoniu. RLP jest silnie skorelowany z bólem fantomowym (PLP), z ponad połową pacjentów doświadczających obu tych dolegliwości. Nasilenie bólu jest wyższe po amputacjach kończyny górnej niż dolnej, co ma znaczenie kliniczne przy planowaniu rehabilitacji i opieki pooperacyjnej.

  1. Epidemiologia bólu kończyny resztkowej
    1. Częstotliwość występowania
    2. Czynniki ryzyka
    3. Związek z innymi rodzajami bólu poamputacyjnego
  2. Nasilenie bólu kończyny resztkowej
    1. Różnice w nasileniu bólu w zależności od przyczyny amputacji
    2. Różnice między kończyną górną i dolną
  3. Bazy danych i systemy nadzoru
    1. Różnice między krajami rozwiniętymi i rozwijającymi się
    2. Problemy z dokumentacją medyczną
  4. Wpływ bólu kończyny resztkowej na jakość życia
    1. Wpływ na rehabilitację
  5. Monitorowanie i nadzór bólu kończyny resztkowej
    1. Znaczenie danych epidemiologicznych
  6. Wyzwania i perspektywy na przyszłość
    1. Potrzeba standaryzacji
    2. Kolejne rozdziały

Epidemiologia bólu kończyny resztkowej

Ból kończyny resztkowej (ang. residual limb pain, RLP), wcześniej określany jako ból kikuta, jest jednym z głównych powikłań po amputacji kończyny, dotykającym znaczącą część pacjentów po zabiegach amputacji. Występuje w miejscu kikuta pozostałego po amputacji, w przeciwieństwie do bólu fantomowego (phantom limb pain, PLP), który jest odczuwany w nieistniejącej już części kończyny12.

Częstotliwość występowania

Częstość występowania bólu kończyny resztkowej jest bardzo zróżnicowana w dostępnych badaniach naukowych. Metaanalizy wskazują, że częstość ta waha się od 0% do ponad 85% w zależności od badania3. Według danych szacunkowych około 60-70% pacjentów po amputacji doświadcza bólu poamputacyjnego, w tym bólu kończyny resztkowej4. Niektóre źródła podają, że około 60% osób po amputacji odczuwa ból w kończynie resztkowej, co może poważnie ograniczać funkcjonowanie, obniżać jakość życia i znacząco utrudniać rehabilitację5.

Bardziej szczegółowe analizy wskazują, że częstość występowania bólu kończyny resztkowej zmienia się w czasie po amputacji. Metaanalizy pokazują następującą częstość występowania RLP w różnych okresach po amputacji6:

  • 1 tydzień po amputacji – 50%
  • 1 miesiąc po amputacji – 11%
  • 3 miesiące po amputacji – 23%
  • 6 miesięcy po amputacji – 27%
  • 1 rok po amputacji – 22%
  • 2 lata po amputacji – 24%

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Warto zauważyć, że od 3 miesięcy do 2 lat po amputacji częstość występowania bólu kończyny resztkowej pozostaje stosunkowo stała i mieści się w przedziale od 22% do 27%9.

Czynniki ryzyka

Badania wskazują na kilka istotnych czynników ryzyka związanych z występowaniem bólu kończyny resztkowej10:

  • Poziom amputacji – wyższy poziom amputacji (bliżej tułowia) może zwiększać ryzyko RLP
  • Ból przed amputacją – intensywność i czas trwania bólu przed amputacją
  • Przyczyna amputacji – etiologia amputacji ma znaczący wpływ na nasilenie bólu
  • Wiek w momencie amputacji – starszy wiek może być czynnikiem zwiększającym ryzyko
  • Palenie tytoniu – wykazano istotny związek między paleniem a RLP11

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Związek z innymi rodzajami bólu poamputacyjnego

Istnieje znaczący związek między bólem kończyny resztkowej a bólem fantomowym. Badania wskazują, że RLP jest najczęstszym czynnikiem pozytywnie skorelowanym z PLP, co zidentyfikowano w pięciu badaniach obejmujących łącznie 920 uczestników13. Biorąc pod uwagę wysoką współzmienność między PLP i RLP, kluczowe jest zrozumienie, czy te dwa zjawiska bólowe są ze sobą mechanistycznie powiązane14.

Więcej niż połowa osób doświadczających bólu fantomowego odczuwa również ból kończyny resztkowej1516. W jednym z badań Kooijman i współpracownicy analizowali dane zebrane od 124 osób po amputacji kończyny górnej i stwierdzili istotny związek między bólem fantomowym a czuciem fantomowym (ryzyko względne 11,3) oraz między bólem fantomowym a bólem kończyny resztkowej (ryzyko względne 1,9)17.

Nasilenie bólu kończyny resztkowej

Nasilenie bólu kończyny resztkowej jest zróżnicowane i zależy od wielu czynników, przede wszystkim od etiologii amputacji18.

Różnice w nasileniu bólu w zależności od przyczyny amputacji

Badania wykazują istotne różnice w nasileniu bólu kończyny resztkowej w zależności od przyczyny amputacji1920:

  • Najwyższe nasilenie bólu zgłaszają pacjenci po amputacjach spowodowanych chorobą nowotworową
  • Umiarkowane nasilenie bólu występuje po amputacjach pourazowych
  • Najniższe nasilenie bólu zgłaszają pacjenci po amputacjach z powodu chorób naczyniowych, takich jak choroba tętnic obwodowych, choroba naczyń obwodowych czy amputacje związane z cukrzycą

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Różnice między kończyną górną i dolną

Metaanalizy wskazują, że zgłaszane nasilenie bólu jest wyższe u osób po amputacji kończyny górnej niż u osób po amputacji kończyny dolnej2324. Jest to istotna obserwacja kliniczna, która powinna być brana pod uwagę przy planowaniu opieki pooperacyjnej i rehabilitacji.

Bazy danych i systemy nadzoru

Nadzór i monitorowanie bólu kończyny resztkowej jest utrudnione ze względu na kilka czynników25:

  • Heterogeniczność objawów i doświadczeń bólowych
  • Niska częstość występowania amputacji w populacji ogólnej
  • Różnorodność przyczyn amputacji (uraz, infekcja, nowotwór, choroba naczyniowa)
  • Brak standaryzacji w definicjach i narzędziach oceny bólu

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Trudności te przyczyniają się do problemów z gromadzeniem wiarygodnych danych na temat bólu kończyny resztkowej28.

Różnice między krajami rozwiniętymi i rozwijającymi się

Interesującą obserwacją z metaanaliz jest różnica w częstości występowania bólu poamputacyjnego między krajami rozwiniętymi a rozwijającymi się. Choć większość badań dotyczy bólu fantomowego, te same systemy nadzoru mogą dotyczyć bólu kończyny resztkowej. W przypadku PLP częstość występowania była znacząco niższa w krajach rozwijających się w porównaniu do krajów rozwiniętych (53,98% vs 64,55%; p=0,04)29.

Ta różnica może wynikać z kilku czynników3031:

  • Różnice w systemach opieki zdrowotnej i dostępie do specjalistycznych usług
  • Niedostateczne rozpoznawanie i raportowanie bólu poamputacyjnego
  • Różnice kulturowe w postrzeganiu i zgłaszaniu bólu
  • Ograniczona edukacja pacjentów i personelu medycznego na temat bólu poamputacyjnego

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Problemy z dokumentacją medyczną

W niektórych regionach ból kończyny resztkowej jest niedostatecznie dokumentowany w kartach pacjentów. Na przykład w badaniu przeprowadzonym w Nigerii stwierdzono, że spośród pacjentów z bólem fantomowym tylko 8,6% miało to udokumentowane w dokumentacji medycznej34. Podobne problemy mogą dotyczyć dokumentacji bólu kończyny resztkowej.

Wpływ bólu kończyny resztkowej na jakość życia

Ból kończyny resztkowej ma istotny wpływ na jakość życia pacjentów po amputacji35:

  • Ograniczenie funkcjonalne – ból może znacząco ograniczać codzienne funkcjonowanie i aktywność
  • Problemy z proteząmi – u niektórych osób z tradycyjną protezą mocowaną na kikucie przewlekły, nawracający ból kończyny resztkowej spowodowany jest chronicznym podrażnieniem skóry wynikającym z pocenia się oraz owrzodzeń uciskowych/tarciowych
  • Mniejsza kontrola nad protezą – co prowadzi do utraty funkcji, zmniejszenia niezależności i obniżenia jakości życia
  • Wpływ na sen – uporczywy ból może zaburzać sen
  • Zwiększony poziom stresu
  • Problemy ze zdrowiem psychicznym – zwiększone ryzyko lęku, depresji i zaburzeń związanych z używaniem substancji psychoaktywnych

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Wpływ na rehabilitację

Ból kończyny resztkowej może stanowić istotną przeszkodę w procesie rehabilitacji po amputacji37. Ból poamputacyjny i doznania fantomowe mogą być wyniszczające, powodować znaczny dyskomfort fizyczny i psychiczny, ograniczać korzystanie z protez i utrudniać powrót pacjenta do funkcjonowania jako członka społeczeństwa38.

Monitorowanie i nadzór bólu kończyny resztkowej

Skuteczne monitorowanie bólu kończyny resztkowej wymaga systematycznego i standardowego podejścia39:

  • Regularna ocena bólu – systematyczne oceny bólu zarówno w okresie wczesnym po amputacji, jak i w perspektywie długoterminowej
  • Standaryzowane narzędzia oceny – stosowanie znormalizowanych kwestionariuszy i skal bólu
  • Interdyscyplinarna opieka – zaangażowanie specjalistów z różnych dziedzin, w tym chirurgów, specjalistów medycyny bólu, fizjoterapeutów, psychologów i protetyków
  • Edukacja pacjentów – informowanie pacjentów o możliwości wystąpienia bólu kończyny resztkowej i zachęcanie do zgłaszania objawów

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Znaczenie danych epidemiologicznych

Badania epidemiologiczne mają kluczowe znaczenie dla informowania badaczy, klinicystów, decydentów i opinii publicznej o obciążeniu chorobą w społeczeństwie41. Jednak duża zmienność w zgłaszanej częstości występowania bólu kończyny resztkowej nie dostarcza jednoznacznych szacunków częstości występowania, a tym samym utrudnia opracowanie lub wdrożenie skutecznych interwencji w zakresie zapobiegania lub leczenia RLP42.

Wyniki przeglądów systematycznych pomagają generować oparte na dowodach wnioski dotyczące szacunkowej częstości występowania RLP, a także powiązanych czynników ryzyka u osób po amputacjach43. Te dane są kluczowe dla opracowywania skutecznych strategii profilaktyki i leczenia.

Wyzwania i perspektywy na przyszłość

Pomimo licznych badań nad bólem poamputacyjnym, wciąż istnieją znaczące wyzwania w zakresie zrozumienia i leczenia bólu kończyny resztkowej4445:

  • Heterogeniczność fenotypów bólu – różnorodność objawów i mechanizmów utrudnia jednolite podejście do leczenia
  • Brak konsensusu co do mechanizmów – wciąż nie ma jasnego konsensusu dotyczącego mechanizmów leżących u podstaw bólu kończyny resztkowej
  • Ograniczone możliwości leczenia – skuteczność dostępnych metod leczenia jest ograniczona
  • Potrzeba dalszych badań klinicznych – konieczne są przyszłe badania kliniczne, które zbadają czas trwania przedoperacyjnej kontroli bólu, dodatkowe metody kontroli bólu, drogę podawania przedoperacyjnej kontroli bólu oraz chirurgiczne zespolenia amputowanego epineurium w czasie amputacji46

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Potrzeba standaryzacji

Przegląd badań dotyczących bólu kończyny resztkowej wskazuje na potrzebę standaryzacji w zakresie definicji, oceny i pomiaru tego zjawiska49. Różnorodność stosowanych definicji i narzędzi oceny utrudnia porównywanie wyników między badaniami i syntetyzowanie danych w metaanalizach.

Pomimo tych wyzwań, najnowsze badania dostarczają cennych informacji na temat epidemiologii bólu kończyny resztkowej, co może prowadzić do lepszego zrozumienia tego problemu i opracowania skuteczniejszych strategii zapobiegania i leczenia50.

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  1. 10.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Amputation pain
    https://www.neuromodulation.com/amputation-pain
    Post-amputation pain occurs in approximately 60 to 70% of patients, often arising weeks or months after a limb has been removed due to accident, injury, or disease. Pain following an amputation may develop as either residual limb pain, phantom limb pain, or phantom limb sensation. […] Residual limb pain is pain or discomfort experienced in or at the stump of the amputated limb. […] A significant association has been found between stump pain and phantom limb pain. […] In 2015, dorsal root ganglion (DRG) stimulation in eight patients with amputation pain was reported to reduce phantom limb and residual limb pain by 53%; one individual reported a complete resolution of pain at 9 months.
  • #2
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    Residual limb pain is defined as pain that is felt in the limb after amputation. […] Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. […] Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. […] The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. […] The reported prevalence of residual limb pain is remarkably variable, ranging from 0% to over 85%. […] Our meta-analyses show that at approximately 1 week postamputation, half of individuals report persistent residual limb pain.
  • #3
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    Residual limb pain is defined as pain that is felt in the limb after amputation. […] Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. […] Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. […] The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. […] The reported prevalence of residual limb pain is remarkably variable, ranging from 0% to over 85%. […] Our meta-analyses show that at approximately 1 week postamputation, half of individuals report persistent residual limb pain.
  • #4 Amputation pain
    https://www.neuromodulation.com/amputation-pain
    Post-amputation pain occurs in approximately 60 to 70% of patients, often arising weeks or months after a limb has been removed due to accident, injury, or disease. Pain following an amputation may develop as either residual limb pain, phantom limb pain, or phantom limb sensation. […] Residual limb pain is pain or discomfort experienced in or at the stump of the amputated limb. […] A significant association has been found between stump pain and phantom limb pain. […] In 2015, dorsal root ganglion (DRG) stimulation in eight patients with amputation pain was reported to reduce phantom limb and residual limb pain by 53%; one individual reported a complete resolution of pain at 9 months.
  • #5 Residual Limb Pain – Special Subjects – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/special-subjects/limb-prosthetics/residual-limb-pain
    After an amputation, about 60% of people have pain in the residual limb, which can severely limit function, impair quality of life, and significantly impede rehabilitation. […] Persistent residual limb pain is a chronic condition that differs from phantom limb pain and phantom limb sensation. […] Some people with a traditional socket-secured prosthesis experience chronic, recurring residual limb pain caused by chronic skin irritation from sweating and pressure/friction ulcers. This results in having less control over the prosthesis, a loss of function, reduced independence, and a decreased quality of life. Persistent pain can affect sleep, increase stress levels, and increase mental health problems (for example. anxiety, depression, and substance use disorders). Some people with persistent residual limb pain may benefit from replacing the traditional socket prosthesis through transcutaneous osseointegration, which involves surgically implanting a prosthetic anchor into the residual limbs bone.
  • #6
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    Residual limb pain is defined as pain that is felt in the limb after amputation. […] Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. […] Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. […] The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. […] The reported prevalence of residual limb pain is remarkably variable, ranging from 0% to over 85%. […] Our meta-analyses show that at approximately 1 week postamputation, half of individuals report persistent residual limb pain.
  • #7
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    Residual limb pain is defined as pain that is felt in the limb after amputation. […] Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. […] Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. […] The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. […] The reported prevalence of residual limb pain is remarkably variable, ranging from 0% to over 85%. […] Our meta-analyses show that at approximately 1 week postamputation, half of individuals report persistent residual limb pain.
  • #8
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    From 3 months to 2 years, the prevalence of residual limb pain remained relatively consistent and was between 22% and 27%. […] Amputations due to vascular diseases such as peripheral artery disease, peripheral vascular disease, or diabetic amputations had the lowest severity of residual limb pain. […] The highest pain severity was reported by individuals with an amputation due to cancer. […] Our meta-analyses indicate that the reported pain severity is higher in individuals undergoing upper extremity than lower extremity amputations. […] Residual limb pain is commonly reported by individuals with an extremity amputation. […] Future clinical trials are needed to investigate duration of preoperative pain control, adjunctive treatments to pain control, route of administering preoperative pain control, and surgical coaptations of the amputated epineurium at the time of amputation.
  • #9
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    From 3 months to 2 years, the prevalence of residual limb pain remained relatively consistent and was between 22% and 27%. […] Amputations due to vascular diseases such as peripheral artery disease, peripheral vascular disease, or diabetic amputations had the lowest severity of residual limb pain. […] The highest pain severity was reported by individuals with an amputation due to cancer. […] Our meta-analyses indicate that the reported pain severity is higher in individuals undergoing upper extremity than lower extremity amputations. […] Residual limb pain is commonly reported by individuals with an extremity amputation. […] Future clinical trials are needed to investigate duration of preoperative pain control, adjunctive treatments to pain control, route of administering preoperative pain control, and surgical coaptations of the amputated epineurium at the time of amputation.
  • #10 Residual limb pain – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/residual-limb-pain/symptoms-causes/syc-20541403
    Residual limb pain is a type of pain felt in the part of an arm or leg that’s left after the arm or leg is removed, called amputation. More than half of people who have an amputation get this type of pain. Sometimes called stump pain, it may happen soon after the surgery, often within the first week. But the pain may last after healing. […] Residual limb pain affects quality of life and may get in the way of using a replacement arm or leg, called a prosthesis. People with residual limb pain may be more likely to be depressed or anxious than people who don’t have the pain. […] Some studies have found that risk factors for residual limb pain may include: How high on the body the arm or leg was removed, called amputation. How much pain there was before amputation. The reason for the amputation. Older age at the time of amputation. […] Researchers are studying other ways to prevent residual limb pain after amputation.
  • #11 Post-amputation pain among lower limb amputees in a tertiary care hospital in Jeddah, Saudi Arabia | Saudi Medical Journal
    https://smj.org.sa/content/43/2/187
    Recent studies have reported an incidence of RLP of 32-93% with long-duration follow-up. […] Residual limb pain was significantly associated with smoking, but it was unrelated to comorbid conditions, indications for amputation, intraoperative nerve ligation, or prosthesis use. […] The main finding of our study was the high frequency (61.5%) of post-amputation pain among lower-limb amputees. […] The majority of those who had experienced RLP complained of pain for a period shorter than a year, and 46.4% had moderately severe pain. […] Managing PAP is a challenging situation, as many mechanisms were involved in the development of PAP.
  • #12 Residual limb pain – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/residual-limb-pain/symptoms-causes/syc-20541403
    Residual limb pain is a type of pain felt in the part of an arm or leg that’s left after the arm or leg is removed, called amputation. More than half of people who have an amputation get this type of pain. Sometimes called stump pain, it may happen soon after the surgery, often within the first week. But the pain may last after healing. […] Residual limb pain affects quality of life and may get in the way of using a replacement arm or leg, called a prosthesis. People with residual limb pain may be more likely to be depressed or anxious than people who don’t have the pain. […] Some studies have found that risk factors for residual limb pain may include: How high on the body the arm or leg was removed, called amputation. How much pain there was before amputation. The reason for the amputation. Older age at the time of amputation. […] Researchers are studying other ways to prevent residual limb pain after amputation.
  • #13 Making sense of phantom limb pain | Journal of Neurology, Neurosurgery & Psychiatry
    https://jnnp.bmj.com/content/93/8/833
    PLP introduces several additional intrinsic challenges. […] PLP is not only heterogenous in the nature of the experience (quality, intensity, frequency, time of onset, etc) but also in the various reasons for amputation (traumatic, infection, cancer, vascular disease). […] The most common factor positively associated with PLP is RLP (identified in five studies, representing a total of 920 participants). […] Considering the high covariation between PLP and RLP, it is essential to understand whether these two pain phenomena relate to each other mechanistically. […] Preamputation pain was the second most common factor positively associated with PLP. […] Approximately 80% of amputees report experiencing some form of these non-painful phantom sensations, which range from kinetic to exteroceptive.
  • #14 Making sense of phantom limb pain | Journal of Neurology, Neurosurgery & Psychiatry
    https://jnnp.bmj.com/content/93/8/833
    PLP introduces several additional intrinsic challenges. […] PLP is not only heterogenous in the nature of the experience (quality, intensity, frequency, time of onset, etc) but also in the various reasons for amputation (traumatic, infection, cancer, vascular disease). […] The most common factor positively associated with PLP is RLP (identified in five studies, representing a total of 920 participants). […] Considering the high covariation between PLP and RLP, it is essential to understand whether these two pain phenomena relate to each other mechanistically. […] Preamputation pain was the second most common factor positively associated with PLP. […] Approximately 80% of amputees report experiencing some form of these non-painful phantom sensations, which range from kinetic to exteroceptive.
  • #15 Phantom pain – Wikipedia
    https://en.wikipedia.org/wiki/Phantom_pain
    It is estimated that the reported prevalence of phantom pain may be as high as 80% among amputees. […] More than half the people that experience phantom pain would also experience residual limb pain.
  • #16
    https://europepmc.org/books/n/statpearls/article-27086/?extid=31751034&src=med
    Phantom limb pain is the perception of pain or discomfort in a limb that is no longer there. […] The condition should be differentiated from other related clinical conditions such as residual limb pain, which was formerly called „stump pain” and is pain that originates from the actual site of the amputated limb that tends to resolve with wound healing. […] Pain after amputation of a limb is a common symptom and is separated into two types of pain including residual limb pain (RLP) and phantom limb pain (PLP). […] This latter condition, formerly known as „stump pain”, is pain that originates from the actual site of the amputated limb. It is most common in the early post-amputation period and tends to resolve with wound healing. […] More than half of people with PLP also have RLP. […] PLP and RLP represent an important challenge in medicine, in terms of epidemiology and therapeutic difficulties. Ninety-five percent of patients, indeed, report experiencing some amputation-related pain, with 79.9% reporting phantom pain and 67.7% reporting RLP.
  • #17 An Algorithm Approach to Phantom Limb Pain | JPR
    https://www.dovepress.com/an-algorithm-approach-to-phantom-limb-pain-peer-reviewed-fulltext-article-JPR
    While the association between pre-amputation pain and phantom pain remains unclear, studies consistently demonstrate an association between phantom pain, phantom sensations and residual limb pain. […] Residual limb pain, or stump pain, is pain at the amputation site, typically near the incision site. This type of pain is common in the immediate postoperative period but for some patients, can persist for years after the wound has healed. […] Kooijman et al reviewed data collected from 124 upper extremity amputees. They found a significant association between phantom pain and phantom sensation (relative risk 11.3) and between phantom pain and residual limb pain (relative risk 1.9). […] Understanding the duration and natural history of PLP remains elusive. Studies by authors such as Parks have suggested that phantom pain often decreases or ceases after two years. […] false
  • #18
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    Residual limb pain is defined as pain that is felt in the limb after amputation. […] Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. […] Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. […] The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. […] The reported prevalence of residual limb pain is remarkably variable, ranging from 0% to over 85%. […] Our meta-analyses show that at approximately 1 week postamputation, half of individuals report persistent residual limb pain.
  • #19
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    Residual limb pain is defined as pain that is felt in the limb after amputation. […] Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. […] Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. […] The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. […] The reported prevalence of residual limb pain is remarkably variable, ranging from 0% to over 85%. […] Our meta-analyses show that at approximately 1 week postamputation, half of individuals report persistent residual limb pain.
  • #20
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    From 3 months to 2 years, the prevalence of residual limb pain remained relatively consistent and was between 22% and 27%. […] Amputations due to vascular diseases such as peripheral artery disease, peripheral vascular disease, or diabetic amputations had the lowest severity of residual limb pain. […] The highest pain severity was reported by individuals with an amputation due to cancer. […] Our meta-analyses indicate that the reported pain severity is higher in individuals undergoing upper extremity than lower extremity amputations. […] Residual limb pain is commonly reported by individuals with an extremity amputation. […] Future clinical trials are needed to investigate duration of preoperative pain control, adjunctive treatments to pain control, route of administering preoperative pain control, and surgical coaptations of the amputated epineurium at the time of amputation.
  • #21
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    Residual limb pain is defined as pain that is felt in the limb after amputation. […] Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. […] Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. […] The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. […] The reported prevalence of residual limb pain is remarkably variable, ranging from 0% to over 85%. […] Our meta-analyses show that at approximately 1 week postamputation, half of individuals report persistent residual limb pain.
  • #22
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    From 3 months to 2 years, the prevalence of residual limb pain remained relatively consistent and was between 22% and 27%. […] Amputations due to vascular diseases such as peripheral artery disease, peripheral vascular disease, or diabetic amputations had the lowest severity of residual limb pain. […] The highest pain severity was reported by individuals with an amputation due to cancer. […] Our meta-analyses indicate that the reported pain severity is higher in individuals undergoing upper extremity than lower extremity amputations. […] Residual limb pain is commonly reported by individuals with an extremity amputation. […] Future clinical trials are needed to investigate duration of preoperative pain control, adjunctive treatments to pain control, route of administering preoperative pain control, and surgical coaptations of the amputated epineurium at the time of amputation.
  • #23
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    Residual limb pain is defined as pain that is felt in the limb after amputation. […] Residual limb pain prevalence at 1 week, 1 month, 3 months, 6 months, 1 year, and 2 years, respectively, was 50%, 11%, 23%, 27%, 22%, and 24%. […] Residual limb pain severity varies according to the etiology of amputation and is more common after upper extremity amputation than lower extremity amputations. […] The most severe pain is reported by patients undergoing amputations due to cancer, followed by traumatic amputations, while vascular amputation patients report lower pain severity. […] The reported prevalence of residual limb pain is remarkably variable, ranging from 0% to over 85%. […] Our meta-analyses show that at approximately 1 week postamputation, half of individuals report persistent residual limb pain.
  • #24
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    From 3 months to 2 years, the prevalence of residual limb pain remained relatively consistent and was between 22% and 27%. […] Amputations due to vascular diseases such as peripheral artery disease, peripheral vascular disease, or diabetic amputations had the lowest severity of residual limb pain. […] The highest pain severity was reported by individuals with an amputation due to cancer. […] Our meta-analyses indicate that the reported pain severity is higher in individuals undergoing upper extremity than lower extremity amputations. […] Residual limb pain is commonly reported by individuals with an extremity amputation. […] Future clinical trials are needed to investigate duration of preoperative pain control, adjunctive treatments to pain control, route of administering preoperative pain control, and surgical coaptations of the amputated epineurium at the time of amputation.
  • #25 Making sense of phantom limb pain | Journal of Neurology, Neurosurgery & Psychiatry
    https://jnnp.bmj.com/content/93/8/833
    Phantom limb pain (PLP) impacts the majority of individuals who undergo limb amputation. […] This heterogeneity, combined with the low prevalence of amputation in the general population, has made it difficult to accumulate reliable data on PLP. […] Consequently, we lack consensus on PLP mechanisms, as well as effective treatment options. […] Individuals who undergo limb amputation commonly report feeling painful sensations perceived to originate from the missing limb. […] Despite multiple theories on what causes PLP, there is still no clear consensus on the underlying mechanisms driving PLP or treatment approaches. […] As such, the dozens of pharmacological and non-pharmacological treatments operate on a variety of targets across the neural axis with limited success. […] A major challenge with studying PLP is that, as a pain condition, it is a multifaceted experience which reflects the combined sensory, emotional and cognitive domains.
  • #26 Making sense of phantom limb pain | Journal of Neurology, Neurosurgery & Psychiatry
    https://jnnp.bmj.com/content/93/8/833
    Phantom limb pain (PLP) impacts the majority of individuals who undergo limb amputation. […] This heterogeneity, combined with the low prevalence of amputation in the general population, has made it difficult to accumulate reliable data on PLP. […] Consequently, we lack consensus on PLP mechanisms, as well as effective treatment options. […] Individuals who undergo limb amputation commonly report feeling painful sensations perceived to originate from the missing limb. […] Despite multiple theories on what causes PLP, there is still no clear consensus on the underlying mechanisms driving PLP or treatment approaches. […] As such, the dozens of pharmacological and non-pharmacological treatments operate on a variety of targets across the neural axis with limited success. […] A major challenge with studying PLP is that, as a pain condition, it is a multifaceted experience which reflects the combined sensory, emotional and cognitive domains.
  • #27
    https://journals.lww.com/pain/fulltext/2024/04000/a_systematic_review_of_the_prevalence_of.4.aspx
    Phantom limb pain was associated with the presence of residual limb pain and phantom limb sensation, more distal amputation in upper limb amputation, and the presence of depression, anxiety, and PTSD. […] Our review highlights the challenges in interpreting pain prevalence data because of significant variability in the definitions and evaluation tools used for both chronic neuropathic pain and postamputation pain.
  • #28 Making sense of phantom limb pain | Journal of Neurology, Neurosurgery & Psychiatry
    https://jnnp.bmj.com/content/93/8/833
    Phantom limb pain (PLP) impacts the majority of individuals who undergo limb amputation. […] This heterogeneity, combined with the low prevalence of amputation in the general population, has made it difficult to accumulate reliable data on PLP. […] Consequently, we lack consensus on PLP mechanisms, as well as effective treatment options. […] Individuals who undergo limb amputation commonly report feeling painful sensations perceived to originate from the missing limb. […] Despite multiple theories on what causes PLP, there is still no clear consensus on the underlying mechanisms driving PLP or treatment approaches. […] As such, the dozens of pharmacological and non-pharmacological treatments operate on a variety of targets across the neural axis with limited success. […] A major challenge with studying PLP is that, as a pain condition, it is a multifaceted experience which reflects the combined sensory, emotional and cognitive domains.
  • #29 The prevalence and risk factors for phantom limb pain in people with amputations: a systematic review and meta-analysis | medRxiv
    https://www.medrxiv.org/content/10.1101/19008961v1.full-text
    The prevalence of PLP among people with amputations is unclear, perhaps because of conflicting reports across the literature. […] The estimates of PLP prevalence in people with limb amputations ranged between 0% and 85.6% […] The meta-analysis that stratified the studies by country developmental status suggested that the prevalence of PLP was significantly lower in developing countries compared to developed countries [53.98% vs 64.55%; p=0.04]. […] This study identified that lower limb amputation, stump pain, phantom sensations, persistent pre-amputation pain, proximal site of amputation and diabetic cause of amputation are risk factors for PLP.
  • #30
    https://journals.lww.com/njom/fulltext/2020/29020/amputation_related_phantom_limb_pain_in_nigeria__a.4.aspx
    Phantom limb pain (PLP) is a common and distressing complication of limb amputations. […] The period prevalence of PLP was 63.6%, and of these, only 8.6% had this documented in their medical record. […] PLP is highly prevalent among limb amputees in our cohort. […] In contrast to the known high prevalence of PLP among amputees worldwide, it is an understatement to say that this common distressing complication of amputation is underrecognized, unreported, or simply ignored by health-care workers here in Nigeria. […] The results of the present study indicate that PLP is a very common complication of limb amputations but poorly recognized and undertreated. […] The period prevalence of PLP (63.6%) obtained in the present study during the 1-year follow-up is in contrast to the very low prevalence of 5.5%, 3.3%, and 14.6% quoted in three Nigerian sources which remotely mentioned PLP while considering complications of limb amputation.
  • #31
    https://journals.lww.com/njom/fulltext/2020/29020/amputation_related_phantom_limb_pain_in_nigeria__a.4.aspx
    The magnitude of neglect and despair suffered by this subpopulation of amputees in both the Nigerian and German studies are reflections of the underrecognition and undertreatment of PLP across national frontiers. […] Despite scant mention in the regional literature, PLP is highly prevalent but untreated among limb amputees in Nigeria and indeed Africa.
  • #32
    https://journals.lww.com/njom/fulltext/2020/29020/amputation_related_phantom_limb_pain_in_nigeria__a.4.aspx
    Phantom limb pain (PLP) is a common and distressing complication of limb amputations. […] The period prevalence of PLP was 63.6%, and of these, only 8.6% had this documented in their medical record. […] PLP is highly prevalent among limb amputees in our cohort. […] In contrast to the known high prevalence of PLP among amputees worldwide, it is an understatement to say that this common distressing complication of amputation is underrecognized, unreported, or simply ignored by health-care workers here in Nigeria. […] The results of the present study indicate that PLP is a very common complication of limb amputations but poorly recognized and undertreated. […] The period prevalence of PLP (63.6%) obtained in the present study during the 1-year follow-up is in contrast to the very low prevalence of 5.5%, 3.3%, and 14.6% quoted in three Nigerian sources which remotely mentioned PLP while considering complications of limb amputation.
  • #33
    https://journals.lww.com/njom/fulltext/2020/29020/amputation_related_phantom_limb_pain_in_nigeria__a.4.aspx
    The magnitude of neglect and despair suffered by this subpopulation of amputees in both the Nigerian and German studies are reflections of the underrecognition and undertreatment of PLP across national frontiers. […] Despite scant mention in the regional literature, PLP is highly prevalent but untreated among limb amputees in Nigeria and indeed Africa.
  • #34
    https://journals.lww.com/njom/fulltext/2020/29020/amputation_related_phantom_limb_pain_in_nigeria__a.4.aspx
    Phantom limb pain (PLP) is a common and distressing complication of limb amputations. […] The period prevalence of PLP was 63.6%, and of these, only 8.6% had this documented in their medical record. […] PLP is highly prevalent among limb amputees in our cohort. […] In contrast to the known high prevalence of PLP among amputees worldwide, it is an understatement to say that this common distressing complication of amputation is underrecognized, unreported, or simply ignored by health-care workers here in Nigeria. […] The results of the present study indicate that PLP is a very common complication of limb amputations but poorly recognized and undertreated. […] The period prevalence of PLP (63.6%) obtained in the present study during the 1-year follow-up is in contrast to the very low prevalence of 5.5%, 3.3%, and 14.6% quoted in three Nigerian sources which remotely mentioned PLP while considering complications of limb amputation.
  • #35 Residual Limb Pain – Special Subjects – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/special-subjects/limb-prosthetics/residual-limb-pain
    After an amputation, about 60% of people have pain in the residual limb, which can severely limit function, impair quality of life, and significantly impede rehabilitation. […] Persistent residual limb pain is a chronic condition that differs from phantom limb pain and phantom limb sensation. […] Some people with a traditional socket-secured prosthesis experience chronic, recurring residual limb pain caused by chronic skin irritation from sweating and pressure/friction ulcers. This results in having less control over the prosthesis, a loss of function, reduced independence, and a decreased quality of life. Persistent pain can affect sleep, increase stress levels, and increase mental health problems (for example. anxiety, depression, and substance use disorders). Some people with persistent residual limb pain may benefit from replacing the traditional socket prosthesis through transcutaneous osseointegration, which involves surgically implanting a prosthetic anchor into the residual limbs bone.
  • #36 Residual Limb Pain – Special Subjects – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/special-subjects/limb-prosthetics/residual-limb-pain
    After an amputation, about 60% of people have pain in the residual limb, which can severely limit function, impair quality of life, and significantly impede rehabilitation. […] Persistent residual limb pain is a chronic condition that differs from phantom limb pain and phantom limb sensation. […] Some people with a traditional socket-secured prosthesis experience chronic, recurring residual limb pain caused by chronic skin irritation from sweating and pressure/friction ulcers. This results in having less control over the prosthesis, a loss of function, reduced independence, and a decreased quality of life. Persistent pain can affect sleep, increase stress levels, and increase mental health problems (for example. anxiety, depression, and substance use disorders). Some people with persistent residual limb pain may benefit from replacing the traditional socket prosthesis through transcutaneous osseointegration, which involves surgically implanting a prosthetic anchor into the residual limbs bone.
  • #37 Phantom Pain and Residual Limb Pain After Amputation FAQs | IHTSC
    https://www.indianahandtoshoulder.com/blog/phantom-pain-limb-pain-after-amputation-answers
    The surgeons at the Indiana Hand to Shoulder Center that participate in the Nerve Injury And Limb Pain Program are experts in evaluating, diagnosing, and treating residual limb pain problems. […] A consultation with our group is recommended if you are suffering from residual limb pain. The consultation will include a detailed evaluation by our group of experts to determine the cause of your problem. […] Post-amputation pain and phantom limb sensations can be debilitating. They can cause significant physical and psychological distress, limit the use of prosthetics, and impede a patient’s return to a functioning member of society. […] Treatment options for injured nerves during an amputation are successful at diminishing pain and phantom limb sensations, improving prosthetic use, and diminishing reliance on narcotics at any time point for amputees with post-amputation nerve pain. […] However, treatments are more effective if done at the same time or soon after the amputation occurs. We recommend amputees seek care as soon as possible to improve the likelihood of a successful outcome.
  • #38 Phantom Pain and Residual Limb Pain After Amputation FAQs | IHTSC
    https://www.indianahandtoshoulder.com/blog/phantom-pain-limb-pain-after-amputation-answers
    The surgeons at the Indiana Hand to Shoulder Center that participate in the Nerve Injury And Limb Pain Program are experts in evaluating, diagnosing, and treating residual limb pain problems. […] A consultation with our group is recommended if you are suffering from residual limb pain. The consultation will include a detailed evaluation by our group of experts to determine the cause of your problem. […] Post-amputation pain and phantom limb sensations can be debilitating. They can cause significant physical and psychological distress, limit the use of prosthetics, and impede a patient’s return to a functioning member of society. […] Treatment options for injured nerves during an amputation are successful at diminishing pain and phantom limb sensations, improving prosthetic use, and diminishing reliance on narcotics at any time point for amputees with post-amputation nerve pain. […] However, treatments are more effective if done at the same time or soon after the amputation occurs. We recommend amputees seek care as soon as possible to improve the likelihood of a successful outcome.
  • #39 The prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol | Systematic Reviews | Full Text
    https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0938-8
    Further, up to date, there is no systematic review that has synthesised data on the risk factors for PLP. […] The results of this review will enable us to generate an evidence-informed conclusion on the prevalence estimate of PLP, as well as associated risk factors in people with amputations. […] The current evidence suggests that rehabilitation approaches rather than pharmacological approaches are most effective for treating PLP. […] The purpose of this review will be to determine the prevalence estimate of and risk factors for PLP in people with amputations. […] The results of this review will be published in a peer-reviewed journal and used to inform researchers, clinicians, policy-makers and the public about the burden of PLP in society.
  • #40 The prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol | Systematic Reviews | Full Text
    https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0938-8
    Further, up to date, there is no systematic review that has synthesised data on the risk factors for PLP. […] The results of this review will enable us to generate an evidence-informed conclusion on the prevalence estimate of PLP, as well as associated risk factors in people with amputations. […] The current evidence suggests that rehabilitation approaches rather than pharmacological approaches are most effective for treating PLP. […] The purpose of this review will be to determine the prevalence estimate of and risk factors for PLP in people with amputations. […] The results of this review will be published in a peer-reviewed journal and used to inform researchers, clinicians, policy-makers and the public about the burden of PLP in society.
  • #41 The prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol | Systematic Reviews | Full Text
    https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0938-8
    The prevalence of phantom limb pain (PLP) in people with amputations is unclear because of the conflicting reports across the literature. […] It has been proposed that risk factors such as persisting pre-operative pain, stump pain and time period since amputation contribute to the onset of PLP. […] The prevalence of PLP among people with amputation is unclear, perhaps because of conflicting reports across the literature. […] The conflicting reports in the literature regarding the prevalence of PLP is perplexing. […] Prevalence studies are key to informing researchers, clinicians, policy-makers and the public about the burden of disease in society. […] However, a wide variation in the reported prevalence of PLP does not provide a definitive prevalence estimate, and therefore hinders the development or implementation of effective interventions for preventing or treating PLP.
  • #42 The prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol | Systematic Reviews | Full Text
    https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0938-8
    The prevalence of phantom limb pain (PLP) in people with amputations is unclear because of the conflicting reports across the literature. […] It has been proposed that risk factors such as persisting pre-operative pain, stump pain and time period since amputation contribute to the onset of PLP. […] The prevalence of PLP among people with amputation is unclear, perhaps because of conflicting reports across the literature. […] The conflicting reports in the literature regarding the prevalence of PLP is perplexing. […] Prevalence studies are key to informing researchers, clinicians, policy-makers and the public about the burden of disease in society. […] However, a wide variation in the reported prevalence of PLP does not provide a definitive prevalence estimate, and therefore hinders the development or implementation of effective interventions for preventing or treating PLP.
  • #43 The prevalence of phantom limb pain and associated risk factors in people with amputations: a systematic review protocol | Systematic Reviews | Full Text
    https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-018-0938-8
    Further, up to date, there is no systematic review that has synthesised data on the risk factors for PLP. […] The results of this review will enable us to generate an evidence-informed conclusion on the prevalence estimate of PLP, as well as associated risk factors in people with amputations. […] The current evidence suggests that rehabilitation approaches rather than pharmacological approaches are most effective for treating PLP. […] The purpose of this review will be to determine the prevalence estimate of and risk factors for PLP in people with amputations. […] The results of this review will be published in a peer-reviewed journal and used to inform researchers, clinicians, policy-makers and the public about the burden of PLP in society.
  • #44 Making sense of phantom limb pain | Journal of Neurology, Neurosurgery & Psychiatry
    https://jnnp.bmj.com/content/93/8/833
    Phantom limb pain (PLP) impacts the majority of individuals who undergo limb amputation. […] This heterogeneity, combined with the low prevalence of amputation in the general population, has made it difficult to accumulate reliable data on PLP. […] Consequently, we lack consensus on PLP mechanisms, as well as effective treatment options. […] Individuals who undergo limb amputation commonly report feeling painful sensations perceived to originate from the missing limb. […] Despite multiple theories on what causes PLP, there is still no clear consensus on the underlying mechanisms driving PLP or treatment approaches. […] As such, the dozens of pharmacological and non-pharmacological treatments operate on a variety of targets across the neural axis with limited success. […] A major challenge with studying PLP is that, as a pain condition, it is a multifaceted experience which reflects the combined sensory, emotional and cognitive domains.
  • #45 Management of Post-Amputation Limb Pain : Virtual Library
    https://resources.wfsahq.org/atotw/management-of-post-amputation-limb-pain/
    Postamputation pain syndromes, including phantom limb pain (PLP), are common in the postamputation patient and are a significant public health burden. […] Up to 78.8% of postamputation patients will experience PLP, with up to 92% of these patients experiencing the onset of this pain within the first week postoperatively. […] Recent reviews of the literature surrounding both PLP and chronic non-PLP support the assertion that the presence of preoperative pain, regardless of its anatomical relationship to the surgical site, significantly increases the risk of developing postoperative chronic pain. […] Despite causing a significant public health burden, clear evidence for optimal management of these complex pain syndromes remains scarce. […] There remains a need for large-scale randomized controlled trials with long-term follow-up, using prevention of PLP as the primary outcome.
  • #46
    https://pmc.ncbi.nlm.nih.gov/articles/PMC9389065/
    From 3 months to 2 years, the prevalence of residual limb pain remained relatively consistent and was between 22% and 27%. […] Amputations due to vascular diseases such as peripheral artery disease, peripheral vascular disease, or diabetic amputations had the lowest severity of residual limb pain. […] The highest pain severity was reported by individuals with an amputation due to cancer. […] Our meta-analyses indicate that the reported pain severity is higher in individuals undergoing upper extremity than lower extremity amputations. […] Residual limb pain is commonly reported by individuals with an extremity amputation. […] Future clinical trials are needed to investigate duration of preoperative pain control, adjunctive treatments to pain control, route of administering preoperative pain control, and surgical coaptations of the amputated epineurium at the time of amputation.
  • #47 Making sense of phantom limb pain | Journal of Neurology, Neurosurgery & Psychiatry
    https://jnnp.bmj.com/content/93/8/833
    Phantom limb pain (PLP) impacts the majority of individuals who undergo limb amputation. […] This heterogeneity, combined with the low prevalence of amputation in the general population, has made it difficult to accumulate reliable data on PLP. […] Consequently, we lack consensus on PLP mechanisms, as well as effective treatment options. […] Individuals who undergo limb amputation commonly report feeling painful sensations perceived to originate from the missing limb. […] Despite multiple theories on what causes PLP, there is still no clear consensus on the underlying mechanisms driving PLP or treatment approaches. […] As such, the dozens of pharmacological and non-pharmacological treatments operate on a variety of targets across the neural axis with limited success. […] A major challenge with studying PLP is that, as a pain condition, it is a multifaceted experience which reflects the combined sensory, emotional and cognitive domains.
  • #48 Management of Post-Amputation Limb Pain : Virtual Library
    https://resources.wfsahq.org/atotw/management-of-post-amputation-limb-pain/
    Postamputation pain syndromes, including phantom limb pain (PLP), are common in the postamputation patient and are a significant public health burden. […] Up to 78.8% of postamputation patients will experience PLP, with up to 92% of these patients experiencing the onset of this pain within the first week postoperatively. […] Recent reviews of the literature surrounding both PLP and chronic non-PLP support the assertion that the presence of preoperative pain, regardless of its anatomical relationship to the surgical site, significantly increases the risk of developing postoperative chronic pain. […] Despite causing a significant public health burden, clear evidence for optimal management of these complex pain syndromes remains scarce. […] There remains a need for large-scale randomized controlled trials with long-term follow-up, using prevention of PLP as the primary outcome.
  • #49
    https://journals.lww.com/pain/fulltext/2024/04000/a_systematic_review_of_the_prevalence_of.4.aspx
    Phantom limb pain was associated with the presence of residual limb pain and phantom limb sensation, more distal amputation in upper limb amputation, and the presence of depression, anxiety, and PTSD. […] Our review highlights the challenges in interpreting pain prevalence data because of significant variability in the definitions and evaluation tools used for both chronic neuropathic pain and postamputation pain.
  • #50 Postamputation pain: epidemiology, mechanisms, and treatment | JPR
    https://www.dovepress.com/postamputation-pain-epidemiology-mechanisms-and-treatment-peer-reviewed-fulltext-article-JPR
    Postamputation pain (PAP) is highly prevalent after limb amputation but remains an extremely challenging pain condition to treat. […] Evidence for peripheral injection therapy with botulinum toxin and pulsed radiofrequency for residual limb pain is limited to very small trials and case series. […] Further investigation into the mechanisms responsible for and the factors associated with the development of PAP is needed to provide an evidence-based foundation to guide current and future treatment approaches.

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