Materiały źródłowe

• #1 Residual limb pain – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/residual-limb-pain/diagnosis-treatment/drc-20541405

  Treatment for residual limb pain depends on the cause. For some people with residual limb pain, the pain gets better in time without treatment. Treatments for residual limb pain may involve medicines, therapies or procedures. […] Pain relievers. Acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve) available without a prescription may help. Some people need stronger, prescription medicines, such as opioids. […] Antidepressants. Tricyclic antidepressants or selective norepinephrine reuptake inhibitors may help with pain that nerve damage causes. […] Anticonvulsants. Gabapentin (Gralise, Neurontin) and pregabalin (Lyrica) may help relieve pain that nerve damage causes. Experts believe these medicines block nerve signals to ease pain. […] Physical and occupational therapy. These therapies involve exercises people do before and after removal of an arm or leg, called amputation. The therapies also include fitting a replacement arm or leg, called a prosthesis, and learning how to use it. Wearing garments that put pressure on the residual arm or leg, called compression garments, also may help.

• #2 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. Residual limb pain should be evaluated and treated aggressively, because some causes can be dangerous. […] Persistent residual limb pain is a chronic condition that differs from phantom limb pain and phantom limb sensation. […] A person with residual limb pain should first check for signs of infection and skin breakdown. If infection looks likely, the doctor should be consulted. Even if there are no obvious signs of infection, the doctor should be consulted if pain is severe and sudden or if there is fever; these symptoms may indicate an infection. […] Surgical wound pain typically resolves as tissues heal, usually over 3 to 6 months. Pain continuing beyond that time has numerous causes, including infection and a poorly fitting preparatory prosthesis. Treatments are directed at the cause and may also include modifying the prosthesis, not wearing the prosthesis until the wound heals, and taking painkillers.

• #3 Pain in the Residual Limb – Special Subjects – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/special-subjects/limb-prosthetics/pain-in-the-residual-limb

  Approximately 60% of individuals with an amputation have post-amputation pain in the residual limb, which can severely limit function, impair quality of life, and significantly impede rehabilitation. Residual limb pain should be evaluated and treated aggressively because some causes can be dangerous. […] Persistent residual limb pain is a chronic condition that differs from phantom limb pain and phantom limb sensation. […] Treatments of postoperative surgical wound pain are directed at the cause and may also include prosthesis modification, discontinuance of prosthesis use until healing, and analgesics. Treatment of neuropathic pain is multimodal (eg, psychologic treatments, physical methods, antidepressants, or antiseizure medications). In patients with a neuroma causing severe pain, surgical neurectomy may be advised.

• #4 Phantom Limb Pain: Current and Emerging Treatments

  https://www.uspharmacist.com/article/phantom-limb-pain-current-and-emerging-treatments

  Since the pathophysiology of PLP is multifactorial, effective treatment often involves a combination of medications such as anticonvulsants, antidepressants, opioids, anesthetics, and NMDA receptor antagonists that target multiple mechanisms. […] Gabapentin is often used as first-line treatment in clinical practice. […] Carbamazepine doses of 400 to 600 mg per day have been effective for treating lancinating pain associated with PLP. […] Although TCAs have been shown to provide some benefit in the treatment of PLP, their use is limited by their negative adverse-effect profile. […] Opioids are commonly used for moderate-to-severe pain, including chronic neuropathic disorders. […] A novel treatment option for PLP is the use of contralateral injections of bupivacaine. […] Ketamine, an NMDA receptor antagonist, has shown promise in reducing PLP when administered as four IV infusions at 0.4 mg/kg.

• #5 Residual Limb Pain – Special Subjects – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/special-subjects/limb-prosthetics/residual-limb-pain

  Treatment of neuropathic pain includes psychologic treatments, physical methods, antidepressants, and antiseizure drugs. […] Painful neuromas (noncancerous overgrowths of nerve tissue) can occur in any severed nerve (from surgery or trauma) and may cause pain that feels electrical, shooting, tingling, sharp and stabbing, or prickly. […] If there is no medical disorder causing the pain, massaging and light tapping combined with elevating the residual limb may help relieve the pain. If this is ineffective, mild painkillers (such as ibuprofen or acetaminophen) can be used. If pain persists, a pain management specialist may be helpful. […] Regularly doing specific stretching exercises and exercises to strengthen muscles may help prevent or relieve this type of pain. A physical therapist can help design an appropriate exercise program.

• #6 Phantom Limb Pain – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK448188/

  Treatment, unfortunately, for PLP has not proven to be very effective. While treatment for RLP tends to focus on an organic cause for the pain, PLP focuses on symptomatic control. […] NSAIDs/Tylenol are the most commonly used treatment for PLP. […] Opioids. Although observational and randomized controlled trials have demonstrated the effectiveness of certain opioids such as tapentadol for neuropathic pain and PLP, they should be used in conjunction with antidepressants or neural modulating agents (i.e., gabapentin, pregabalin). […] Antidepressants are commonly used for addressing PLP. Amitryptiline, in particular, tends to be the tricyclic antidepressant (TCA) of choice as it has shown the best overall results, but other studies looking at nortriptyline and desipramine have shown them to be equally effective.

• #7 Treatment Recommendations for Phantom Limb Pain in People with Amputations: An Expert Consensus Delphi Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8597012/

  Phantom limb pain (PLP) is common and often accompanied by serious suffering. Current systematic review evidence suggests that recommended treatments are no more effective than placebo for reducing PLP. […] Consensus was reached on seven treatments that were considered effective for managing PLP and on two treatments that were considered ineffective. Graded motor imagery, mirror therapy, amitriptyline, sensory discrimination training, and use of a functional prosthesis were endorsed by most experts because of the available backing scientific evidence and their reported efficacy in clinical practice. Cognitive behavioral therapy and virtual reality training were endorsed by most experts because of their reported efficacy in clinical practice despite indicating a dearth of scientific evidence to support their ranking.

• #8 Phantom limb sensation / pain following amputation – University Hospitals Sussex NHS Foundation Trust

  https://www.uhsussex.nhs.uk/resources/phantom-limb-sensation-pain-following-amputation/

  This information is to help you understand phantom limb pain and ways to manage it. […] If you are experiencing any phantom pain, inform your doctor or health care professional and they can refer you for treatment if needed. […] Examples of treatment are: A review of the medication you are on. Some medications that you may be given include simple painkillers and anti-inflammatories such as paracetamol and ibuprofen. Anticonvulsants such as gabapentin and pregabalin, or opioids such as codeine or morphine may also be offered. […] Review of your prosthesis (if you are wearing one) to ensure good fit and comfort. […] A look at lifestyle: for example any stress, smoking, diet, exercise and how these may impact on your pain. […] Juzo sock: an elasticated compression sock which helps with swelling and may reduce phantom pain.

• #9 Guide | Physical Therapy Guide to Phantom Limb Pain | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-phantom-limb-pain

  Phantom limb pain is a painful or unpleasant sensation in a body part that has been surgically amputated or traumatically lost. The sensation may occur immediately following surgery or years later. Phantom pain is different from stump pain (or residual limb pain), which is localized in the remaining body part, or stump. […] Phantom limb pain needs to be managed to prevent symptom flare-ups, or to resolve the problem. Pain management includes treating the biological and complex mechanisms of the problem with different strategies. A symptom-specific approach may includein addition to physical therapythe use of medication prescribed by the physician, psychological and behavioral therapies, and, if needed, surgical intervention. […] Your physical therapist may provide hands-on treatment and other interventions and exercises.

• #10 Guide | Physical Therapy Guide to Phantom Limb Pain | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-phantom-limb-pain

  Electrical stimulation. This can include the use of: TENS (transcutaneous electrical nerve stimulation). […] Manual therapy. Physical therapists use hands-on (manual) therapy including: Massage. […] Stump management. Your physical therapist can assist you with: Skin care. […] Prosthetic fittings and proper use training. Your physical therapist may perform and/or refer you for proper prosthetic device fittings, and help train you in the safe usage of your prosthetic device. […] Nervous system treatments. Treatment that focuses on improving how the nervous system is processing sensations from the amputated limb can help change the brains representation or body image of the affected part and improve nervous system function. Your physical therapist may prescribe the following treatments/exercises: Desensitization. This treatment helps modify how sensitive an area is to factors like clothing pressure or touch.

• #11 Phantom Pain | PM&R KnowledgeNow

  https://now.aapmr.org/phantom-pain/

  Noninvasive physical modalities, such as massage, active and passive movement, and manipulation may be useful in treating the residual limb. […] Mirror box imagery has shown to significantly reduce phantom pain. […] Myoelectrical prosthetic use, probably based on visual feedback, can be used. […] Desensitization, biofeedback, cognitive coping strategies, proper prosthetic management are important parts of treatment, as well as skin care and edema management. […] Intravenous ketamine and dextromethorphan reduce wind-up-like pain, hyperalgesia and phantom pain. […] Tricyclic antidepressants, effective in treating neuropathic pain, may also be helpful in treating phantom pain. […] Neuromas or other causes of pain can be surgically removed; however, stump revision should be reserved for cases of obvious pathology.

• #12 Guide | Physical Therapy Guide to Phantom Limb Pain | Choose PT

  https://www.choosept.com/guide/physical-therapy-guide-phantom-limb-pain

  Graded motor imagery/movement imagery training. These imagery exercises help your brain process information about your amputated limb more accurately, which can help you form a clearer image of the affected limb to improve or resolve phantom pain. […] Mirror visual feedback/mirror box therapy. This treatment uses a mirror or mirror box to „trick” your brain into believing the reflection of your nonamputated limb is actually your opposite limb. The brain adapts how it processes perception and sensation of the amputated limb, which can help reduce phantom sensations.

• #13 Management of Post-Amputation Limb Pain : Virtual Library

  https://resources.wfsahq.org/atotw/management-of-post-amputation-limb-pain/

  Recent research has demonstrated level 1 evidence supporting the use of either epidural or perineural catheters for reducing acute postoperative pain, particularly when continued 72 hours postoperatively. […] There does exist some data to support the use of peripheral nerve blocks for the prevention of PLP, with some studies producing encouraging results. […] Although its analgesic efficacy has been noted in spinal cord injury, there has been mixed level 2 evidence for its efficacy in treating PLP, with some studies suggesting a positive effect on pain levels acutely. […] There exists level 2 evidence demonstrating that early postoperative use of gabapentinoids does not reduce the incidence of chronic stump pain or PLP. […] Graded motor imagery is a treatment regimen that incorporates the sequential training activities of laterality training, explicit motor imagery, followed by mirror therapy.

• #14 Treatment Recommendations for Phantom Limb Pain in People with Amputations: An Expert Consensus Delphi Study

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8597012/

  The results of this study suggest that the nonpharmacological treatments endorsed in this study may have an important role in the management of PLP. […] Six of the seven treatments endorsed by experts in this study are nonpharmacologically based. […] The results of this study support the role of nonpharmacological treatments in PLP management. […] The high level of expert consensus in this Delphi study and the promising body of literature on GMI provide the basis for recommending GMI for managing PLP. […] The high level of expert consensus for the use of a functional prosthesis in this study is in line with the positive findings in the literature. […] The appropriateness of pharmacological treatments in the management of PLP have been placed in doubt because they are typically ineffective. […] The results of this study suggest that nonpharmacological and noninterventional treatments: GMI, mirror therapy, CBT, virtual reality training, use of a functional prosthesis, and sensory discrimination training may have an important role in the management of PLP.

• #15 Residual limb pain – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/residual-limb-pain/diagnosis-treatment/drc-20541405

  Massage. Gentle massaging of the arm or leg sometimes can ease pain. […] Hypnosis. A small study found that three sessions of hypnosis eased residual limb pain. […] Nerve blocks. These shots, called injections, block or turn off a nerve’s pain signals. They can help ease residual limb pain. And, if the block works, it may help diagnose a tangle of nerve endings, called a neuroma. […] Neuromodulation. These treatments use electrical impulses, called stimulation, on a nerve to relieve residual limb pain. Treatments may include spinal cord stimulation, also called SCS, peripheral nerve stimulation, also called PNS, and transcutaneous electrical nerve stimulation, also called TENS. […] Osseointegration. This newer procedure connects a replacement arm or leg, called a prosthesis, directly to bone. It may help people who have trouble with a standard prosthesis, including residual limb pain. This procedure is not widely available. […] Regenerative peripheral nerve interface. Also called RPNI, this newer procedure helps prevent neuroma, a tangle of nerve endings that often forms after an amputation. It also helps prevent pain from neuromas that have formed. Neuromas are a major cause of residual limb pain.

• #16 Residual limb pain – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/residual-limb-pain/symptoms-causes/syc-20541403

• #17 Managing Pain After Amputation: Pain Treatment for Amputees

  https://primecareprosthetics.com/blog/post-amputation-pain-management

  Residual limb pain, also known as stump pain, persists in the remaining affected body segment for extended periods, sometimes years after surgery. Described in various modalities including deep tissue pain, superficial incision pain, and neuropathic sensations, this pain can significantly impact prosthetic fitting and patient mobility. Causes include infection, stump neuroma, and heterotopic ossification. […] To address amputated limb pain, various treatment modalities have been explored, ranging from pharmacological interventions to physical and stimulation therapies. […] Nerve blockade, both preoperative and postoperative, stands as the current standard of care for preventing peripheral sensitization and subsequent onset of phantom limb pain. Peripheral nerve blocks, including continuous catheter infusions and single-shot blocks, have been shown to demonstrate efficacy in reducing postoperative morphine requirements and mitigating chronic pain.

• #18 Pain in the Residual Limb – Special Subjects – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/special-subjects/limb-prosthetics/pain-in-the-residual-limb

  If there is no medical disorder causing the pain, massaging and light tapping combined with elevating the residual limb may help relieve the pain. If this is ineffective, analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen can be used. If pain persists, referral to a pain management specialist may be helpful. […] Transcutaneous osseointegration is an alternative for patients who have experienced problems from a socket-secured prosthesis, including residual limb pain. This surgical reconstructive procedure involves inserting a biocompatible implant directly into the residual bone, which modifies the interface between the residual limb and traditional socket. […] Osseointegration should be considered in patients with complications from socket-secured prosthesis (eg, persistent residual limb pain, recurrent skin infections, ulcerations).

• #19 Phantom Pain | PM&R KnowledgeNow

  https://now.aapmr.org/phantom-pain/

  Virtual Reality and Augmented Reality have been used to treat phantom limb pain in a manner similar to mirror therapy. […] A systematic review of amputation surgical techniques demonstrated that Targeted Muscle Reinnervation (TMR) and Regenerative Peripheral Nerve Interface (RPNI) are effective at prevention of phantom limb pain development.

• #20 Neuroma and Phantom Limb Pain: Diagnosis & Treatment | IFAR

  https://www.advancedreconstruction.com/lower-extremity/neuroma-phantom-limb-pain

  Phantom limb pain is the sensation of pain in a limb that has been amputated. It is a type of chronic pain that can affect people who have undergone an amputation, and it can range in intensity from mild to severe. Phantom limb pain can be difficult to treat and may require a combination of medications, physical therapy, and other therapies to manage the pain. It is important for people experiencing phantom limb pain to work with their healthcare team to find the most effective treatment plan. […] TMR is an advanced surgical procedure that involves transferring the sensory nerves that once provided sensation to an amputated limb to reinnervate other muscles to disrupt the painful sensory sensation. Following surgery, the nerves grow back into the new muscles thereby disrupting the sensory signal pathway and thus stopping the pain mechanism and phantom limb sensation. This procedure also prevents misdirected nerve growth, or neuroma formation, which can contribute to pain within the residual limb and/or cause PLP. TMR surgery can occur at the same time as or after an amputation to prevent neuromas from forming and causing phantom limb pain. […] Schedule an appointment today and find out if TMR surgery is an option for treating your phantom limb pain.

• #21 A new treatment for post-amputation pain? – Northwestern Now

  https://news.northwestern.edu/stories/2025/02/hydrodissection-a-promising-treatment-for-post-amputation-pain/

  A reliable method to treat post-amputation pain remains elusive, but a new Northwestern Medicine study conducted in collaboration with Ukrainian physicians suggests that hydrodissection a simple procedure that injects fluid around nerves may reduce residual limb pain and opioid dependence. […] The study showed that hydrodissection combined with opioids provided better pain relief and reduced opioid use. […] Additionally, nearly two-thirds of patients in the hydrodissection group reduced their opioid use, while only about one-third of the opioid-only group did. […] This research is highly relevant to Americans, Cohen said. Trauma is the leading cause of upper-extremity amputations worldwide, and post-amputation pain affects most amputees, limiting their reintegration into society. […] Additionally, the simplicity of hydrodissection means the procedure could be easily adopted by most community hospitals in the U.S., Cohen said. […] Cohen intends to return to Ukraine this spring to launch new randomized trials focused on novel treatments for post-amputation pain, traumatic brain injury, and PTSD undeterred by the dangers of working in a conflict zone.

• #22 10 Ways Doctors Relieve Phantom Limb Pain for Amputees

  https://www.hackensackmeridianhealth.org/en/healthu/2022/09/28/10-ways-doctors-relieve-phantom-limb-pain-for-amputees

  Acupuncture may help to regulate the central nervous system and reduce nerve signals that cause bothersome sensations in the amputated limb. […] Massage can desensitize and calm overactive nerve signals. […] Clinical hypnosis may improve pain control. […] CBD/THC compounds in marijuana may decrease disturbing sensations. […] Using a heating pad or ice pack on the residual limb can reduce PLP symptoms. […] TENS units deliver a small electrical impulse through electrodes attached to the residual limb. […] VR therapy uses VR technology to create a digital illusion of having the amputated body part. Using a mirror to create a reflection of the amputated body part can create a similar illusion. This technique works by tricking the brain into believing the limb is still there, which may calm unexpected nerve signals.

• #23

  https://journals.lww.com/painrpts/fulltext/2021/01000/clinical_updates_on_phantom_limb_pain.7.aspx

  Although studies on preamputation pain as risk factor for later PLP showed contradictory results, severe preoperative and postoperative pain are the most consistent risk factors for chronic postsurgical pain per se. […] Even if there is insufficient evidence for effective prophylaxis of PLP, from the clinical point of view, anesthetic procedures should also include the use of preoperative and intraoperative coanalgesics. […] Several recent reviews have summarized the limited evidence for the pharmacological treatment of PLP. […] From a clinical perspective, the current evidence for pharmacological and interventional prevention as well as therapy of established PLP is unsatisfying. A pragmatic clinical approach might be to reduce perioperative pain intensity as effectively as possible. Approaches should include the use of techniques of regional anesthesia, the perioperative combination of analgesics and of coanalgesics as well as nonpharmacological procedures. Multimodal approaches should be pursued in an interdisciplinary team. In the case of established pain after amputation, the focus should be on differential diagnosis, mechanistic- and function-oriented therapy, coordinated within the interdisciplinary team. The early restoration of the patients’ body scheme to reduce sensomotory incongruences by using nonpharmacological treatments, such as mirror therapy and proprioceptive training, has promising potential to reduce PLP, possibly further enhanced by VR and sensory feedback approaches. Innovative prosthetic and surgical approaches can support the reestablishment of body scheme and proprioceptive input.

• #23

  https://journals.lww.com/painrpts/fulltext/2021/01000/clinical_updates_on_phantom_limb_pain.7.aspx

  Phantom limb pain is highly prevalent after amputation. Treatment results will probably benefit from an interdisciplinary team and individually adapted surgical, prosthetic and pain medicine approaches. […] Although this has not been shown in dedicated studies, patients with postamputation pain syndromes probably benefit from assessment, treatment, and monitoring within an interdisciplinary team including surgeons, anesthetists and pain physicians, psychologists, occupational therapists and physiotherapists, and orthopedic technicians. This should allow for optimizing potential synergistic effects and careful differential diagnosis. Main treatment options (for both prevention and established PLP) can be summarized under the following categories: surgical technique, prosthetic supply, pharmacotherapy including regional anesthesia, nonpharmacological treatment, education, and cognitive-behavioral therapy (possibly trauma-focused or eye movement desensitization and reprocessing therapy in case of posttraumatic stress disorder).

• #24

  https://link.springer.com/article/10.1007/s40122-021-00236-1

  Phantom limb pain (PLP) is a common complaint among patients after amputation, while jumping residual limb is a rare post-amputation complication, they rarely happen at the same time and both remain difficult to manage. […] The aim of this article is to describe a successful auricular therapy (AT) treatment of severe PLP accompanied by jumping residual limb in a 28-year-old female after below-the-knee amputation. […] After a 3-week period AT treatment, the intensity of pain, the frequency of jumping stump attacks, and the dosage of analgesic were significantly reduced, meanwhile, the overall condition of the patient was improved. […] This case report demonstrates that AT may be an effective alternative therapy for PLP accompanied by jumping residual limb. […] Currently, PLP remains intractable to be managed.

• #25 A New Treatment for Phantom Limb Pain – International Association for the Study of Pain (IASP)

  https://www.iasp-pain.org/publications/relief-news/article/a-new-treatment-for-phantom-limb-pain/

  Phantom limb pain (PLP) belongs to a group of neuropathic pain syndromes that is characterized by pain in the amputated limb that follows partial or complete deafferentation. […] PLP is considered as a challenging clinical condition since it is often refractory to classical pharmacological and surgical treatments, and it has detrimental effects on physical and psychological health and quality of life. […] Accordingly, there is a pressing need for the development of new therapeutic approaches for PLP. […] Given that tDCS has the potential to modulate synaptic plasticity, we predicted that tDCS may be suitable to treat PLP, by modulating its maladaptive plastic components. […] Our findings show that increasing the excitability of the motor cortex with anodal tDCS (delivered for 15 minutes, at an intensity of 2 mA) can induce a short-lasting (90 minutes) reduction of PLP, without affecting other amputation-related phenomena.

• #26 A New Treatment for Phantom Limb Pain – International Association for the Study of Pain (IASP)

  https://www.iasp-pain.org/publications/relief-news/article/a-new-treatment-for-phantom-limb-pain/

  Therefore, while a single application of tDCS of the motor cortex may induce a short-lived and selective relief from PLP, likely mediated by a local and transient modulation of motor cortex excitability, repetitive motor cortex stimulations may affect modulation of multiple components of the post-amputation pain, namely PLP and stump pain, with enduring benefits. […] These results have exciting theoretical and practical implications that will open new frontiers in the management of post-amputation pain.

• #27 Beyond traditional therapies: a network meta-analysis on the treatment efficacy for chronic phantom limb pain | Regional Anesthesia & Pain Medicine

  https://rapm.bmj.com/content/early/2024/02/21/rapm-2023-105104

  Phantom limb pain (PLP) frequently affects individuals with limb amputations. When PLP evolves into its chronic phase, known as chronic PLP, traditional therapies often fall short in providing sufficient relief. The optimal intervention for chronic PLP remains unclear. […] The objectives of this network meta-analysis (NMA) were to examine the efficacy of different treatments on pain intensity for patients with chronic PLP. […] The NMA suggests that neuromodulation using repetitive transcranial magnetic stimulation may be associated with significantly larger pain improvement for chronic PLP. However, the paucity of studies, varying patient characteristics across each trial, and absence of long-term results underscore the necessity for more comprehensive, large-scale RCTs. […] A wide range of treatments for chronic PLP exists, yet no standard treatment for chronic PLP has been established, making the most effective option remains challenging. These treatments encompass neuromodulation techniques such as repetitive transcranial magnetic stimulation (rTMS), cerebellar transcranial direct current stimulation (ctDCS), and peripheral nerve stimulation (PNS), established nerve-blocking methods such as continuous perineural block (CPNB) and cryoneurolysis, pharmaceutical options such as oral amitriptyline, gabapentin, memantine, mexiletine, and morphine, and other techniques, notably electromagnetic shielding (EMS).

• #28 Strategies for Managing Residual and Phantom Limb Pain

  https://www.gainesvilleprosthetics.com/post/easing-the-echoes-of-absence-strategies-for-managing-residual-and-phantom-limb-pain

  Pre-existing conditions such as diabetes or vascular disease can haunt the amputation site, exacerbating RLP. Proactive management of these conditions is critical in the overarching battle against pain. […] The emergence of bone spurs and heterotopic ossification can turn the residual limb into a battleground of discomfort. Surgical and non-surgical options exist to address these skeletal intrusions, restoring peace to the corporeal domain. […] Scarring can ensnare nerves, leading to heightened pain. Timely intervention with scar massage, stretching, and other therapeutic modalities can prevent this painful imprisonment. […] A pain journal is an indispensable ally in the fight against RLP and PLP. It’s a chronicle that empowers both patient and clinician to uncover patterns, triggers, and effective treatments, turning the tides in this ongoing battle.

• #29 Managing Phantom Limb Pain | Hanger Clinic

  https://hangerclinic.com/blog/lifestyle/managing-phantom-limb-pain/

  Currently, there is no medication developed specifically for phantom limb pain, but there are drugs designed for other purposes that have been found to relieve it. Many amputees may utilize medication in the early stages of amputation and work with their doctor to develop a step down program to eventually eliminate use of these medications. […] Discuss the side effects of any medications with your doctor so that you understand if it may negatively impact using a prosthesis, and consider other options for managing phantom pain, when possible. […] The following techniques relieve phantom pain for some amputees. Try a few and figure out what works best for you. […] There are some minimally invasive procedures that may relieve your pain if none of the other methods have worked for you. […] To help you most effectively manage any phantom pain you might experience, it is a good idea to keep a log of when the pain occurs and try to identify and eliminate any triggers you can identify. […] If one method doesn’t relieve your pain, do not give up. Keep experimenting until you find the particular technique that works for you.

• #29 Managing Phantom Limb Pain | Hanger Clinic

  https://hangerclinic.com/blog/lifestyle/managing-phantom-limb-pain/

  About 80 percent of amputees experience phantom limb pain, which is when an amputee experiences real pain sensations that seem to be located in the missing limb. […] Many people find that phantom pain and sensations are reduced once they are fit with a prosthesis and begin wearing it regularly. […] You may also experience actual pain in your residual limb. Residual limb pain may be caused by many factors including overuse or issues with the fit of the socket due to residual limb changes. If you experience pain in your residual limb, contact your prosthetist or physician. […] Phantom limb pain may be severe enough to interfere with rehabilitation and often needs medical intervention and pain management. If you are suffering from this type of pain, you can take some solace in knowing there are potential remedies. Speak with your doctor, prosthetist, physical therapist, occupational therapist, and other amputees to decide what treatment options might be helpful for you.

• #30 Phantom limb sensation / pain following amputation – University Hospitals Sussex NHS Foundation Trust

  https://www.uhsussex.nhs.uk/resources/phantom-limb-sensation-pain-following-amputation/

  Desensitisation: initially your limb may be sensitive to touch. Desensitisation is important to prepare for wearing a prosthetic limb. This can include touching, tapping and rubbing over the end of your residual limb. […] Distraction: taking your mind off the pain like reading, listening to music or engaging in a hobby you enjoy. […] Mirror therapy: this is a type of therapy where you move you remaining limb whilst watching the movement in a mirror. […] Try keeping a daily log or diary of your phantom limb pain. This can help to see if there is a pattern to the pain or if there are any triggers. […] Everyone is different and everyone’s pain experiences are different, therefore no single treatment will suit all. By assessing and talking with you we can try to work out which method of treatment will work best for you.

• #31 Residual Limb Pain Management and Recovery

  https://isbrave.com/guides/residual-limb-pain-management/

  Residual limb pain, also known as stump pain, is a common issue for most amputees that is felt through the remaining part of your amputated limb. […] Management of residual limb pain can involve medical treatments, home remedies, and proactive care: […] Medications: Pain relievers like acetaminophen, anti-inflammatory drugs, or tricyclic antidepressants can help. But consult your doctor before taking these medicines. […] Home remedies: Strategies such as hot/cold therapy, gentle massages, acupuncture, biofeedback, or relaxation techniques may provide relief from the pain. […] Correct prosthetic fitting: Ensuring a good fit is essential to reduce discomfort and improve functionality. This includes using compression garments or elastic wraps to reduce swelling and wearing residual limb socks for added comfort.

• #32 Phantom Sensation and Phantom Pain After Amputation

  https://www.veteranshealthlibrary.va.gov/rehab/PhysicalTherapy/LowerLimbAmputation/142,88860_VA

  Frequent touch. Desensitization is used to lessen or relieve pain. Gentle tapping and massaging the end of the residual limb helps to calm the sensations down. […] Wearing a shrinker sock. A shrinker sock is a compression sock made for the shape and size of your limb. The compression in the shrinker keeps constant pressure on the end of the limb helping to relieve phantom sensation and pain. […] Using your prosthesis. Like wearing a shrinker sock, using a prosthesis provides steady pressure to the limb. This seems to reduce phantom pain for some people.

• #33 Assistive technologies for pain management in people with amputation: a literature review | Military Medical Research | Full Text

  https://mmrjournal.biomedcentral.com/articles/10.1186/s40779-018-0151-z

  Electrical nerve block can be used as an assistive device to alleviate pain in people with amputation. […] A TENS unit can be used as an assistive device/technology for pain relief after amputation. […] Elastomeric pump and catheter is an assistive device/technology that can infuse local anesthesia for pain relief in people with amputation. […] Some specially designed and manufactured residual limb covers such as Farabloc and Medipro Liner Relax are applicable as assistive device/technology for pain relief in people with amputation. […] Auricular acupuncture with laser might be another treatment method to alleviate post amputation pain. […] Myoelectric prostheses when equipped with some biofeedbacks are potentially assistive devices/technologies that can alleviate phantom limb pain.

• #34 Phantom Pain Treatment After Amputation Surgery | University of Utah Health

  https://healthcare.utah.edu/neilsen-physical-rehab-hospital/specialties/amputee/phantom-pain

  After Amputation Surgery: Phantom Pain Treatment […] Alleviating phantom pain is possible. Many patients find significant relief through the following treatments and therapies: […] For some patients, wearing a prosthetic (artificial limb) more frequently helps decrease the level of pain. This is especially true in amputations of the hand and arm. […] You may need the following treatments to manage your pain: […] Occasionally, a residual limb (the remaining portion of the limb after amputation) has a shape, skin, nerve, or bone problem that can only be resolved with surgery. In these cases, our surgeons can reconstruct the residual limb for optimal success with a prosthetic. […] We use the most advanced techniques to restore strength, function, control, and avoid pain. One such approach is targeted muscle reinnervation (TMR) surgery where we split the ends of the nerves and place them into new muscles where they will grow into new muscle. This surgical procedure will prevent pain and allow robotic limbs to read signals from the muscles. […] You may need the following treatments to manage your pain: […] Occasionally, a residual limb (the remaining portion of the limb after amputation) has a shape, skin, nerve, or bone problem that can only be resolved with surgery.

• #35 Phantom Limb Pain: What It Is, Causes, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/12092-phantom-limb-pain

  There are a variety of treatment options for phantom pain, so your provider will help you find the right one for your situation. […] Medications for phantom limb pain vary based on your needs. […] Each medication comes with possible side effects. Your provider will let you know what side effects to look out for during treatment. […] Healthcare providers can help you manage the pain. There are a variety of treatment options available based on your needs. […] Treatment is available to minimize the impact that phantom pain has on your life.

• #36 Living With Phantom Limb Pain – Amputee Coalition

  https://amputee-coalition.org/resources/living-with-phantom-limb-pain-fs/

  Your phantom limb pain/sensation can be managed so that it does not overwhelm your life. […] The goal of pain management is to reduce pain levels to allow you to get you back to living and enjoying life again. […] Work closely with your healthcare team to create and maintain the pain management plan that works for you.

Zobacz więcej