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Relationship between mechanical sensitivity and postamputation pain: a prospective study.

L Nikolajsen1, S Ilkjaer, T S Jensen

  • 1Danish Pain Research Center, University of Arhus.

European Journal of Pain (London, England)
|December 22, 2000
PubMed
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Pre-amputation limb tenderness is weakly linked to early stump and phantom limb pain. This relationship fades over time, suggesting neuronal sensitization may contribute to persistent phantom pain after amputation.

Area of Science:

  • Neuroscience
  • Pain Research
  • Clinical Medicine

Background:

  • Limb amputation frequently results in stump and phantom limb pain.
  • Postamputation pain can manifest with signs of neuronal hyperexcitability, including mechanical hyperalgesia.

Purpose of the Study:

  • To investigate the relationship between mechanical pain thresholds and early (1 week) and late (6 months) postamputation stump and phantom limb pain.
  • To explore the potential role of preamputation limb tenderness in predicting postamputation pain.

Main Methods:

  • Thirty-five lower limb amputation patients were assessed before, 1 week, and 6 months post-amputation.
  • Mechanical pain thresholds (pressure pain thresholds) and pain intensity (Visual Analogue Scale) were measured.
  • Statistical analysis examined the correlation between preamputation thresholds and early/late phantom pain.

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Main Results:

  • A weak but significant inverse relationship was observed between preamputation pain thresholds and early stump/phantom pain.
  • No correlation was found between preamputation thresholds and late stump/phantom pain.
  • A significant inverse relationship existed between mechanical thresholds and phantom pain at 1 week post-amputation, but not at 6 months.

Conclusions:

  • Limb tenderness before and shortly after amputation is weakly associated with early stump and phantom pain.
  • The predictive relationship diminishes over time, indicating other factors may be involved in late phantom pain.
  • Neuronal sensitization, either peripherally or centrally, is suggested as a potential mechanism in the development of phantom limb pain.