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Phantom-limb pain: characteristics, causes, and treatment
1Department of Clinical and Cognitive Neuroscience, University of Heidelberg, Central Institute of Mental Health, Mannheim, Germany. flor@zi-mannheim.de
The Lancet. Neurology
|July 10, 2003
Summary
Phantom-limb pain, affecting up to 80% of amputees, is influenced by central nervous system changes. Effective treatments may target these central changes and prevent memory processes.
Area of Science:
- Neuroscience
- Pain Management
- Amputee Rehabilitation
Background:
- Phantom-limb pain (PLP) is a frequent complication following amputation.
- Differentiating PLP from other post-amputation sensations is crucial for effective management.
- Both central and peripheral nervous system changes, alongside psychological factors, contribute to PLP.
Purpose of the Study:
- To present a comprehensive model of phantom-limb pain.
- To review existing treatments and propose mechanism-based therapeutic strategies.
- To explore the role of central changes and memory processes in PLP.
Main Methods:
- Review of existing literature on phantom-limb pain.
- Development of a comprehensive model integrating pre-amputation pain, central, and peripheral factors.
- Analysis of proposed mechanism-based treatments.
Main Results:
- Central nervous system changes are identified as major determinants of phantom-limb pain.
- A comprehensive model highlights the significance of pre-amputation pain and related neural changes.
- Few mechanism-based treatments currently exist, with many reports being anecdotal.
Conclusions:
- Interventions targeting central changes show promise for phantom-limb pain management.
- Peripheral analgesia has yielded inconsistent results for PLP prevention.
- Reversing or preventing central memory processes may offer a more effective therapeutic approach.