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[Referred pain from amputation stump trigger points into the phantom limb].

K-U Kern1, C Martin, S Scheicher

  • 1Schmerz- und Palliativzentrum, Wiesbaden. dr.kern@schmerzzentrum-wiesbaden.de

Schmerz (Berlin, Germany)
|October 29, 2005
PubMed
Summary

Myofascial trigger points (TPs) in leg amputation stumps are common and can cause stump pain, phantom pain, and phantom sensations. These TPs, often found in the distal stump, frequently project sensations to the toes.

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Area of Science:

  • Pain Medicine
  • Neurology
  • Rehabilitation Medicine

Context:

  • Lower limb amputations present unique challenges for pain management.
  • Phantom limb pain (PLP) and stump pain (SP) are common and debilitating post-amputation.
  • The role of myofascial trigger points (TPs) in generating these pain phenomena is not fully understood.

Purpose:

  • To investigate the presence and characteristics of myofascial TPs in lower leg amputation stumps.
  • To determine if these TPs can elicit stump pain (SP), phantom pain (PP), and phantom sensations (PS).
  • To map the referred sensations and pain to specific locations in the phantom limb.

Summary:

  • Myofascial TPs were palpated in 30 lower leg amputees (12 transfemoral, 18 transtibial).
  • A significant number of TPs were found to produce involuntary stump movements, fasciculations, and referred sensations/pain.

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  • Phantom phenomena, particularly in the toes, were frequently reported and correlated with specific TP locations in the stump.

    • Impact:

    • Identifies myofascial TPs as a prevalent and actionable source of phantom limb pain and sensations.
    • Suggests a potential common origin for referred stump pain and phantom pain.
    • Provides insights for targeted therapeutic interventions for amputees experiencing persistent pain.