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Targeted Muscle Reinnervation: Surgical Protocol for a Randomized Controlled Trial in Postamputation Pain
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Chronic pain associated with upper-limb loss.

Marisol A Hanley1, Dawn M Ehde, Mark Jensen

  • 1Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA.

American Journal of Physical Medicine & Rehabilitation
|August 21, 2009
PubMed
Summary

Pain is highly prevalent after upper-limb loss, affecting nearly all individuals. Beyond phantom and residual limb pain, back, neck, and nonamputated limb pain significantly impact quality of life and function.

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Area of Science:

  • Rehabilitation Medicine
  • Pain Management
  • Prosthetics and Orthotics

Background:

  • Upper-limb loss presents complex challenges, including various types of pain that can affect patient well-being.
  • Understanding the prevalence and impact of different pain types is crucial for effective management.

Purpose of the Study:

  • To determine the prevalence, intensity, and functional impact of phantom limb, residual limb, back, neck, and nonamputated-limb pain in individuals with upper-limb loss.

Main Methods:

  • A cross-sectional survey was conducted with 104 individuals who had experienced upper-limb loss at least six months prior.
  • Participants completed validated measures assessing pain intensity, interference, disability, and health-related quality of life.

Main Results:

  • Nearly all respondents (90%) reported pain, with 76% experiencing multiple pain types.
  • Phantom limb (79%) and residual limb (71%) pain were most common, followed by back (52%), neck (43%), and nonamputated limb pain (33%).
  • Nonamputated limb pain, though least prevalent, caused the greatest interference and disability days; all pain types were linked to lower quality of life.

Conclusions:

  • Pain is a pervasive issue following upper-limb amputation, encompassing phantom, residual, back, neck, and nonamputated limb pain.
  • These pain types significantly contribute to disability and activity interference, underscoring the need for comprehensive pain assessment.
  • A holistic approach evaluating multiple pain locations is essential for improving outcomes in individuals with upper-limb loss.