Phantom pain: pathogenesis, clinical features, complex conservative therapy (review)

Authors

  • Vasyl Makolinets
  • Viktorya Melnik
  • Tamara Grashchenkova

DOI:

https://doi.org/10.15674/0030-598720153110-115

Keywords:

phantom pain, treatment with preformed factors, conservative treatment

Abstract

In this review we analyzed and systematized modern studies on phantom pain (FP) due to amputation of extremities of different etiologies. An appearance of FP after amputation of extremity or of its part is a complicated medical and social problem which has not any optimal solution till now. In this article we reviewed relevance, etiology, clinical picture , pathogenesis, prevention and treatment of FP using non-drug methods. Relevance of FP problem stipulates increasing number of victims of military conflicts, natural disasters, man-made disasters as well as significant specific weight of occlusive lesions of the lower extremities vessels and tumors. In the structure of its spreading more than half amount of cases of FP takes mine-explosive and fragmentув injuries of the extremities. To preconditions of FP belongs inadequate anesthesia during surgery, advanced age, the dominant limb amputation, previous psychologi­cal disorders, pain in the stump under conditions of inflammatory and degenerative changes in muscles, somatic burdeness. The au­thors presented the complex of treatment for this pathology which includes invasive methods of treatment, pharmacotherapy, using of physical factors, reflexotherapy, functional rehabilitation, methods of biofeedback therapy, psyhotherapy. There was underlined the lack of a unified view of experts on the effectiveness of different methods of conservative treatment, sequence, combination and duration of their using. The authors concluded that for achieve­ment of optimal therapeutic effect it is possible just by individual multimodal and integrated approach where an important role play factors of non-drug treatment. There was outlined some promising areas of research in medical rehabilitation of patients with FP in order to determine the role, sequence and combination of methods of conservative therapy.

References

  1. Avdeiev A. N. phantom-limb pains and acupuncture points / A. N. Avdeiev // Palliative care and rehabilitation. — 2003. — No. 1. — P. 30–31.
  2. Barinov A. N. Neuropathic pain: clinical practice guidelines and algorithms. Lectures / A. N. Barinov // Doctor. — 2012. — No. 9. — P. 17–22.
  3. Bezsmertnyi Iu. O. Phantom pain syndrome differentiated pharmacotherapy / Iu. O. Bezsmertnyi // Odessa medical journal. — 2003. — No. 6. — P. 48–50.
  4. Boiarkiva H. V. Postsurgical pain intensity connected with postsurgical disturbance and depression level / H. V. Boiarkiva, O. L. Potapov // Pain, pain relief and intensive medical care. — 2013. — No. 29. — P. 48–50.
  5. Buiavykh A. H. Physiotherapy in traumatological and orthopedic practice. Information book / A. H. Buiavykh. — Simferopol, 2012. — 700 p.
  6. Danilov A. B. Neuropathic pain / A. B. Danilov, O. S. Davydov. — М.: Borges, 2007. — 192 p.
  7. Zdybski V. I. Chronical pain syndrome reflex therapy / V. I. Zdybski // Emergency medicine. — 2006. — No. 1 (2). — P. 111–115.
  8. Kandaurov F. B. Integrative duplicating system of acupuncture points and areas / F. B. Kandaurov— Ufa : Healthcare Service of Bashkortostan, 2003. — 1196 p.
  9. Ovechkin A. M. Postsurgical pain and pain relief: current status on the matter / A. M. Ovechkin, S. V. Sviridov // Emergency medicine. — 2014. — No. 6 (61). — P. 135–144.
  10. Osipova N. A. Pain in surgery: protection means and facilities / N. A. Osipova, V. V. Petrova В. — М.: MIA, 2013. — 459 p.
  11. Osipova N. A. Post amputation phantom pain syndrome: medical and social problems / N. A. Osipova, L. A. Sobchenko // Anesthesiology and intensive care. — 2011. — No. 6. — P. 41–43.
  12. Osipova N. A. Analgesics usage approaches for acute and chronic pain: clinical practice guidelines / N. A. Osipova, N. R. Arbuzova, V. V. Petrova. — М., 2011. — 71 p.
  13. Pavlenko N. S. Phantom pain [digital resource] / N. S. Pavlenko. — Novosibirsk, 2010. — Access mode: http://www.painstudy.ru/matls/review/fantom.htm.
  14. Pozhidaieva L. M. Acupuncture tactics in case of pain syndromes after extremities amputation / L. M. Pozhidaieva, V. N. Bogdanov, A. T. Kachan // Orthopedics, traumatology and prosthetics care. — 1983. — No. 2. — P. 45–48.
  15. Ponomarenko H. A. Private physiotherapy / H. A. Ponomarenko. — М.: Medicine, 2005. — 744 p.
  16. European Federation of Neurological Societies Guidelines in neuropathic pain syndrome pharmacotherapy // European Journal of Neurology. — 2006. — Vol. 13. — P. 1153–1169.
  17. Phantom pain syndrome reflex therapy / V. I. Makolinets, V. V. Melnyk, T. N. Hrashchenkova, Ia. A. Holovina // Physiotherapy and balneology journal. — 2011. — Vol. 17, No. 2. — P. 33–35.
  18. Rushai A.K. Phantom pain early treatment / A.K. Rushai // Trauma. — 2013. — Vol. 14, No. 1. — P. 22–24.
  19. Sobchenko L. A. Preventive multimodal anesthesiological protection of the patient in oncologic orthopedic surgery: PhD Med. thesis research: 14.01.20 «anesthesiology and intensive care» / L. A. Sobchenko — М., 2012. — 120 p.
  20. Sulim N. I. Reflex therapy of the phantom pain syndrome patients / N. I. Sulim, V. N. Kremlev // Prosthetic care and engineering. — 1990. — Edition 88. — P. 17–21.
  21. Phantom pain syndrome — a problem a person has to deal with after an extremity amputation / A. S. Ivanov, D. P. Tatarenko, S. A. Shalimov [and others] // Ukrainian scientific medical youth journal. — 2013. — No. 1. — P. 53–55.
  22. Phantom pain syndrome — a real problem a person with an amputated extremity has to deal with / I. B. Iershova, A. S. Ivanov, S. A. Shalimov [and others] // Taurida medical-biological journal. — 2012. — Vol. 15, No. 3 (Part 2). — P. 97–99.
  23. Phantom pain syndrome: pathogenesis, treatment, prophylaxis (literature review) / O. K. Chegurov, S. V. Kolesnikov, Ie. S. Kolesnikova, A. A. Skripnikov // Orthopedics genius. — 2014. — No. 1. — P. 89–93.
  24. Federal clinical guidelines in phantom pain syndrome prevention after extremity amputation / Edited by N. A. Osipova, А. M. Ovechkin, A. V. Hnezdilov. — М., 2014. — 25 p.
  25. Cherkes-Zade D. I. Foot surgery / D. I. Cherkes-Zade, Iu. F. Kamaniev // Foot surgery. — 2nd edition reworked and added. — М.: Medicine, 2002. — 328 p.
  26. Iakhno N. N. Pain. Guidelines for students and doctors / N. N. Iakhno. — М.: Medpress-inform, 2010. — 302 p.
  27. A randomized controlled study to evaluate the efficacy of noninvasive limb cover for chronic phantom limb pain among veteran amputees / A. F. Hsiao, R. York, I. Hsiao [et al.] // Arch. Phys. Med. Rehabil. — 2012. — Vol. 93, № 4. — P. 617–622, doi: 10.1016/j.apmr.2011.11.021.
  28. Ahmed M. A. Long-term antalgic effects of repetitive tran¬scranial magnetic stimulation of motor cortex and serum beta-endorphin in patients with phantom pain / M. A. Ahmed, S. A. Mohamed., D. Sayed // Neurol. Res. — 2011. — Vol. 33, № 9. — P. 953–958, doi: 10.1179/1743132811Y.0000000045.
  29. Bradbrook D. Acupuncture treatment of phantom limb pain and phantom limb sensation in amputees / D. Bradbrook // Acupunct. Med. — 2004. — Vol. 22, № 2. — P. 93–97.
  30. Cohen S. Postamputation pain / S. Cohen // Pain Practice. — 2009. — Vol. 9, № 1. — P. 14–15.
  31. Comparable disorder of the body schema in patients with complex regional pain syndrome (CRPS) and phantom pain / A. Reinersmann, G. S. Haarmeyer, M. Blankenburg [et al.] // Schmerz. — 2011. — Vol. 25, № 5. — P. 558–562, doi: 10.1007/s00482-011-1048-x.
  32. Comparison of phantom limb pain or phantom extremity sensation of upper and lower extremity amputations / F. Ugur, A. Akin, A. Esmaoglu [et al.] // Agri. — 2007. — Vol. 19, № 1. — P. 50–56.
  33. Current and future options for the management of phantom-limb pain. H. Knotkova, R. A. Cruciani, V. M. Tronnier, D. Rasche // J. Pain Res. — 2012. — Vol. 5. — P. 39–49, doi: 10.2147/JPR.S16733.
  34. Deep brain stimulation for phantom limb pain / R. G. Bittar, S. Otero, H. Carter, T. Z. Aziz // J. Clin. Neurosci. — 2005. — Vol. 12, № 4. — P. 399–404.
  35. Factors associated with phantom limb pain: a 31/2-year pro¬spective study / J. C. Bosmans, J. H. Geertzen, W. J. Post [et al.] // Clin. Rehabil. — 2010. — Vol. 24, № 5. — P. 444–453, doi: 10.1177/0269215509360645.
  36. Fieldsen D. Dealing with phantom limb pain after amputation / D. Fieldsen, S. Wood // Nurs. Times. — 2011. — Vol. 107, № 1. — P. 21–23.
  37. Flor H. Phantom limb pain: characteristics, causes and treatment / H. Flor // Lancet Neurol. — 2002. — Vol. 1. — P. 182–189.
  38. Foley K. M. Opioids and chronic neuropathic pain / K. M. Foley // N. Engl. J. Med. — 2003. — Vol. 348, № 13. — P. 1279–1281.
  39. Giuffrida O. Contralateral stimulation, using TENS, of phantom limb pain: two confirmatory cases / O. Giuffrida, L. Simpson, P. W. Halligan // Pain Med. — 2010. — Vol. 11, № 1. — P. 133–141, doi: 10.1111/j.1526-4637.2009.00705.x.
  40. Giummarra M. J. Phantom limb pain and bodily awareness: current concepts and future directions / M. J. Giummarra, G. L. Moseley // Curr. Opin. Anaesthesiol. — 2011. — Vol. 24, № 5. — P. 524–531, doi: 10.1097/ACO.0b013e32834a105f.
  41. Ketz A. K. The experience of phantom limb pain in patients with combat-related traumatic amputations / A. K. Ketz // Arch. Phys. Med. Rehabil. — 2008. — Vol. 89, № 6. — P. 1127–1132.
  42. Kim S. Y. Mirror therapy for phantom limb pain / S. Y. Kim, Y. Y. Kim // Korean. J. Pain. — 2012. — Vol. 25, № 4. — P. 272–274, doi: 10.3344/kjp.2012.25.4.272.
  43. Manchikanti L. Managing phantom pain / L. Manchikanti, V. Singh // Pain Physician. — 2004. — Vol. 7, № 3. — P. 365–375.
  44. Mind-body interventions for treatment of phantom limb pain in persons with amputation / V. L. Moura, K. R. Faurot, S. A. Gaylord [et al.] // Am. J. Phys. Med. Rehabil. — 2012. — Vol. 91, № 8. — P. 701–714, doi: 10.1097/PHM.0b013e3182466034.
  45. Optimized perioperative analgesia reduces chronic phantom limb pain intensity, prevalence, and frequency: a prospective, randomized, clinical trial / M. Karanikolas, D. Aretha, I. Tsolakis [et al.] // Anesthesiology. — 2011. — Vol. 114, № 5. — P. 1144–1154, doi: 10.1097/ALN.0b013e31820fc7d2.
  46. Painful and nonpainful phantom and stump sensations in acute traumatic amputees / M. T. Schley, P. Wilms, S. Toepfner [et al.] // J. Trauma. — 2008. — Vol. 65, № 4. — P. 858–864.
  47. Phantom limb pain, cortical reorganization and the therapeutic effect of mental imagery / K. MacIver, D. M. Lloyd, S. Kelly [et al.] // Brain. — 2008. — Vol. 131 (Pt 8). — P. 2181–2191.
  48. Phantom limb phenomena in cancer amputees / D. Probst¬ner, L. C. S. Thuler, N. M. Ishikawa, R. M. P. Alvarenga // Pain Practice. — 2010. — Vol. 10, № 3. — P. 249–256, doi: 10.1111/j.1533-2500.2009.00340.x.
  49. Phantom pain / A. Wolff, E. Vanduynhoven, M. van Kleef [et al.] // Pain Practice. — 2011. — Vol. 11, № 4. — P. 403–413, doi: 10.1111/j.1533-2500.2011.00454.x.
  50. Phantom pain and posttraumatic pain conditions / L. Rasulic, S. Ivanovic, V. Bascarevic, V. Simic // Acta Chir. Iugosl. — 2004. — Vol. 51, № 4. — P. 71–80.
  51. Phantom pain, residual limb pain, and back pain in amputees: results of a national survey / P. L. Ephraim, S. T. Wegener, E. J. MacKenzie [et al.] // Arch. Phys. Med. Rehabil. — 2005. — Vol. 86, № 10. — P. 1910–1919.
  52. Phantom limb pain: a systematic neuroanatomical-based re¬view of pharmacologic treatment / L. McCormitck, G. Chang-Chien, B. Marshall [et al.] // Pain Medicine. — 2014. — Vol. 15, № 2. — P. 292–305, doi: 10.1111/pme.12283.
  53. Pharmacological interventions for phantom limb pain / J. Fang, Y. H. Lian, K. J. Xie, S. N. Cai // Chin. Med. J. (Engl). — 2013. — Vol. 126, № 3. — P. 542–549.
  54. Preamputation pain and acute pain predict chronic pain after lower extremity amputation / M. A. Hanley, M. P. Jensen, D. G. Smith [et al.] // J. Pain. — 2007. — Vol. 8, № 2. — P. 102–109.
  55. Schwarzer A. Therapy of phantom limb pain / A. Schwarzer, M. Zenz, C. Maier // Anasthesiol. Intensivmed. Notfallmed. Schmerzther. — 2009. — Vol. 44, № 3. — P. 174–180, doi: 10.1055/s-0029-1215547.
  56. Self-reported treatments used for lower-limb phantom pain: descriptive findings / M. A. Hanley, D. M. Ehde, K. M. Camp¬bell [et al.] // Arch. Phys. Med. Rehabil. — 2006. — Vol. 87, № 2. — P. 270–277.
  57. Sensory feedback prosthesis reduces phantom limb pain: proof of a principle / C. Dietrich, K. Walter-Walsh, S. Preissler [et al.] // Neurosci. Lett. — 2012. — Vol. 507, № 2. — P. 97–100, doi: 10.1016/j.neulet.2011.10.068.
  58. Sherman R. A. Chronic phantom and stump pain among Ameri¬can veterans: results of survey / R. A. Sherman, C. J. Sherman, L. Parker // Pain. — 1984. — Vol. 18, № 1. — P. 83–95.
  59. The treatment of phantom limb pain using immersive virtual reality: three case studies / C. D. Murray, S. Pettifer, T. Howard [et al.] // Disabil. Rehabil. — 2007. — Vol. 29, № 18. — P. 1465–1469.
  60. The use of prolonged peripheral neural blockade after lower extremity amputation: the effect on symptoms associated with phantom limb syndrome / B. Borghi, M. D’Addabbo, P.F. White [et al.] // Anesth. Analg. — 2010. — Vol. 111, № 5. — P. 1308–1315, doi: 10.1213/ANE.0b013e3181f4e848.
  61. Viswanathan A. Use of spinal cord stimulation in the treatment of phantom limb pain: case series and review of the literature / A. Viswanathan, P. C. Phan, A. W. Burton // Pain Pract. — 2010. — Vol. 10, № 5. — P. 479–484, doi: 10.1111/j.1533-2500.2010.00374.x.

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How to Cite

Makolinets, V., Melnik, V., & Grashchenkova, T. (2015). Phantom pain: pathogenesis, clinical features, complex conservative therapy (review). ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 110–115. https://doi.org/10.15674/0030-598720153110-115

Issue

No. 3 (2015)

Section

DIGESTS AND REVIEWS

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Copyright (c) 2015 Vasyl Makolinets, Viktorya Melnik, Tamara Grashchenkova

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