Acupuncture as an adjuvant therapy in amputation pain

Abstract

Stump pain is usually hard to cure. This pain is often beyond the efficiency of painkillers, so hard that some patients threaten to commit suicide in order to end it. We analyzed our experience of the efficiency of acupuncture for painful amputees suffering from their stumps. Retrospective analysis of acupuncture sessions performed on painful amputees referred to our center for intractable pain. Pain was evaluated with Visual Analog Scale, before and after acupuncture sessions. We used a various number of needles per patient (1 to 10) and depth of puncture varies from 1 mm to few centimeters. The average duration of the acupuncture sessions was 30 minutes. Stumps were carefully analyzed in order to puncture the acupuncture needles in the damaged tissues (painful neuroma, muscular trigger point, painful scar) and in classical acupuncture points. The needles were carefully places to avoid the pain caused by a too fast and too deep puncture. Fifty painful amputees (34 men and 16 women) were included in our study. The cause of amputation was traumatic ( n = 45), arteritic ( n = 2), septic shock ( n = 2), tumoral ( n = 2). The level of amputation was transtibial ( n = 26), transfemoral ( n = 14), hands ( n = 3), forearms ( n = 2), arms ( n = 2), disarticulation of shoulder ( n = 2), foot ( n = 1). These intractable pains were relieved by successive acupuncture session in 80% of patients; among those, the mean VAS improved from 9 to 3/10. Acupuncture seems to be particularly efficient for pathologic neuromas pains as for causalgias, muscles trigger points and algo-hallucinosis. After some sessions, acupuncture may alleviate for months or years the neuroma pain. Acupuncture is a cheap, easy and efficient antalgic therapy for neuroma pains, causalgias, muscular triggers points and algo-hallucinosis of amputated stumps. Further studies are needed to determine the best modalities of this therapy.