Abstract
Phantom limb pain (PLP) and phantom limb sensation (PLS) are common and distressing sequelae of amputation. Current pain management following amputation is challenging and unsatisfying. In this case study, a 74-year-old woman underwent above-knee amputation because of the rhabdomyosarcoma in the right leg. Despite several analgesics, pain was poorly controlled. The phantom limb pain and sensation were immediately reduced by the contralateral acupuncture, and abolished after the third session with no side-effects, no relapse during the next 9 months. Contralateral acupuncture showed positive effect on PLP and PLS in this case, but more robust evidence would be needed to support the efficacy of this treatment technique for indication.
Highlights
Most amputees complain of various distressing sensations in the amputated limb such as burning, stinging, shooting, piercing or cramping pain, known as phantom limb pain (PLP), and non-painful phantom limb sensations (PLS), (Stankevicius et al, 2021)
A special therapy that aims at multiple mechanisms of phantom limb pain seems to be optimum, but has not yet been presented
Acupuncture analgesia is associated with downregulation of glutamate in the ascending excitatory pathway and upregulation of opioids, norepinephrine, and 5-hydroxytryptamine in the descending pain modulatory system, contributing to alleviate central sensitization (Lyu et al, 2021)
Summary
Most amputees complain of various distressing sensations in the amputated limb such as burning, stinging, shooting, piercing or cramping pain, known as phantom limb pain (PLP), and non-painful phantom limb sensations (PLS), (e.g., temperature, pressure, itching, touch), (Stankevicius et al, 2021). Phantom limb pain may occur immediately or in the following days after surgery, and may gradually diminish over a few months to decades (Raggi and Ferri, 2019; Erlenwein et al, 2021) These may affect all aspects of life, including mood, sleep, family relationship, and social interaction (Colquhoun et al, 2019) which in turn will aggravate the intractable sensations and form a vicious circle. Used treatments for PLP include pharmacotherapy (analgesics, anesthetics, muscle relaxants, antidepressants, and anticonvulsants, etc) and non-pharmacological interventions (transcutaneous electrical nerve stimulation, mirror therapy, virtual reality, and acupuncture, etc), (Erlenwein et al, 2021). From the perspective of the patient, she was very satisfied with the treatment, because the PLP and PLS disappeared completely, and her sleep and mood returned to normal in the long term
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