Protective and Risk Factors for Phantom Limb Pain and Residual Limb Pain Severity.
amputation
associated factors
phantom limb pain
Journal
Pain practice : the official journal of World Institute of Pain
ISSN: 1533-2500
Titre abrégé: Pain Pract
Pays: United States
ID NLM: 101130835
Informations de publication
Date de publication:
07 2020
07 2020
Historique:
received:
21
10
2019
revised:
29
02
2020
accepted:
04
03
2020
pubmed:
17
3
2020
medline:
24
11
2020
entrez:
17
3
2020
Statut:
ppublish
Résumé
The exact mechanisms underlying the development and maintenance of phantom limb pain (PLP) are still unclear. This study aimed to identify the factors affecting pain intensity in patients with chronic, lower limb, traumatic PLP. This is a cross-sectional analysis of patients with PLP. We assessed amputation-related and pain-related clinical and demographic variables. We used univariate and multivariate models to evaluate the associated factors modulating PLP and residual limb pain (RLP) intensity. We included 71 unilateral traumatic lower limb amputees. Results showed that (1) amputation-related perceptions were experienced by a large majority of the patients with chronic PLP (sensations: 90.1%, n = 64; residual pain: 81.7%, n = 58); (2) PLP intensity has 2 significant protective factors (phantom limb movement and having effective treatment for PLP previously) and 2 significant risk factors (phantom limb sensation intensity and age); and (3) on the other hand, for RLP, risk factors are different: presence of pain before amputation and level of amputation (in addition to the same protective factors). These results suggest different neurobiological mechanisms to explain PLP and RLP intensity. While PLP risk factors seem to be related to maladaptive plasticity, since phantom sensation and older age are associated with more pain, RLP risk factors seem to have components leading to neuropathic pain, such as the amount of neural lesion and previous history of chronic pain. Interestingly, the phantom movement appears to be protective for both phenomena.
Identifiants
pubmed: 32176435
doi: 10.1111/papr.12881
pmc: PMC7363546
mid: NIHMS1574026
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
578-587Subventions
Organisme : NICHD NIH HHS
ID : R01 HD082302
Pays : United States
Organisme : NIH HHS
ID : 1R01HD082302-01A1
Pays : United States
Informations de copyright
© 2020 World Institute of Pain.
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