![amputee phantom pain management amputee phantom pain management](https://image.slidesharecdn.com/stumpcarephantomlimbpaingait-140322115635-phpapp02/95/amputationstump-care-phantom-limb-pain-and-gait-training-in-lower-limb-78-638.jpg)
El tratamiento farmacológico regular del dolor del miembro fantasma casi nunca es efectivo. El dolor de miembro fantasma ocurre en al menos 42 al 90% de los amputados. Dicho dolor puede ser inducido por un conflicto entre la representación de la retroalimentación visual y propioceptiva del miembro previamente sano. Studies with more representative samples, specifically randomised trials are required.Įl dolor de miembro fantasma ha sido descrito como una condición en la que los pacientes experimentan una sensación de prurito, espasmo o dolor en un miembro o parte del cuerpo previamente amputado. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitisation and reprocessing eye movements, imagery and hypnosis. The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitisation and reprocessing eye movements and hypnosis. To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature. Additionally cross references of included articles and literature were reviewed. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. MethodsĪ systematic review of the literature was conducted in Medline and Cochrane using the MESH terms “phantom limb pain” and “psychotherapy”, published in the last 10 years, in English and Spanish, finding 49 items. Regular drug treatment of phantom limb pain is almost never effective. The phantom limb pain occurs in at least 42–90% of amputees. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. In severe cases, surgical neurectomy may be advised.The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Magnetic resonance imaging and/or ultrasound can be used to confirm the diagnosis of neuroma. The longer the neuroma is irritated, either mechanically by the prosthesis or from muscle contraction, the longer it takes to dissipate. Neurogenic pains that occur while using the prosthesis and disappear quickly or slowly upon removal of the prosthesis suggest a neuroma. Other symptoms that suggest neuroma include unusual and unpleasant sensations that occur without stimulation or upon contraction of residual-limb muscles and a disagreeable sensation (dysesthesia) that occurs with light palpation of skin. The pain typically does not involve the phantom limb but can. Pain from a neuroma may have neurogenic characteristics such as feeling electrical, shooting, tingling, sharp and stabbing, or prickly. The diagnosis of a neuroma is suggested by history and physical examination. Painful neuroma can occur in any severed nerve (from surgery or trauma) and may cause a focal or enlarged area of pain that can be temporarily blocked (as a diagnostic maneuver) by local anesthetic injection.