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Molecular Neurobiology

, Volume 55, Issue 1, pp 70–84 | Cite as

Coping with Phantom Limb Pain

  • Damien P. KufflerEmail author
Article

Abstract

Phantom limb pain is a chronic neuropathic pain that develops in 45–85% of patients who undergo major amputations of the upper and lower extremities and appears predominantly during two time frames following an amputation: the first month and later about 1 year. Although in most patients the frequency and intensity of pain diminish over time, severe pain persists in about 5–10%. It has been proposed that factors in both the peripheral and central nervous systems play major roles in triggering the development and maintenance of pain associated with extremity amputations. Chronic pain is physically and mentally debilitating, affecting an individual’s capacity for self-care, but also diminishing an individual’s daily capacity for personal and economic independence. In addition, the pain may lead to depression and feelings of hopelessness. A National Center for Biotechnology Information study found that in the USA alone, the annual cost of dealing with neuropathic pain is more than $600 billion, with an estimated 20 million people in the USA suffering from this condition. Although the pain can be reduced by antiepileptic drugs and analgesics, they are frequently ineffective or their side effects preclude their use. The optimal approach for eliminating neuropathic pain and improving individuals’ quality of life is the development of novel techniques that permanently prevent the development and maintenance of neuropathic pain, or that eliminate the pain once it has developed. What is still required is understanding when and where an effective novel technique must be applied, such as onto the nerve stump of the transected peripheral axons, dorsal root ganglion neurons, spinal cord, or cortex to induce the desired influences. This review, the second of two in this journal volume, examines the techniques that may be capable of reducing or eliminating chronic neuropathic pain once it has developed. Such an understanding will improve amputees’ quality of life by blocking the mechanisms that trigger and/or maintain PLP and chronic neuropathic pain.

Keywords

Spinal cord injury Neuropathic pain Brain stimulation Deep brain stimulation (DBS) Motor cortex stimulation (MCS) Transcranial magnetic stimulation (TMS) Transcranial direct current stimulation (tDCS) Cranial electrotherapy stimulation (CES) 

Notes

Acknowledgements

No support was involved in the production of this paper.

Compliance with Ethical Standards

Conflict of Interest

The author declares that he has no conflicts of interest.

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Institute of NeurobiologyUniversity of Puerto RicoSan JuanPuerto Rico

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