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Radiofrequency Techniques for the Alleviation of Post-amputation Phantom Limb Pain: a Systematic Review

  • Amputation Rehabilitation (JM Cohen, Section Editor)
  • Published:
Current Physical Medicine and Rehabilitation Reports Aims and scope Submit manuscript

Abstract

Objective

Phantom limb pain is characterized by painful sensations that emanate from portions of an amputated limb and has a prevalence estimated as high as 75–80%. Radiofrequency, which is used interventionally as either pain-ablation or neuromodulation for axial pain, has also been increasingly used for non-axial pain. To conduct a systematic review to determine the therapeutic response of radiofrequency techniques for post-amputation phantom limb pain.

Design/Methods

A comprehensive search of several databases from January 1, 2000, to November 23, 2020, was conducted. Eligible study designs included randomized controlled trials, prospective and retrospective studies, cross-sectional studies, case series, and case reports. The risk of bias was assessed using a tool specifically for assessing case series and case reports. We assessed the level of evidence using the Oxford tool and the quality of evidence with GRADE. A total of 98 articles were screened, with nine studies meeting inclusion criteria.

Results

Five studies had a moderate risk of bias, and four had a high risk of bias. All nine studies, including three case series and six case reports, discussed phantom limb pain treatment for fourteen patients by various radiofrequency techniques, including radiofrequency ablation, cooled radiofrequency ablation, pulsed radiofrequency, and low-temperature plasma radiofrequency ablation. Of the fourteen patients receiving one of the radiofrequency techniques, eleven (78.6%) received ≥ 50% pain relief post-intervention. No adverse effects were seen in any of the included studies.

Conclusions

Despite the limited quantity and quality of evidence, radiofrequency techniques show potential therapeutic benefits for phantom limb pain.

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Data Availability

All data are included in the manuscript.

Code Availability

Not applicable.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA

    James B. Meiling, Christopher T. Ha & F. Clay Smither

  2. Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA

    George M. Raum

  3. Department of Physical Medicine and Rehabilitation, Temple University/MossRehab, Philadelphia, PA, USA

    Brandon S. Barndt

  4. Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

    Nicole V. Nguyen

  5. Mayo Clinic Library, Mayo Clinic, Rochester, MN, USA

    Cynthia J. Beeler

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  1. James B. Meiling
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Correspondence to James B. Meiling.

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This article is part of the Topical Collection on Amputation Rehabilitation

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Meiling, J.B., Raum, G.M., Barndt, B.S. et al. Radiofrequency Techniques for the Alleviation of Post-amputation Phantom Limb Pain: a Systematic Review. Curr Phys Med Rehabil Rep 9, 207–214 (2021). https://doi.org/10.1007/s40141-021-00328-1

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  • DOI: https://doi.org/10.1007/s40141-021-00328-1

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