After amputation, all three may occur together. 4 Post-amputation pain at the wound site should also be distinguished from pain in the residual limb and the phantom limb. This is known as residual limb (RLP) or stump pain and its intensity is often positively correlated with PLP. PLP is often confused with pain or sensation in the areas adjacent to the amputated body part. Treatment options are also proposed to furnish the reader with ideas which they can investigate further. Thus, this work is applicable to those who have had a traumatic amputation rather than an amputation resulting from a chronic health condition. The treatment approach has been formulated from the clinical experience of working with battle casualties at the Defence Medical Rehabilitation Centre (DMRC), Headley Court and the concurrent review of literature which has informed practice. The purpose of this paper is to explore the interplay of factors involved in PLP and propose a multidisciplinary approach to treatment for first-line management within primary and secondary care. It is essential that both primary and secondary care clinicians understand and attend to it appropriately.Ī growing pathophysiological understanding of PLP is shedding new light on the mechanisms involved. 3 The potential for this condition to become chronic is well documented and it can have catastrophic effects upon an individual. This, together with a lack of a definitive treatment, results in under-reporting of pain by patients and a lack of attention to the problem by clinicians. The aetiology of PLP is complex and it is often mistaken as residual limb pain (RLP) or phantom sensation. After amputation, phantom limb pain (PLP) affects between 50 and 80% of patients and its incidence is not related to the cause of the amputation. 1 Wounding to vulnerable extremities is common and if limb salvage is unattainable, amputation will result. The poly-trauma injury pattern resulting from blast is well documented.
This approach has been formulated from an amalgamation of clinical experience working with battle casualties at the Defence Medical Rehabilitation Centre, Headley Court. This paper seeks to outline current research into this condition and proposes an approach to treatment. Knowledge of these mechanisms will inform treatment and enable clinicians to plan and implement solutions which make a difference to those individuals with this condition. A growing pathophysiological understanding is shedding new light on the mechanisms which underlie PLP. It is widely acknowledged that its complex aetiology means that this condition is often poorly understood and difficult to manage. With an increasing number of battle casualties having had an amputation after combat trauma, it is inevitable that both primary and secondary care clinicians will come into contact with a patient with phantom limb pain (PLP). Phantom limb pain affects between 50 and 80% of amputees.
0 kommentar(er)
