Treatment of Chronic Phantom Limb Pain Using a Trauma-Focused Psychological Approach. (2010)

• Record Type: Journal Article
• Authors: de Roos, C; Veenstra, AC; de Jongh, A; den Hollander-Gijsman, ME; van der Wee, NJA; Zitman, FG; van Rood, YR
• Is Part Of: Pain research and management. Volume 2010(2010)
• Page Start: 65
• Page End: 71
• Publication Date: 2010
• Subjects: Cortical reorganization -- EMDR -- Longitudinal descriptive study -- Pain memories -- Phantom limb pain (PLP) -- Post-traumatic stress disorder (PTSD); Pain -- Periodicals; Pain -- Treatment -- Periodicals; 616.0472
• DOI: 10.1155/2010/981634
• Languages: English
• ISSNs: 1203-6765

Abstract

Abstract : BACKGROUND: Chronic phantom limb pain (PLP) is a disabling chronic pain syndrome for which regular pain treatment is seldom effective. Pain memories resulting from long-lasting preamputation pain or pain flashbacks, which are part of a traumatic memory, are reported to be powerful elicitors of PLP. OBJECTIVE: To investigate whether a psychological treatment directed at processing the emotional and somatosensory memories associated with amputation reduces PLP. METHODS: Ten consecutive participants (six men and four women) with chronic PLP after leg amputation were treated with eye movement desensitization and reprocessing (EMDR). Pain intensity was assessed during a two-week period before and after treatment (mean number of sessions = 5.9), and at short- (three months) and long-term (mean 2.8 years) follow-up. RESULTS: Multivariate ANOVA for repeated measures revealed an overall time effect (F[2, 8]=6.7; P<0.02) for pain intensity. Pairwise comparison showed a significant decrease in mean pain score before and after treatment (P=0.00), which was maintained three months later. All but two participants improved and four were considered to be completely pain free at three months follow-up. Of the six participants available at long-term follow-up (mean 2.8 years), three were pain free and two had reduced pain intensity. CONCLUSIONS: These preliminary results suggest that, following a psychological intervention focused on trauma or pain-related memories, substantial long-term reduction of chronic PLP can be achieved. However, larger outcome studies are required.