PHANTOM PAIN TREATMENT IN PACIENTS SUBMITTED TO AMPUTATION: A REVIEW OF CLINICAL AND REHABILITATION APPROACHES

Abstract

Introduction: Phantom limb pain is a common sequel of amputation and difficult-to-treat condition. It compromises the amputees’ acquisition of skills and quality of life, which justifies the establishment of an effective treatment. Objective: To identify and describe the clinical and/or rehabilitation interventions to treat phantom limb pain in patients who underwent amputations. Material and Methods: This was a literature review of articles published in the electronic databases Pubmed and Bireme between 2003 and 2014 (except classical literature). We selected complete scientific papers available in full in Portuguese, English or Spanish. Results: Seven different types of treatment for phantom limb pain were identified. Two out of the eight papers included addressed the same physical therapy approach. Therefore, the therapeutic modalities were classified as invasive measures associated or not to pharmacological (four articles) and physical therapies (four articles). All therapeutic modalities identified in the review were proved to be beneficial in ameliorating phantom pain, as follows: intravenous infusion of lidocaine followed by thoracic sympathetic chain blockage; replacement of the pharmacological therapy by a ziconotide intrathecal injection pump; continuous sciatic blockage; use of gabapentin preoperatively; mirror box therapy; practice-oriented exercises; and application of transcutaneous electrical nerve stimulation. Conclusion: The most frequently reported and used therapeutic measures were drug therapy, invasive therapy and physical therapy. However, there was no consensus in the literature about the best therapeutic option to treat phantom limb pain. DESCRIPTORS Phantom Limb Pain. Amputation. Physical Therapy Modalities.