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      Journal of Pain Research (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on reporting of high-quality laboratory and clinical findings in all fields of pain research and the prevention and management of pain. Sign up for email alerts here.

      52,235 Monthly downloads/views I 2.832 Impact Factor I 4.5 CiteScore I 1.2 Source Normalized Impact per Paper (SNIP) I 0.655 Scimago Journal & Country Rank (SJR)

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      Ultrasonography-Guided Radiofrequency Ablation for Painful Stump Neuromas to Relieve Postamputation Pain: A Pilot Study

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          Abstract

          Objective

          Postamputation pain (PAP) is a serious problem, and thus far, there is no perfect treatment strategy. Clinically, minimally invasive treatments for peripheral neuromas are simple and feasible. This study aimed to investigate the immediate and long-term effects of ultrasonography-guided radiofrequency ablation (RFA) on PAP.

          Methods

          Eighteen PAP subjects with painful peripheral neuromas were treated with ultrasonography-guided RFA.

          Results

          A total of 18 PAP subjects were included in the final analyses. Fourteen of the 17 subjects with residual limb pain (RLP) (82.4%) had successful outcomes. A successful outcome was noted in 9 of the 13 subjects with phantom limb pain (PLP) (69.2%). There were no significant associations between symptom relief and sex, age, or the duration of symptoms. There were no severe complications.

          Conclusions

          Ultrasonography-guided RFA for painful stump neuromas can effectively relieve stump pain and PLP in amputees with PAP (follow-up time was 12 months). Ultrasonography-guided RFA is easy and safe and does not involve radiation exposure, making it very suitable for clinical applications.

          Most cited references29

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          Estimating the prevalence of limb loss in the United States: 2005 to 2050.

          Kathryn Ziegler-Graham, Ellen J MacKenzie, Patti L Ephraim … (2008)
          To estimate the current prevalence of limb loss in the United States and project the future prevalence to the year 2050. Estimates were constructed using age-, sex-, and race-specific incidence rates for amputation combined with age-, sex-, and race-specific assumptions about mortality. Incidence rates were derived from the 1988 to 1999 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, corrected for the likelihood of reamputation among those undergoing amputation for vascular disease. Incidence rates were assumed to remain constant over time and applied to historic mortality and population data along with the best available estimates of relative risk, future mortality, and future population projections. To investigate the sensitivity of our projections to increasing or decreasing incidence, we developed alternative sets of estimates of limb loss related to dysvascular conditions based on assumptions of a 10% or 25% increase or decrease in incidence of amputations for these conditions. Community, nonfederal, short-term hospitals in the United States. Persons who were discharged from a hospital with a procedure code for upper-limb or lower-limb amputation or diagnosis code of traumatic amputation. Not applicable. Prevalence of limb loss by age, sex, race, etiology, and level in 2005 and projections to the year 2050. In the year 2005, 1.6 million persons were living with the loss of a limb. Of these subjects, 42% were nonwhite and 38% had an amputation secondary to dysvascular disease with a comorbid diagnosis of diabetes mellitus. It is projected that the number of people living with the loss of a limb will more than double by the year 2050 to 3.6 million. If incidence rates secondary to dysvascular disease can be reduced by 10%, this number would be lowered by 225,000. One in 190 Americans is currently living with the loss of a limb. Unchecked, this number may double by the year 2050.
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            Targeted muscle reinnervation: a novel approach to postamputation neuroma pain.

            Jason M Souza, Jennifer Cheesborough, Jason Ko … (2014)
            Postamputation neuroma pain can prevent comfortable prosthesis wear in patients with limb amputations, and currently available treatments are not consistently effective. Targeted muscle reinnervation (TMR) is a decade-old technique that employs a series of novel nerve transfers to permit intuitive control of upper-limb prostheses. Clinical experience suggests that it may also serve as an effective therapy for postamputation neuroma pain; however, this has not been explicitly studied.
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              Phantom pain, residual limb pain, and back pain in amputees: results of a national survey.

              Amanda Mackenzie, L Pezzin, R. Ephraim … (2005)
              To describe the prevalence of amputation-related pain; to ascertain the intensity and affective quality of phantom pain, residual limb pain, back pain, and nonamputated limb pain; and to identify the role that demographics, amputation-related factors, and depressed mood may contribute to the experience of pain in the amputee. Cross-sectional survey. A sample of persons who contacted the Amputee Coalition of America from 1998 to 2000 were interviewed by telephone. A stratified sample by etiology of 914 persons with limb loss. Not applicable. Prevalence, intensity, and bothersomeness of residual, phantom, and back pain, depressed mood as measured by the Center for Epidemiologic Study Depression Scale, characteristics of the amputation, prosthetic use, and sociodemographic characteristics of the amputee. Nearly all (95%) amputees surveyed reported experiencing 1 or more types of amputation-related pain in the previous 4 weeks. Phantom pain was reported most often (79.9%), with 67.7% reporting residual limb pain and 62.3% back pain. A large proportion of persons with phantom pain and stump pain reported experiencing severe pain (rating 7-10). Across all pain types, a quarter of those with pain reported their pain to be extremely bothersome. Identifiable risk factors for intensity and bothersomeness of amputation-related pain varied greatly by pain site. However, across all pain types, depressive symptoms were found to be a significant predictor of level of pain intensity and bothersomeness. Chronic pain is highly prevalent among persons with limb loss, regardless of time since amputation. A common predictor of an increased level of intensity and bothersomeness among all pain sites was the presence of depressive symptoms. Further studies are needed to elucidate the relationship between pain and depressive symptoms among amputees.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Pain Res
                Journal ID (iso-abbrev): J Pain Res
                Journal ID (publisher-id): jpr
                Journal ID (pmc): jpainres
                Title: Journal of Pain Research
                Publisher: Dove
                ISSN (Electronic): 1178-7090
                Publication date (Electronic): 18 December 2020
                Publication date Collection: 2020
                Volume: 13
                Pages: 3437-3445
                Affiliations
                [1 ]Department of Pain Management, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital , Shanghai, 200233, People’s Republic of China
                [2 ]Institutes of Brain Science, Fudan University , Shanghai 200032, People’s Republic of China
                [3 ]Center for Translational Pain Medicine, Department of Anesthesiology, Duke University School of Medicine , Durham, NC 27710, USA
                Author notes
                Correspondence: Dongping Du Department of Pain Management, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital , Shanghai200233, People’s Republic of ChinaTel +86 21 2405 8896Fax +86 21 2405 8330 Email dudp@sjtu.edu.cn
                Author information
                http://orcid.org/0000-0003-3227-0155
                Article
                Publisher ID: 283986
                DOI: 10.2147/JPR.S283986
                PMC ID: 7755346
                PubMed ID: 33376389
                SO-VID: f3ca5612-1764-4c05-aae9-82b0f7c84736
                Copyright © © 2020 Pu et al.
                License:

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                Date received : 01 October 2020
                Date accepted : 09 December 2020
                Page count
                Figures: 5, Tables: 3, References: 29, Pages: 9
                Categories
                Subject: Clinical Trial Report

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: postamputation pain,neuroma,ultrasonography-guided,radiofrequency ablation
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: postamputation pain, neuroma, ultrasonography-guided, radiofrequency ablation

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