Decrease in phantom limb pain associated with prosthesis-induced increaseduse of an amputation stump in humans

The experience of phantom limb pain, non-painful phantom limb sensation and telescoping was ascertained by questionnaire in a group of upper extremity amputees wearing a functionally effective Sauerbruch prosthesis which perm its extensive use of the affected limb and in a group of patients wearing a cosmetic prosthesis that did little to increase the utilization of the amp utation stump. The Sauerbruch prosthesis group exhibited a significant and large decrease in amount of phantom limb pain while the cosmetic prosthesis group showed no change. Neither group experienced a decrease in non-painfu l phantom limb sensation or telescoping. The amount of phantom limb pain ha s been found to be highly correlated with the amount of injury-related, aff erent-decrease cortical reorganization. It is possible that the increased u se of the amputation stump induced by wearing a Sauerbruch prosthesis produ ced a countervailing use-dependent, afferent-increase type of cortical reor ganization that reversed the phantom limb pain. These preliminary results r equire replication. Their therapeutic implications are discussed. (C) 1999 Elsevier Science Ltd. All rights reserved.