Article

While phantom limb pain is a well-recognized phenomenon, clinical experience has
suggested that the augmentation of phantom limb pain with visceral stimulation is
an issue for many military personnel with amputation (visceral stimulation being
the sensation of the bowel or bladder either filling or evacuating). However, the
prevalence of this phenomenon is not known. The aim of this study was to
investigate the prevalence of the alteration in phantom limb pain and the effect
that visceral stimulation has on phantom limb pain intensity. A cross-sectional
study of 75 military personnel who have lost one or both lower limbs completed a
questionnaire to assess the prevalence of the alteration of phantom limb pain
with visceral stimulation. Included in the questionnaire was a pain visual analog
scale (VAS) graded from 0 to 10. Patients recorded the presence and intensity of
phantom limb pain. They also recorded whether and how this pain altered with a
need to micturate or micturition, and/or a need to defecate or defecation, again
using a pain VAS. Time since amputation, level of amputation, and medications
were also recorded. Patients reported a phantom limb pain prevalence of 85% with
a mean VAS of 3.6. In all, 56% of patients reported a change in the severity of
phantom limb pain with visceral stimuli. The mean increase in VAS for visceral
stimulation was 2.5 +/- 1.6 for bladder stimulation and 2.9 +/- 2.0 for bowel
stimulation. Of the patients questioned, 65% reported an improvement in symptoms
over time. VAS scores were highest in the subgroup less than 6 mo postamputation.
An increase in phantom limb pain with visceral stimulation is a common problem
for military personnel with amputation.

Langue : ANGLAIS