Accelerating the translation of research findings to clinical practice: insights from phantom limb pain clinical trials.

Abstract

Phantom limb pain (PLP) is defined as a painful sensation in an amputated limb or pain that follows partial or complete deafferentation. It belongs to a group of neuropathic pain syndromes, and its treatment is challenging and often refractory to many modalities, causing significant burden and suffering. The prevalence of PLP after amputation ranges between 60–80% (Limakatso et al., 2020). In some cases, the pain might decrease with time and even fade away, but studies have shown that even after two years, a majority of the patients still present pain, and only a small percentage have reported a decrease in intensity of pain (Erlenwein et al., 2021). To date, there is no guidelines for the treatment of PLP and most therapies have low levels of evidence. Possible treatments include the use of pharmacotherapy including opioids, antidepressants, neuroleptics, muscle relaxants and anticonvulsants (Flor, 2002), a variety of surgical procedures (Nikolajsen & Christensen, 2015), nerve blocks, local anesthesia, transcutaneous electrical nerve stimulation (TENS) (Kern et al., 2012), acupuncture, psychological interventions, physiotherapy, and mind-body techniques such as hypnosis(Bamford, 2006; Moura et al., 2012). Conventional treatments used for PLP, such as pharmacologic agents, have pertinent limitations. The use of pharmacologic agents for controlling pain is associated with several side effects and can become unsustainable in the long term (Els et al.,