Content » Vol 41, Issue 6

Original report

Phantom limb pain relief by contralateral myofascial injection with local anaesthetic in a placebo-controlled study: Preliminary results

Roberto Casale, Francesco Ceccherelli , Alaa Abd Elaziz Mohamed Labeeb, Gabriele Biella
DOI: 10.2340/16501977-0353


Objective: To ascertain the existence of contralateral painful muscle areas mirroring phantom pain and to evaluate the short-term effects of anaesthetic vs saline, injected contra¬laterally to control phantom and phantom limb pain.
Design: Double-blinded cross-over study.
Setting: Inpatients; rehabilitation institute.
Participants: Eight lower limb amputees with phantom limb pain in the past 6 months.
Interventions: Either 1 ml of 0. 25% bupivacaine or 0. 9% saline injected alternately in each point with a 28-gauge needle, with 72 h between injections.
Main outcome measure: Phantom sensation modification and the intensity of phantom limb pain (visual analogue scale) before and after injections.
Results: Although present, painful muscle areas in the healthy limb do not mirror the topographical distribution of phantom limb pain. Sixty minutes after the injection, a statistically significant greater relief of phantom limb pain was observed after using local anaesthetic than when using saline injection (p = 0. 003). Bupivacaine consistently reduced/abolished the phantom sensation in 6 out of 8 patients. These effects on phantom sensation were not observed after saline injections.
Conclusion: Contralateral injections of 1 ml 0. 25% bupivacaine in myofascial hyperalgesic areas attenuated phantom limb pain and affected phantom limb sensation. The clinical importance of this treatment method requires further investigation.

Lay Abstract


Do you want to comment on this paper? The comments will show up here and if appropriate the comments will also separately be forwarded to the authors. You need to login/create an account to comment on articles. Click here to login/create an account.