Prosthetic Categories

Using Electroacupuncture To Relieve Phantom Limb Pain

    It's widely known that most individuals with limb loss will experience phantom limb pain, a condition that significantly affects sleep and rehabilitation outcomes. For years, the medical community has been confounded by phantom pain and has allotted resources to find the best treatments.

     Electroacupuncture is a promising treatment for phantom limb pain.

    Existing scientific evidence consists of various clinical reports describing drugs and interventional techniques to treat phantom limb pain. And recent approaches to restoring the patient's sensory-motor input have shown promise. One such promising treatment is electroacupuncture.

    A recently published paper detailed the case study of a male in his 30s who underwent above-knee amputation resulting from a car accident. Upon discharge from the hospital, he was prescribed 900 mg gabapentin three times a day and 3.75 mg zopiclone, a sleeping pill, as needed. However, despite taking his medication, the patient only felt minimal pain relief. He also experienced significant side effects, including loss of alertness and focus, as well as increased fatigue.

    Upon discharge from the hospital, the patient was prescribed 900 mg gabapentin three times a day and 3.75 mg zopiclone, a sleeping pill.

    To address his phantom limb pain, the patient checked into a private facility to avail of treatments like graded motor imagery and education on sleep strategies. The pain the patient experienced was quantified through the Brief Pain Inventory (BPI), a pain assessment tool that determines how pain impacts functioning. After the various treatments, his BPI score decreased from 46 to 35. However, he didn't experience any discernible improvement in his phantom limb pain.     

    Electroacupuncture Treatment  

    Seven months after the accident, Holly King, MCSP, one of the study's authors, began working with the patient as his specialist amputee physiotherapist. Despite being skeptical of electroacupuncture, the patient consented to receive the treatment.  His starting pain was 7-9/10 on VAS and BPI 35.

    Treatment started immediately. His starting pain was measured using the BPI (35) and the VAS pain scale (7 to 9/10). Eight needles were placed in the central lumbar paraspinal, and two needles were placed in sensitized areas in the residual limb.

    The electroacupuncture intensity was high at 2.0 to 3.0 mAmp and was controlled by the patient. For six weeks, the patient underwent 40 minutes of electroacupuncture once a week. The frequency was reduced to fortnightly for another six weeks.  

    Treatment Results  

    The patient felt an improvement soon after the first session. He reported a significant reduction in phantom limb pain intensity and frequency. And for the first time since the accident, the patient could get four hours of uninterrupted sleep.

    Four sessions in the treatment plan, the patient had his gabapentin prescription reduced from 900 to 800 mg three times a day. He also stopped taking the sleeping pill. He reported consistently getting better sleep; phantom limb pain no longer woke him up.

    Six sessions in, the patient reduced his gabapentin dosage to 600 mg three times a day, and after eight sessions, he further decreased the dosage to 400 mg gabapentin twice a day. His phantom limb pain was also reduced to 5/10 on the VAS scale.  

    Over three months, the patient had nine electroacupuncture sessions. A single treatment provided up to five days of pain relief; the pain became less intense—reduced to 4 to 6/10 on the VAS pain scale. The case study quoted the patient saying, "I feel better with less medication and feel less spaced-out."

    Over three months of treatment, the patient's pain became less intense—from 7 to 9/10 to 4 to 6/10 on the VAS pain scale.

    A year after the accident, the patient continues to receive electroacupuncture every four to five weeks. He also goes through weekly physiotherapy interventions. His phantom limb pain is significantly better, occurring only one night a week and lasts for no more than an hour. Meanwhile, his BPI score is now 18. He has also stopped taking all his medication and can sleep seven to eight hours a night.

    The study's authors concluded the paper by saying that electroacupuncture is a safe treatment method for amputees, whether lower-limb or upper-limb loss.

    What do you think of electroacupuncture? Would you avail of this treatment to relieve your phantom limb pain?