Contralateral Stimulation, Using TENS, of Phantom Limb Pain: Two Confirmatory Cases

Abstract

OBJECTIVES: This study aims to evaluate the effectiveness of trans-electric nerve stimulation (TENS) for phantom limb pain applied to contralateral limb (nonamputated limb). DESIGN: Two detailed single case studies using TENS on the contralateral limb are reported in a longitudinal study with one-year follow-up. Five variables were measured across this period. The study comprised of five sequential stages (Pre-assessment, Preliminary baseline, Start of intervention, Extended assessment, One-year follow-up). SETTING AND PATIENTS: Patients were identified at the Rookwood Hospital in Cardiff. They subsequently received regular home visits. The first patient was a 24-year-old male who had suffered a left below-elbow amputation following a car crash. The second patient was a 38-year-old male who had a transfemoral right amputation further to a viral infection. MEASURES: The following semistructured interview and questionnaires were used: McGill Comprehensive pain questionnaire part A and B; The Cambridge Phantom Limb Profile; The Groningen Questionnaire: Problems after Arm Amputation; and 13 Visual Analog Scales. CONCLUSIONS: Both patients showed a significant improvement in their perception of phantom limb pain and sensations that was maintained at one-year follow-up. A randomized blinded controlled trial to confirm these positive outcomes is required.