Pain in the amputee

1. What are the characteristics of incisional pain?
2. What is the etiology of phantom pain? What is the time course?
3. What are treatments for pain in amputees?

Answers:
1. Incisional pain should subside with healing and can persist if there is an unprotected neuroma (nerve ending left exposed).
2. Etiology is neuron deafferentation hyperexcitability, and it is described as cramping, aching, burning, and occ lancinating. 50-85% of amputees experience some phantom limb pain, and there is no correlation between phantom pain and time after amputation, but does not occur in congenital amputation. It usually diminishes with time.
3. Modalities, medications, psychological interventions. Procedures are generally less effective.