Successful treatment of phantom limb pain and phantom limb sensation in the traumatic amputee using scalp acupuncture

Up to 80% of amputees report phantom limb pain (PLP), the management of which remains a considerable challenge. Here I describe the successful treatment with scalp acupuncture (SA) of a woman with PLP. A 71-year-old woman with no significant medical history was injured in a road-traffic accident in January 2010, leaving her with a fracture of the right elbow and right scapula, and multiple lacerations in her left foot and right inguinal area. The fracture caused displacement of the middle third of her right radius from the distal end of her right ulna. This, combined with other fractures in the fifth metacarpal bone and the proximal phalanx, resulted in almost total traumatic amputation. Her right arm was amputated surgically below the elbow. Recurrent wound infections occurred in her right forearm stump. As a result she underwent three debridement operations and split-thickness skin graft surgery. A skin rash, diagnosed as erythema multiforme, developed over the upper trunk after the operation. Steroid treatment stabilised the condition. After a hospital stay of about 1.5 months, she was discharged with outpatient follow-up. The woman had PLP and phantom limb sensation (PLS) after the surgical amputation. She described this as “severe numbness and pain from the phantom fingers and through her right forearm stump”, and could feel the missing limb’s position in space and even attempted to use it to reach for objects. She took pharmacological agents such as barbiturates, muscle relaxants, antidepressants, analgesics, etc, for almost 2 years. However, the drugs did not relieve her PLP. The pain persisted throughout the night, affecting her sleep and overall quality of life. As the drugs were ineffective and various side effects occurred she decided to stop taking them.