Following
amputation, 50% to 90% of individuals experience phantom and/or stump
pain.
Transcutaneous electrical nerve stimulation (
TENS) may prove to be a useful adjunct
analgesic intervention, although a recent systematic review was unable to judge effectiveness owing to lack of quality evidence. The aim of this pilot study was to gather data on the effect of
TENS on
phantom pain and stump
pain at rest and on movement. Ten individuals with a transtibial
amputation and persistent moderate-to-severe phantom and/or stump
pain were recruited. Inclusion criteria was a baseline
pain score of ≥3 using 0 to 10 numerical rating scale (NRS).
TENS was applied for 60 minutes to generate a strong but comfortable
TENS sensation at the site of stump
pain or projected into the site of
phantom pain. Outcomes at rest and on movement before and during
TENS at 30 minutes and 60 minutes were changes in the intensities of
pain, nonpainful
phantom sensation, and
prosthesis embodiment. Mean (SD)
pain intensity scores were reduced by 1.8 (1.6) at rest (P < 0.05) and 3.9 (1.9) on movement (P < 0.05) after 60 minutes of
TENS. For five participants, it was possible to project
TENS sensation into the
phantom limb by placing the
electrodes over transected afferent nerves. Nonpainful
phantom sensations and
prosthesis embodiment remained unchanged. This study has demonstrated that
TENS has potential for reducing
phantom pain and stump
pain at rest and on movement. Projecting
TENS sensation into the
phantom limb might facilitate perceptual embodiment of prosthetic limbs. The findings support the delivery of a feasibility trial.