Residual limb pain is not a diagnosis: a proposed algorithm to classify postamputation pain.

dc.contributor.author

Clarke, Collin

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Lindsay, David R

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Pyati, Srinivas

dc.contributor.author

Buchheit, Thomas

dc.date.accessioned

2019-12-23T13:50:59Z

dc.date.available

2019-12-23T13:50:59Z

dc.date.issued

2013-06

dc.date.updated

2019-12-23T13:50:59Z

dc.description.abstract

BACKGROUND: Although postamputation pain (PAP) syndromes have been described since the 16th century, taxonomy of these conditions remains ill-defined. The term "Residual Limb Pain" fails to distinguish between distinct diagnostic entities such as neuroma, complex regional pain syndrome, and somatic pathology. Even phantom limb pain (PLP), although easily distinguished from residual limb pain (RLP), has not been consistently delineated from other PAP syndromes. METHODS: A systematic review of the literature was conducted to identify the degree of delineation of various post amputation pain states and what diagnostic criteria were utilized if any. Furthermore, papers that involved treatment modalities were reviewed to determine efficacy of treatment. RESULTS: Of the 151 papers reviewed, none further categorized RLP into more specific diagnostic criteria. Furthermore, the literature contains numerous case reports, case series, letters to the editors, and grossly underpowered studies demonstrating significant positive results, yet few high-quality randomized controlled trials. CONCLUSIONS: Describing and defining the distinct clinical entities, intuitively, is a prerequisite to developing optimal treatments. The reported variation in the incidence of PAP phenomena may well represent inconsistency in assessment tools and diagnostic categories rather than variation in prevalence of these conditions. In this paper, we review the historical evolution of the current understanding of these syndromes and propose an algorithm for uniform classification.

dc.identifier.issn

0749-8047

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1536-5409

dc.identifier.uri

https://hdl.handle.net/10161/19644

dc.language

eng

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Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

The Clinical journal of pain

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10.1097/ajp.0b013e318261c9f9

dc.subject

Humans

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Phantom Limb

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Pain

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Pain Measurement

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Amputation

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Algorithms

dc.title

Residual limb pain is not a diagnosis: a proposed algorithm to classify postamputation pain.

dc.type

Journal article

duke.contributor.orcid

Buchheit, Thomas|0000-0001-8586-0365

pubs.begin-page

551

pubs.end-page

562

pubs.issue

6

pubs.organisational-group

School of Medicine

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Duke

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Anesthesiology, VA Anesthesiology Service

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Anesthesiology

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Clinical Science Departments

pubs.organisational-group

Anesthesiology, Regional

pubs.publication-status

Published

pubs.volume

29

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