Acupuncture for Amputees?

Acupuncture as an Adjuvant Therapy in the Treatment of Phantom Limb Syndrome:

A Study Proposal

Background

Phantom Limb Syndrome (PLS), Phantom Limb Pain (PLP), and Residual Limb Pain (RLP) are common complications following limb amputation and represent a significant clinical challenge. These conditions are associated with complex multifactorial mechanisms involving peripheral nerve injury, central nervous system reorganisation, and psychological factors. Despite the availability of pharmacological and non-pharmacological treatments, conventional therapies often provide incomplete symptom control, leading to persistent pain, impaired sleep, and reduced quality of life. Acupuncture has been increasingly investigated as a complementary therapeutic approach for chronic pain conditions, including Phantom Limb Syndrome.

Objectives

This thesis aims to explore the potential role of acupuncture as an adjuvant therapy in the management of Phantom Limb Syndrome. The objectives are to review the current understanding of the pathophysiology and treatment of phantom limb conditions, examine the theoretical framework and therapeutic principles of Traditional Chinese Medicine (TCM), and propose a clinical study investigating the effectiveness of acupuncture combined with conventional therapy.

Methods

The work includes a narrative review of the literature on Phantom Limb Syndrome and Acupuncture, an analysis of diagnostic and therapeutic principles according to TCM, and the presentation of a clinical case report. The case report describes a patient with long-standing phantom limb pain following lower limb amputation who underwent acupuncture treatment using a two-phase approach: an initial symptomatic phase based on the Balance Method and a second phase aimed at restoring the circulation of Qi and Blood and addressing psychological components through Shen-regulating points. Based on the clinical experience and literature review, a randomised controlled study design is proposed to compare conventional postoperative therapy alone versus conventional therapy combined with acupuncture.

Results

In the presented case, acupuncture treatment was associated with a progressive reduction in pain episodes, improvement in sleep quality, and overall enhancement of psychological well-being and quality of life. The patient reported complete resolution of episodic phantom limb pain and significant improvement in functional status without adverse effects.

Conclusions

Acupuncture may represent a promising complementary therapy for the management of Phantom Limb Syndrome, potentially improving pain control, psychological well-being, and quality of life while reducing reliance on pharmacological treatments. However, current evidence remains limited, and well-designed randomised controlled trials are needed to confirm its effectiveness and define standardised treatment protocols.

Keywords: Phantom Limb Syndrome; Phantom Limb Pain; Residual Limb Pain; Acupuncture; Traditional Chinese Medicine; Chronic Pain; Rehabilitation.