Presentation summary

Co-Authors : 
VU TRI Doan,
MD, PMR, Institut Merle D’Aubigne- Valenton, France.
SAUTREUIL Patrick,
MD, PMR, Chairman Icmart

In our Institute, and on a permanent basis, we take care of about a hundred amputees for rehabilitation andlimb fittings.
The causes of their multiple limb losses are varied: arterial disease, diabetes, septic shock, road accidents,attacks, war trauma, etc.

Without counting neuropsychiatric causes, we have distinguished ten forms of amputated pain, and in order offrequency : conflicts with prosthesis, myofascial trigger points, causalgia, phantom limbs (hallucinosis, algohallucinosis), allodynias, hypersensitive scar, osteoma (exostosis), vascular cause (arterial ischemia,venous thrombosis), pathological neuroma, algodystrophy.

The amputee’s pain, which interferes with his equipment, is known to be complex and requires a wide range oftherapeutic measures : physiotherapy, chemotherapy, hypnosis, neurosurgery, etc.

It should be noted that the usual medications, morphine, antiepileptics (gabapentin, pregabalin), with all their side effects, only partially control the suffering of the patient who has to walk with a prosthesis.

Acupuncture, which is time-consuming, is deployed as a second line of treatment in the event of failure of conventional therapies.

Pain can affect several residual limbs of the same patient who no longer have intact meridians, which requiresus to develop a strategy with a precise mapping of the points to be punctuated, adapted to their residual anatomy.

We systematically combine auriculotherapy, based on the Battlefield acupuncture protocol, which is a greathelp for our amputee patients.

We report five clinical cases of recently amputated patients with five different types of pain to illustrate ourcurrent practice with varying degrees of success.