Psychotherapeutic modalities for phantom limb pain: a scoping review.

Abstract

Objectives: To review the literature regarding psychotherapeutic modalities for phantom limb pain (PLP).

Methods: The PubMed, ScienceDirect, and Scopus databases were searched to identify English-language studies, including review articles, related to psychotherapeutic modalities for PLP published before December 2024. Non-English-language studies, books, book chapters, or unpublished literature were excluded.

Results: In total, 55 studies were included in the analysis. There were 28 original studies (such as randomised controlled trials, clinical trials, observational studies, experimental studies, pilot studies, cohort studies, etc), 16 case reports or case series, nine systematic or narrative reviews, one case report with review, and one Delphi study. The most commonly used modality for PLP was mirror therapy, followed by virtual reality or augmented reality therapy, motor imagery, hypnotherapy, eye movement desensitisation and reprocessing, graded motor imagery, virtual feedback, biofeedback, imaginative resonance training, cognitive behavioural therapy, auditory feedback, neurofeedback, thermal biofeedback, illusory touch, mental imagery, group therapy, and phantom exercises.

Conclusion: PLP is a complex condition encompassing physiological, psychological, and social factors. Due to its biopsychosocial nature, pharmacological treatments alone provide limited relief. Psychotherapeutic modalities have demonstrated effectiveness in treating PLP. Mirror therapy and virtual/augmented reality therapy are among the most commonly used modalities. The combined use of multiple psychotherapeutic modalities is more beneficial than standalone approaches.