Regaining the intention to live after relief of intractable phantom limb pain: A case study.

Abstract

Objectives: Phantom limb pain (PLP) is common after limb amputation and can lead to chronic pain and psychosocial risks, potentially leading to suicide or euthanasia. This study aimed to explore the consequences of intractable PLP on a person's life before, during, and after receiving phantom motor imagery (PMI) treatment, focusing on the person's experiences with PMI and how it influenced his life and decision regarding euthanasia.

Methods: This case study focused on a single participant from the PMI treatment group of a PLP randomized clinical trial (RCT). The participant, who joined the RCT as a last resort before euthanasia, experienced decreased PLP during the trial, but the pain returned 1 month post-treatment. Subsequently, the participant initiated self-administered PMI training at home. A mixed quantitative-qualitative method approach was used to analyze this case study.

Results: Understanding and living with PLP was challenging for the participant, making him lose interest in life. Despite starting with low expectations, the participant enjoyed PMI, particularly home training. PLP disappeared during the RCT, returned after therapy cessation, and vanished again during PMI home training. PMI returned his motivation to live, leading him to discontinue his plans for euthanasia.

Conclusions: This case illustrates the severity of chronic PLP, highlighting also the complex interaction of biopsychosocial factors in pain, which can lead a person to consider euthanasia. Representing the first use of PMI in a home setting, this study, along with previous studies in clinical setting, indicates PMI to be a promising and feasible innovative intervention for decreasing PLP, encouraging further research. This study also emphasizes the need to enhance PLP education among clinicians and people with amputations.