Treatment of Phantom Limb Pain with Laser and Needle Auricular Acupuncture: A Case Report

Background: Amputees often report the sensation of phantom limb pain. Medications and nonpharmacologic therapies do not always improve symptoms. Objective: To describe treatment of phantom limb pain with laser and needle auricular acupuncture. Design, Setting, and Patient: A 25-year-old male military amputee with phantom limb pain underwent treatment with laser and needle auricular acupuncture in the fall of 2010. Pain intensity was typically rated from 4/10 to 0/10 during the day and 7/10 in the evening. His medications included methadone, memantine, pregabalin, and oxycodone as needed. Nonpharmacologic therapies included massage, physical therapy, and compression bandage. Intervention: Auricular acupuncture was performed on the left ear with a low-level laser device (output <= 5mW) at a frequency of 650 nm onto the cingulate gyrus point, with light pressure. The patient was offered needle auricular acupuncture but declined. Main Outcome Measure: Patient-reported phantom limb pain. Results: After approximately 30 seconds, the patient reported that the pain was eliminated completely (0/10). He reported that the pain relief lasted approximately 4 hours. The pain then gradually increased. Eight days later, the patient requested additional auricular acupuncture for the same phantom limb pain. The laser device was not available, so needle auricular acupuncture was performed. After 1 minute, the patient reported reduction of his pain (from 9/10 to 5/10). Upon questioning the next day, he reported that his pain remained under satisfactory control. Conclusions: Acupuncture treatment for phantom limb pain has been described in the literature in a few case reports and case series, but data are limited on the use of laser and needle acupuncture for this purpose. Auricular acupuncture may be a simple, cost-effective, and useful adjunct for the treatment of hospitalized and outpatient amputees with phantom limb pain and should be researched further.