Vasanth Selvam, DO
Physician Resident
Mercy Hospital
Floral Park, New York, United States
Kevin Paul, DO
Physician
Mercy Hospital
Rockville Centre, New York, United States
Nivetha Srinivasan, MD
Physician Resident
Rutgers University
Jersey City, New Jersey, United States
Maryrose Zavaro, MMSc
Medical Student OMS IV
LECOM
El Cajon, California, United States
Thomas Jan, DO
Physician
Mercy Hospital
Rocville Centre, New York, United States
Phantom limb pain(PLP) is a distressing condition characterized by tingling, burning, and pain in the area of an amputated limb. The use of cryoneurolysis has demonstrated potential for providing pain relief and improved functional outcomes. This review evaluates the efficacy of cryoneurolysis in treating patients with phantom limb pain.
Design:
A total of 23 articles on phantom limb pain were reviewed, of which 12 specifically focused on the use of cryoneurolysis. These articles were identified through a PubMed search using key terms such as “phantom limb pain,” “post-amputee pain,” “cryoneurolysis,” and “cryoanalgesia,” either individually or in combination.
Results:
Phantom limb pain arises from complex interactions between peripheral nerve injury and central nervous system reorganization, often exacerbated by preoperative pain and neuroma formation. Cryoneurolysis involves applying temperatures around −70°C to ablate targeted peripheral nerves, inducing reversible neuronal injury and Wallerian degeneration. This technique aims to disrupt the peripheral pain signals contributing to PLP, providing pain relief and reducing symptom severity. Patients with PLP have shown pain reduction on the Visual Analog Scale(VAS) and Numeric Rating Scale(NRS) following cryoneurolysis. Patients have also shown improvement in functional outcomes according to the Roland-Morris Disability questionnaire following cryoneurolysis. Research indicates that cryoneurolysis provided the most pain relief in patients with trans-tibial amputation compared to amputations at other levels.
Conclusions:
Physiatrists focus on reducing pain and enhancing functional outcomes in post-amputee patients. Research indicates that cryoneurolysis can be an effective treatment for these patients, but a well-powered prospective randomized controlled trial is needed to assess the long-term benefits of this modality. As the population of military veterans living with limb amputations continues to grow, identifying effective long-term pain control methods becomes increasingly important.
