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Restoring touch perception for individuals with upper extremity limb loss is an ambitious task. It is important to understand how persons with upper limb loss think this would be best achieved.An anonymous online survey was developed to obtain data from prosthetic users. Participants ranked the perceived acceptability and effectiveness of noninvasive sensory feedback to areas of intact sensation not typically involved in sensory feedback (i.e., the arm). The focus was on 4 main types of haptic information-object contact, proprioception, surface texture, and grasp force-as well as how best to convey those senses with various stimuli. The users were asked to grade themselves in certain tasks and then analyze which tasks would be improved with sensory feedback. Associations were explored between demographic characteristics and interest in sensory feedback.Nationally, prostheses providers sent more than 2000 email invitations to the online survey and received 142 unique responses. Responses indicated interest in sensory feedback through prosthetic limbs by individuals with upper limb loss. The most popular pairing of haptic information with sensory substitution was grasp force paired with gentle vibration. Tasks that most persons taking the survey agreed would benefit from sensory feedback were zipping a jacket, tying shoes, buttoning a shirt, and using a cup. No difference was observed in interest between sex and employment status, but a significant decrease (P = .004) was seen in interest among participants with more years of prosthetic use.The results from this national survey of upper extremity prosthetic users can be used to help guide the development of noninvasive sensory feedback options.

Phantom limb pain is characterized by painful sensations that emanate from portions of an amputated limb and has a prevalence estimated as high as 75–80%. Radiofrequency, which is used interventionally as either pain-ablation or neuromodulation for axial pain, has also been increasingly used for non-axial pain. To conduct a systematic review to determine the therapeutic response of radiofrequency techniques for post-amputation phantom limb pain. A comprehensive search of several databases from January 1, 2000, to November 23, 2020, was conducted. Eligible study designs included randomized controlled trials, prospective and retrospective studies, cross-sectional studies, case series, and case reports. The risk of bias was assessed using a tool specifically for assessing case series and case reports. We assessed the level of evidence using the Oxford tool and the quality of evidence with GRADE. A total of 98 articles were screened, with nine studies meeting inclusion criteria. Five studies had a moderate risk of bias, and four had a high risk of bias. All nine studies, including three case series and six case reports, discussed phantom limb pain treatment for fourteen patients by various radiofrequency techniques, including radiofrequency ablation, cooled radiofrequency ablation, pulsed radiofrequency, and low-temperature plasma radiofrequency ablation. Of the fourteen patients receiving one of the radiofrequency techniques, eleven (78.6%) received ≥ 50% pain relief post-intervention. No adverse effects were seen in any of the included studies. Despite the limited quantity and quality of evidence, radiofrequency techniques show potential therapeutic benefits for phantom limb pain.

Neuropathic pain (NP) can have either central nervous system causes or ones from the peripheral nervous system. This article will focus on the epidemiology, classifications, pathology, non-invasive treatments and invasive treatments as a general review of NP involving the peripheral nervous system. NP has characteristic symptomatology such as burning and electrical sensations. It occurs in up to 10% of the general population. Its frequency can be attributed to its occurrence in neck and back pain, diabetes and patients receiving chemotherapy. There are a wide range of pharmacologic options to control this type of pain and when such measures fail, numerous interventional methods can be employed such as nerve blocks and implanted stimulators. NP has a cost to the patient and society in terms of emotional consequences, quality of life, lost wages and the cost of assistance from the medical system and thus deserves serious consideration for prevention, treatment and control.