Phantom Limb, Residual Limb, and Back Pain After Lower Extremity Amputations

TLDR

The study describes sensations and pain reported by individuals with unilateral lower extremity amputations. Participants (n = 92) completed the Prosthesis Evaluation Questionnaire, reporting frequency, intensity, and bothersomeness of phantom limb, residual limb, and back pain (and nonpainful phantom limb sensations) and medication use via visual analog scales. Nonpainful phantom limb sensations were most frequent, while residual limb and back pain were common; back pain was more bothersome and more prevalent in above‑knee amputees, underscoring the need to view pain multidimensionally and to address this often overlooked issue.

Abstract

This study describes the sensations and pain reported by persons with unilateral lower extremity amputations. Participants (n = 92) were recruited from two hospitals to complete the Prosthesis Evaluation Questionnaire which included questions about amputation related sensations and pain. Using a visual analog scale, participants reported the frequency, intensity, and bothersomeness of phantom limb, residual limb, and back pain and nonpainful phantom limb sensations. A survey of medication use for each category of sensations also was included. Statistical analyses revealed that nonpainful phantom limb sensations were common and more frequent than phantom limb pain. Residual limb pain and back pain were also common after amputation. Back pain surprisingly was rated as more bothersome than phantom limb pain or residual limb pain. Back pain was significantly more common in persons with above knee amputations. These results support the importance of looking at pain as a multidimensional rather than a unidimensional construct. They also suggest that back pain after lower extremity amputation may be an overlooked but very important pain problem warranting additional clinical attention and study.