Original articlePhantom Pain, Residual Limb Pain, and Back Pain in Amputees: Results of a National Survey
Section snippets
Study Design and Sample
The study was a cross-sectional survey design that was conducted as part of a larger project, the Limb Loss Research and Statistics Program (LLRSP). The LLRSP is a partnership between the Johns Hopkins University Bloomberg School of Public Health and the Amputee Coalition of America (ACA). Using an existing database, we identified 6500 amputees who had contacted the ACA between 1998 and 2000. Of these, we selected a sample of 1538 amputees stratified by etiology (608 persons with amputation
Measures
The survey consisted of 5 parts: (1) demographics and characteristics of the amputation; (2) general health and well-being; (3) measures of pain and depressed mood; (4) use and satisfaction with prosthesis; and (5) use and unmet needs for medical services. Our primary outcome measures for this analysis were phantom pain, residual limb pain, back pain, and nonamputated limb pain.
Characteristics of the Study Population
Of the 1538 persons identified for the survey, 182 were ineligible due to age (n=5; 2.2%), type or level of amputation (n=12; 6.6%), lack of an amputation (n=29; 15.9%), non-English speaking (n=6; 3.3%), physically or mentally unable to respond (n=19; 10.4%), or death or institutionalization (n=111; 61.0%). Of those eligible for participation, 960 (71.3%) completed the interview, of which 21 were conducted with a proxy respondent who resided in the home. One hundred forty-seven persons could
Discussion
Overall, 95% of amputees reported having 1 or more types of amputation-related pain during the preceding 4 weeks. The most common type of amputation-related pain cited was phantom limb pain (79.9%). Similar to previous reports, no statistically significant differences were found in the prevalence of phantom pain by etiology, age or level of amputation after controlling for other potential confounding factors.4, 6, 10 In a sample comprised of traumatic and dysvascular amputees, Houghton et al12
Conclusions
This is the first national survey to report the intensity of and risk factors for phantom pain, residual limb pain, and nonamputated limb pain in community-dwelling persons with limb loss. Chronic pain is highly prevalent among persons with limb loss regardless of time since amputation. While there are several identifiable risk factors for intensity and bothersomeness of amputation-related pain, these varied greatly by pain site. The size of our sample allows for control of multiple factors to
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Supported by the National Center for Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC; grant no. U59/CCU416733). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of CDC.
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