The experience of phantom limb pain in patients with combat-related traumatic amputations

Arch Phys Med Rehabil. 2008 Jun;89(6):1127-32. doi: 10.1016/j.apmr.2007.11.037.


Objectives: To describe the prevalence and characteristics of phantom limb pain (PLP) and the use and perceived effectiveness of standard medical and self-treatment methods by traumatic amputees with combat-related injuries.

Design: A retrospective descriptive questionnaire study.

Setting: Outpatient amputee clinic at a major military medical center.

Participants: Convenience sample of military members (N=30) with single or multiple traumatic amputations from combat and/or training. Inclusion criteria were 18 to 50 years old and amputation within 5 years of the study. Exclusion criteria were nontraumatic amputees and amputation or most recent surgical revision within 3 months before the study.

Interventions: Not applicable.

Main outcome measures: The primary dependent variables were pain and relief, as measured by an investigator-developed questionnaire.

Results: Seventy-seven percent of participants experienced PLP at some time since their amputation. Of those with PLP, the mean average intensity was 3.3+/-2.0 out of 10 and the mean worst intensity was 5.4+/-2.6 out of 10. The PLP was intermittent, and 78% reported episodes of PLP at least weekly. Sixty-eight percent of participants with PLP were receiving treatment from their health care providers. The most common medical treatment was gabapentin, although some patients reported greater pain relief from self-treatment methods such as distraction and relaxation techniques.

Conclusions: With over 750 service members living with amputations from recent combat, PLP will continue to be a troubling problem that requires effective interventions. The discrepancy between perceived effectiveness of different treatment types supports the need for highly individualized pain management plans.

MeSH terms

  • Adolescent
  • Adult
  • Amines / therapeutic use
  • Amputation, Traumatic / complications*
  • Amputation, Traumatic / psychology
  • Amputees / psychology*
  • Amputees / rehabilitation
  • Analgesics / therapeutic use
  • Cyclohexanecarboxylic Acids / therapeutic use
  • Gabapentin
  • Humans
  • Male
  • Middle Aged
  • Military Personnel*
  • Outpatient Clinics, Hospital
  • Pain Measurement
  • Phantom Limb / etiology*
  • Phantom Limb / psychology
  • Phantom Limb / therapy
  • Relaxation Therapy
  • Retrospective Studies
  • Surveys and Questionnaires
  • United States
  • gamma-Aminobutyric Acid / therapeutic use


  • Amines
  • Analgesics
  • Cyclohexanecarboxylic Acids
  • gamma-Aminobutyric Acid
  • Gabapentin