Phantom pain: natural history and association with rehabilitation

Ann R Coll Surg Engl. 1994 Jan;76(1):22-5.

Abstract

All 338 lower limb amputees under the care of one disablement services centre were asked to assess phantom pain severity at different times after amputation. Of 212 (63%) replies, 13 had died, 22 were non-limb wearers and 22 were unable to complete the questionnaire. In all, 176 useful replies were received--96 below-knee, 74 above-knee and 6 through-knee. Of these, 98 amputations were performed for trauma and 78 for vascular disease. Below-knee amputees rehabilitated better than above-knee amputees (P < 0.05) and traumatic better than vascular amputees (P < 0.0001). Preoperative pain was worse in vascular amputees (P < 0.0005), but there was no significant difference in the amount of phantom-pain experienced by vascular and traumatic amputees. Phantom sensations were experienced by 82% and phantom pain by 78%. Phantom pain decreased with time, was present equally in traumatic and vascular amputees, and was related to the amount of preoperative pain (P < 0.005). Only 22% felt phantom pain had impaired their rehabilitation. Rehabilitation score was related to phantom pain severity at the time of questionnaire completion (P < 0.05), but not at other specified times after operation.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amputation / adverse effects
  • Amputation / rehabilitation*
  • Humans
  • Leg / blood supply
  • Leg / surgery*
  • Leg Injuries / surgery
  • Middle Aged
  • Pain Measurement*
  • Phantom Limb / etiology*
  • Phantom Limb / physiopathology
  • Postoperative Period
  • Regional Blood Flow
  • Thigh / surgery
  • Vascular Diseases / surgery