Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation

Objectives: To determine the characteristics of phantom limb sensation, pha ntom limb pain, and residual limb pain, and to evaluate pain-related disabi lity associated with phantom limb pain. Design: Retrospective, cross-sectional survey. Six or more months after low er limb amputation, participants (n = 255) completed an amputation pain que stionnaire that included several standardized pain measures. Setting: Community-based survey from clinical databases. Participants: A community-based sample of persons with lower limb amputatio ns. Main Outcome Measures: Frequency, duration, intensity, and quality of phant om limb and residual limb pain, and pain-related disability as measured by the Chronic Pain Grade. Results: Of the respondents, 79% reported phantom limb sensations, 72% repo rted phantom limb pain, and 74% reported residual limb pain. Many described their phantom limb and residual limb pain as episodic and not particularly bothersome. Most participants with phantom limb pain were classified into the two low pain-related disability categories: grade I, low disability/low pain intensity (47%) or grade Il, low disability/high pain intensity (28%) . Many participants reported having pain in other anatomic locations, inclu ding the back (52%). Conclusions: Phantom limb and residual limb pain are common after a lower l imb amputation. For most, the pain is episodic and not particularly disabli ng. However, for a notable subset, the pain may be quite disabling. Pain af ter amputation should be viewed from a broad perspective that considers oth er anatomic sites as well as the impact of pain on functioning.