Variation in phantom limb pain: Results of a diary study

Amputees experience multiple, complex problems in addition to phantom limb pain. Although studies have yielded useful data on the relationship between phantom limb pain and other variables, this research generally has evaluat ed only one aspect of phantom limb pain and measured it at only one time po int. The present study examined ongoing phantom limb pain and associated fa ctors prospectively through the use of hourly pain diaries that are complet ed over a 7-day period. The sample comprised a subset of 89 lower limb ampu tees taking part in a longitudinal research study. Subjects had a mean age of 46.1 years. Forty-seven per cent were female, 53% mate. Subjects complet ed a Pain/Coping Diary that measured phantom limb pain intensity, activity levels, medication use, and alcohol use on an hourly, basis over a 7-day pe riod. It also asked subjects to list the coping strategies used on the same hourly basis over a 7-day period. The diaries highlighted the following: P hantom limb pain appears to be episodic in nature and there is great variat ion in its intensity. Amputees use a limited repertoire of coping strategie s to deal with episodes of phantom limb pain, and of those strategies that are used, few reduce the level of pain. This variability in phantom limb pa in has important implications for those involved in the care of amputees as a report of phantom limb pain at a given point in time may not reflect the amputee's overall pain experience. J Pain Symptom Manage 2001: 22:947-953. (C) U.S. Cancer Pain Relief Committee, 2001.