engleski

Characteristics of phantom limb pain in lower limb amputees – experience during prosthetic supplyY

Introduction/Aims: The amputation of a limb is commonly followed by the sensation that the body part that has been cut off is still present. These phantom sensations in 50-80 % of patients are painful. Phantom limb pain must be differentiated from nonpainful phantom phenomena, residual-limb pain, and nonpainful residual-limb phenomena. The aim of this study was to determine the characteristics of post-amputation phantom limb pain in lower limb amputees during prosthetic supply. Patients/Methods: Data were collected in unit of prosthetics in medical rehabilitation hospital during 2012. Lower limb amputees attending the prosthetic supply were administered a questionnaire survey of their pain experiences. Forty-five amputees participated in the study. A questionnaire assessed the following questions: cause of amputation, date, preamputation pain, presence or absence of phantom pain, intensity of pain (visual analogue scale), phantom and residual-limb sensations, residual- limb pain and therapy. Results: Forty-five lower limb amputees (thirty males and sixteen females ; mean age 66.15 years) completed the questionnaire survey. Mean time since amputation to admission for prosthetic supply was 4.26 months. According to the level of amputations there were: 28 trans-femoral, 9 trans-tibial, 7 bilateral amputations and 1 hip disarticulation. The most common diseases that resulted in amputation were: obstructive vascular diseases 42.22% ; both obstructive vascular disease and diabetes mellitus 31.11% ; diabetes mellitus 20.00% and trauma 6.66%. The prevalence ofphantom limb pain was 46.66%, phantom limb sensation 80.00% and residual-limb pain 31.11%. Phantom limb pain occurred immediately after amputation in 16 (35.55%) amputees and between 1 month and 6 months in 5 (11.11%) amputees. Average VAS pain intensity was 5.19. Six amputees (13.33%) had feeling of persistent pain and others reported episodic pain with no need for continuous treatment. One patient has twice had surgery for recurrent neuromas. Preamputation pain has existed in 51.11% of amputees in seven days to nine years time frame. Conclusion: The study suggests that phantom limb pain, phantom limb sensation and residual limb pain are common after a lower limb amputation. For most, the pain was episodic and not particularly disabling. However, refractory pain may significantly worsen the functioning of patients and result in poor quality of life.

phantom limb pain ; lower limb amputees ; prosthetic supply

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