Cognitive Behavioral Therapy for Postamputation Chronic Pain: A Case Report

Abstract

Limb amputation has a significant impact on an individual, not only physically but emotionally. Consequences of both traumatic and atraumatic amputations are vast and can result in functional disability, impaired emotional functioning, and changes in overall quality of life. These consequences may be further complicated by the development of chronic pain. Traditional management of postamputation chronic pain often involves invasive procedures and pharmacotherapy. While research notes behavioral interventions, such as cognitive-behavioral therapy (CBT) as a viable treatment alternative for chronic pain, there is no literature supporting CBT for postamputation chronic pain. In this case report, we present a 63-year-old male lower limb amputee complicated with chronic pain who experienced pain reduction and improved quality of life following manualized treatment with CBT for chronic pain. Treatment took place over 12 sessions with fidelity (93%) being measured throughout to ensure accurate utilization of the treatment manual. As part of the treatment manual, self-report measures (Pain Rating Scale, Pain Catastrophizing Scale, Pain Outcomes Questionnaire, and subjective units of distress) were used throughout to track patient progress. All measures showed improvement with the biggest gains being seen in pain ratings and pain catastrophizing.