Factors associated with phantom limb pain

Abstract

BackgroundPhantom limb pain (PLP) occurs with concerning frequency in patients after extremity amputation. However, the factors that influence or predict its onset are not clear. MethodsWe performed a cross-sectional chart review of all patients at our community hospital who underwent lower extremity amputation and separated groups into those who developed PLP and those who did not. Comparisons were then made between the two groups. ResultsA total of 64 limbs in 61 patients were evaluated. Our results suggested that preoperative comorbidities cannot be used to predict postoperative PLP. However, higher visual analog scale pain scores immediately after surgery (PLP 8.5 vs non-PLP 6.0; P = .022) and at first follow-up appointment (PLP 1.0 [0-5] vs non-PLP 0 [0-0]; P = .005) were associated with patients later developing PLP. Similarly, a patient's ability to ambulate before and after surgery also showed a positive association with later PLP (P = .047). ConclusionsOur results suggest a central nervous system-mediated theory on the etiology of PLP, which has been supported previously in the literature.