Phantom Pain, Phantom Sensation, and Spine Pain in Bilateral Lower Limb Amputees: Results of a National Survey of Iraq-Iran War Victims' Health Status

Abstract

In Brief To determine the prevalence and characteristics of phantom limb pain, phantom limb sensation, and spine pain and to evaluate their relevance to the various levels of amputation. This is a retrospective, cross-sectional survey. All bilateral lower limb amputees with war-related amputations sustained from 1980 to 2006 were invited by Janbazan Medical and Engineering Research Center to participate in a retrospective, cross-sectional study. Most of them participated (n = 335) and, after giving consent, underwent thorough assessment and examination by three physiatrists, including completion of a detailed questionnaire. Information was analyzed and compared with other literature. Prevalence, intensity, patient's perception of the impact on their quality of life, phantom sensation, prevalence of various levels of spine pain (neck, back, and low back), characteristics of amputation, and prosthetic use are the main outcome measures. The majority of participants were men (97.6%), who aged from 18 to 70 years (mean = 42); 97.6% were married, and 73.1% had a job. The most common cause of injury leading to amputation was trauma, suffered from artillery and mortar shells. The most common level of amputation was transtibial (53%), with 94% being prosthesis users. Low back pain was the most common complaint (53%) relative to spine involvement. The overall prevalence of phantom limb pain and phantom sensation was 64% and 83%, respectively. Phantom limb pain or sensation is highly prevalent in war-related amputees; however, only a minor proportion experience severe pain or sensation. There was not any relevance of phantom limb pain or sensation to the level of limb amputation. This study aimed to determine the prevalence and characteristics of phantom limb pain, phantom limb sensation, and spine pain, and evaluate their relevance to the various levels of amputation. Phantom limb pain/sensation is highly prevalent in war-related amputees; however, only a minor proportion experience severe pain or sensation. There was not any relevance of phantom limb pain/sensation to the level of limb amputation.