title: Phantom pain: natural history and association with rehabilitation.
abstract: All 338 lower limb amputees under the care of one disablement services centre were asked to assess phantom pain severity at different times after amputation. Of 212 (63%) replies, 13 had died, 22 were non-limb wearers and 22 were unable to complete the questionnaire. In all, 176 useful replies were received--96 below-knee, 74 above-knee and 6 through-knee. Of these, 98 amputations were performed for trauma and 78 for vascular disease. Below-knee amputees rehabilitated better than above-knee amputees (P < 0.05) and traumatic better than vascular amputees (P < 0.0001). Preoperative pain was worse in vascular amputees (P < 0.0005), but there was no significant difference in the amount of phantom-pain experienced by vascular and traumatic amputees. Phantom sensations were experienced by 82% and phantom pain by 78%. Phantom pain decreased with time, was present equally in traumatic and vascular amputees, and was related to the amount of preoperative pain (P < 0.005). Only 22% felt phantom pain had impaired their rehabilitation. Rehabilitation score was related to phantom pain severity at the time of questionnaire completion (P < 0.05), but not at other specified times after operation.
authors.affiliation: Department of Surgery, Guy's Hospital, London.
authors.forename: A D
authors.initials: AD
authors.lastname: Houghton
authors.forename: G
authors.initials: G
authors.lastname: Nicholls
authors.forename: A L
authors.initials: AL
authors.lastname: Houghton
authors.forename: E
authors.initials: E
authors.lastname: Saadah
authors.forename: L
authors.initials: L
authors.lastname: McColl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical / Q000009:adverse effects / Q000534:rehabilitation*; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D007869:Leg Injuries / Q000601:surgery; D008875:Middle Aged; D010147:Pain Measurement; D010591:Phantom Limb / Q000209:etiology* / Q000503:physiopathology; D011184:Postoperative Period; D012039:Regional Blood Flow; D013848:Thigh / Q000601:surgery; D014652:Vascular Diseases / Q000601:surgery