The experience of phantom limb pain in patients with combat-related traumatic amputations.
OBJECTIVE
To describe the prevalence and characteristics of phantom limb pain (PLP) and the use and perceived effectiveness of standard medical and self-treatment methods by traumatic amputees with combat-related injuries.


METHODS
A retrospective descriptive questionnaire study.


METHODS
Outpatient amputee clinic at a major military medical center.


METHODS
Convenience sample of military members (N=30) with single or multiple traumatic amputations from combat and/or training. Inclusion criteria were 18 to 50 years old and amputation within 5 years of the study. Exclusion criteria were nontraumatic amputees and amputation or most recent surgical revision within 3 months before the study.


METHODS
Not applicable.


METHODS
The primary dependent variables were pain and relief, as measured by an investigator-developed questionnaire.


RESULTS
Seventy-seven percent of participants experienced PLP at some time since their amputation. Of those with PLP, the mean average intensity was 3.3+/-2.0 out of 10 and the mean worst intensity was 5.4+/-2.6 out of 10. The PLP was intermittent, and 78% reported episodes of PLP at least weekly. Sixty-eight percent of participants with PLP were receiving treatment from their health care providers. The most common medical treatment was gabapentin, although some patients reported greater pain relief from self-treatment methods such as distraction and relaxation techniques.


CONCLUSIONS
With over 750 service members living with amputations from recent combat, PLP will continue to be a troubling problem that requires effective interventions. The discrepancy between perceived effectiveness of different treatment types supports the need for highly individualized pain management plans.
Ketz
Ann K
AK
Landstuhl Regional Medical Center, Landstuhl, Germany. ann.kobiela.ketz@us.army.mil
D000293:Adolescent; D000328:Adult; D000588:Amines / Q000627:therapeutic use; D000673:Amputation, Traumatic / Q000150:complications* / Q000523:psychology; D000674:Amputees / Q000523:psychology* / Q000534:rehabilitation; D000700:Analgesics / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010044:Outpatient Clinics, Hospital; D010147:Pain Measurement; D010591:Phantom Limb / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D012064:Relaxation Therapy; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin