Immediate and long-term phantom limb pain in amputees: Incidence, clinical characteristics and relationship to pre-amputation limb pain

&NA; In a prospective study 58 patients undergoing limb amputation were interviewed the day before operation about their pre‐amputation limb pain and 8 days, 6 months and 2 years after limb loss about their stump and phantom limb pain. All but one patient had experienced pain in the limb prior to amputation. Pre‐amputation limb pain lasted less than 1 month in 25% of patients and more than 1 month in the remaining 75% of patients. At the first examination the day before amputation 29% had no limb pain. The incidence of phantom pain 8 days, 6 months and 2 years after amputation was 72, 65 and 59%, respectively. Within the first half year after limb loss phantom pain was significantly more frequent in patients with long‐lasting pre‐amputation limb pain and in patients with pain in the limb immediately prior to amputation. Phantom pain and pre‐amputation pain were similar in both localization and character in 36% of patients immediately after amputation but in only 10% of patients later in the course. Both the localization and character of phantom pain changed within the first half year; no further change occurred later in the course. The incidence of stump pain 8 days, 6 months and 2 years after limb loss was 57, 22 and 21%, respectively. It is suggested that preoperative limb pain plays a role in phantom pain immediately after amputation, but probably not in late persistent phantom pain.

[1]  C. Aldrich,et al.  Phantom limb pain. , 1982, American family physician.

[2]  Ronald Melzack,et al.  Phantom body pain in paraplegics: Evidence for a central “pattern generating mechanism” for pain , 1977, Pain.

[3]  A. Abramson,et al.  The phantom phenomenon: its use and disuse. , 1981, Bulletin of the New York Academy of Medicine.

[4]  Patrick D. Wall,et al.  Ongoing activity in peripheral nerves: The physiology and pharmacology of impulses originating from a neuroma ☆ , 1974 .

[5]  Richard A. Sherman,et al.  Chronic phantom and stump pain among american veterans: results of a survey , 1984, Pain.

[6]  P K Thomas,et al.  Nerves and Nerve Injuries , 1969 .

[7]  T. Jensen,et al.  Phantom limb, phantom pain and stump pain in amputees during the first 6 months following limb amputation , 1983, Pain.

[8]  G. Riddoch PHANTOM LIMBS AND BODY SHAPE1 , 1941 .

[9]  T. Jensen,et al.  Non‐painful phantom limb phenomena in amputees: incidence, clinical characterstics and temporal course , 1984, Acta neurologica Scandinavica.

[10]  P. Wall On the Origin of Pain Associated with Amputation , 1981 .

[11]  R. Melzack,et al.  Phantom limb pain: implications for treatment of pathologic pain. , 1971, Anesthesiology.

[12]  T. Jensen,et al.  Phantom limb phenomena in amputees 7 years after amputation , 1984, Pain.

[13]  S. Weir Mitchell,et al.  Injuries to Nerves and Their Consequences , 1872, Buffalo Medical and Surgical Journal.

[14]  J. Gallagher,et al.  DORSAL CORDOTOMY FOR PAINFUL PHANTOM LIMB , 1948, Annals of surgery.

[15]  T Steinbach,et al.  Phantom limbs and related phenomena in recent traumatic amputations , 1978, Neurology.

[16]  C. Parkes Factors determining the persistence of phantom pain in the amputee. , 1973, Journal of psychosomatic research.

[17]  G. J. Romanes,et al.  Current Problems of Lower Vertebrate Phylogeny. , 1969 .

[18]  J. Ewalt,et al.  The Phantom Limb* , 1947, Psychosomatic medicine.