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Incidence of Phantom Phenomena Including Phantom Limb Pain 6 Months After Major Lower Limb Amputation in Patients With Peripheral Vascular Disease

Richardson, Cliff BSc (Hons), AUS, RGN, MSc, PG Cert (HE), PhD*; Glenn, Sheila BSc (Hons), PhD*; Nurmikko, Turo MD, PhD; Horgan, Maureen RGN, RSCN, SCM, BA (Hons), PhD, Cert FE*

The Clinical Journal of Pain: May 2006 - Volume 22 - Issue 4 - p 353-358
doi: 10.1097/01.ajp.0000177793.01415.bd
Original Articles
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Objectives Contentions exist regarding the true incidence of phantom limb pain (PLP) and other associated post-amputation phenomena. Recognizing and understanding these phenomena would assist in the rehabilitation of amputees. This study was designed to investigate all post-amputation phenomena in a homogenous group of amputees.

Methods Prospective amputees were recruited prior to amputation of a lower limb due to peripheral vascular disease. All survivors were followed 6 months after surgery and interviewed to identify post-amputation phenomena, including phantom sensations, PLP, and stump pain.

Results Sixty amputees were recruited and 52 survived until the 6-month interview. Phantom sensations were universal, and aspects of the nonpainful phenomena, including kinetic, kinesthetic, and exteroceptive components, were identified at varying rates within the sample. PLP was found in 78.8% of the survivors, and 51.2% had stump pain. Super-added phenomena occurred in 15.4%. Links were found between PLP and stump pain (P=0.01) and PLP and the ability to move the phantom (P=0.01). No link was found between PLP and telescoping of the phantom (P=0.47).

Conclusions Phantom phenomena are associated with many myths. This study starts to unravel myth from fact, but further study is required before this enigmatic condition and its influence on rehabilitation are fully understood.

*Liverpool John Moores University, Liverpool, UK

Liverpool University/Pain Relief Foundation, Liverpool, UK

Reprints: Dr. Cliff Richardson, Lecturer, Manchester University, School of Nursing, Midwifery and Social Work, Gateway House, Piccadilly South, Manchester, M60 7LP, UK (e-mail: clifford.richardson@manchester.ac.uk).

Received for publication June 28, 2004;; revised May 1, 2005; accepted June 21, 2005

© 2006 Lippincott Williams & Wilkins, Inc.