Prevalence and patterns of back pain and residual limb pain in lower limb amputees at the National Rehabilitation Hospital

Residual limb pain is defined as a painful sensation or feeling from the remaining part of the leg. Aggressive bone edge, bone spur formation, neuroma, abscess or bursitis are common causes of residual limb pain. On the other hand, regional osteoporosis on femur and tibia is an inevitable consequence in patients with lower limb amputations. The etiology of bone loss is uncertain but it is likely to be a local phenomenon in lower limb amputees. Altered gait pattern, decreased weight load, disuse atrophy and lack of muscular action at the limb seem to be important causal factors in the development of both local and generalized osteoporosis. The aims of this study are: (i) To determine if there is significant bone mineral density (BMD) difference at proximal tibias and femurs between intact and amputated limbs, (ii) to investigate the factors affecting bone loss in these areas and (iii) to investigate the possible relationship between residual limb pain and local bone loss. The 36 men who participated in this study had amputations due to land-mine injuries. Dual energy X-ray absorptiometry was used to determine BMD of the proximal femur and proximal tibia. The non-amputated limb was used as a control for the amputated side. BMD values on the amputated side were significantly lower than non-amputated side. In addition, BMD values on the amputated limbs with residual limb pain were significantly less than in those without residual limb pain. Insufficient mechanical loading leads to bone loss in patients with trans-tibial amputations. Furthermore, bone loss at tibia may be a cause of residual limb pain. However, this needs to be confirmed with more specific studies in the future.

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Phantom Pain, Residual Limb Pain, and Back Pain in Amputees: Results of a National Survey

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2005.03.031 ◽

2005 ◽

Vol 86 (10) ◽

pp. 1910-1919 ◽

Cited By ~ 319

Author(s):

Patti L. Ephraim ◽

Stephen T. Wegener ◽

Ellen J. MacKenzie ◽

Timothy R. Dillingham ◽

Liliana E. Pezzin

Keyword(s):

Back Pain ◽

National Survey ◽

Phantom Pain ◽

Residual Limb ◽

Limb Pain ◽

Residual Limb Pain

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Residual limb claudication after vascular transfemoral amputation

Prosthetics and Orthotics International ◽

10.1177/0309364617706747 ◽

2017 ◽

Vol 41 (6) ◽

pp. 601-604 ◽

Cited By ~ 1

Author(s):

Riemke GA de Boer ◽

Marieke A Paping ◽

Bert Kap ◽

Jan HB Geertzen

Keyword(s):

Lower Limb ◽

Developed Countries ◽

Occlusive Disease ◽

Limb Amputation ◽

Residual Limb ◽

Peripheral Artery ◽

Transfemoral Amputation ◽

Limb Pain ◽

Peripheral Artery Occlusive Disease ◽

Residual Limb Pain

Background:In all, 68% of all lower limb amputees experience residual limb pain. More than 95% of all lower limb amputations in developed countries are due to peripheral artery occlusive disease in combination with diabetes mellitus. Therefore, claudication, which is one of the most common manifestations of peripheral artery occlusive disease, should be taken into consideration in making a differential diagnosis of residual limb pain.Case description and methods:We present a case study of a 60-year-old diabetic patient who underwent a transfemoral amputation due to peripheral artery occlusive disease and who experiences residual limb pain. A computed tomography angiography was performed, and we searched for relevant literature on claudication pain after lower limb amputation.Conclusion:Little research has explored claudication as a cause of residual limb pain. More research will lead to a decrease in unnecessary prosthetic fittings and adjustments give more insight into the treatment and management of residual limb pain and prevent a decrease in mobility in amputees.Clinical relevanceClaudication due to peripheral artery occlusive disease should be included as a possible cause of residual limb pain to prevent unnecessary prosthetic fittings and adjustments and to minimize psychological effects and limitations in activities and participation.

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Phantom Pain, Residual Limb Pain, and Back Pain in Amputees: Results of a National Survey

Yearbook of Orthopedics ◽

10.1016/s0276-1092(08)70410-3 ◽

2006 ◽

Vol 2006 ◽

pp. 110-111

Author(s):

M.F. Swiontkowski

Keyword(s):

Back Pain ◽

National Survey ◽

Phantom Pain ◽

Residual Limb ◽

Limb Pain ◽

Residual Limb Pain

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Factors associated with prosthesis embodiment and its importance for prosthetic satisfaction in lower limb amputees

10.31234/osf.io/atrph ◽

2020 ◽

Author(s):

Robin Bekrater-Bodmann

Keyword(s):

Lower Limb ◽

Body Representation ◽

Residual Limb ◽

Present Sample ◽

Visual Appearance ◽

Factors Associated ◽

Residual Limb Pain ◽

The Trinity ◽

Insufficient Knowledge ◽

Lower Limb Amputees

Perceptual integration of a prosthesis into an amputee’s body representation, that is, prosthesis embodiment, has been proposed to be a major goal of prosthetic treatment, potentially contributing to the user’s satisfaction with the device. However, insufficient knowledge about individual or prosthetic factors predicting prosthesis embodiment challenges basic as well as rehabilitation research. In the present study, hierarchical multiple regression analyses on prosthesis embodiment – as assessed with the recently introduced Prosthesis Embodiment Scale – were applied to the survey data of 161 prosthesis-using lower limb amputees, entering relevant impartial (i.e., objective characteristics of the amputation or the prosthesis) and subjective-evaluative variables (i.e., the amputee’s perceptions related to the amputation or the prosthesis) as first- or second-level regressors, respectively. Significant regressors identified in these analyses together explained R2 = 36.5% of prosthesis embodiment variance in the present sample, with a lower level of amputation, less severe residual limb pain, more realistic visual appearance of the device, higher prosthetic mobility, and the absence of prosthesis-induced adverse stimulations of the residual limb representing significantly associated factors. Using the identical set of regressors hierarchically complemented by prosthesis embodiment on measures of prosthetic satisfaction – as assessed with the Trinity Amputation and Prosthesis Experience Scales – revealed that prosthesis embodiment significantly and positively predicted aesthetic as well as functional prosthesis satisfaction. These findings emphasize the importance of psychological factors for the integration of a prosthesis into the amputee’s body representation, which itself represents a crucial factor associated with prosthesis satisfaction. These results might have important implications for future prosthetic treatment. However, replication of the findings in an independent sample is required, as well as sophisticated experimental designs in order to elucidate the causality of effects.

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Chronic phantom sensations, phantom pain, residual limb pain, and other regional pain after lower limb amputation

Archives of Physical Medicine and Rehabilitation ◽

10.1053/apmr.2000.7583 ◽

2000 ◽

Vol 81 (8) ◽

pp. 1039-1044 ◽

Cited By ~ 241

Author(s):

Dawn M. Ehde ◽

Joseph M. Czerniecki ◽

Douglas G. Smith ◽

Kellye M. Campbell ◽

W.Thomas Edwards ◽

...

Keyword(s):

Lower Limb ◽

Lower Limb Amputation ◽

Limb Amputation ◽

Phantom Pain ◽

Residual Limb ◽

Limb Pain ◽

Residual Limb Pain

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Pain and psychosocial adjustment to lower limb amputation amongst prosthesis users

Prosthetics and Orthotics International ◽

10.1080/03093640802067046 ◽

2008 ◽

Vol 32 (2) ◽

pp. 244-252 ◽

Cited By ~ 19

Author(s):

Deirdre Desmond ◽

Pamela Gallagher ◽

David Henderson-Slater ◽

Rob Chatfield

Keyword(s):

Psychosocial Adjustment ◽

Lower Limb ◽

Postal Survey ◽

Lower Limb Amputation ◽

Phantom Limb ◽

Limb Amputation ◽

Residual Limb ◽

Limb Pain ◽

Activity Restriction ◽

Residual Limb Pain

The aim of this study was to investigate associations between post-amputation phantom and residual limb pain and prosthesis satisfaction, activity restriction and psychosocial adjustment to amputation among lower limb prosthesis users. Eighty-nine people with a lower limb amputation completed a postal survey. Characteristics of phantom and residual limb pain, prosthesis satisfaction, activity restriction and psychosocial adjustment to amputation were assessed using the Trinity Amputation and Prosthesis Experience Scales (TAPES). Comparisons of those who experienced residual and/or phantom limb pain in the preceding assessment with those who did not revealed significant differences in prosthesis satisfaction, psychosocial adjustment but not in activity restriction. Overall, it is important for clinicians to ascertain the type and level of pain that the person is experiencing and to separate the experiences of the pain from the experiences of the prosthetic limb.

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