Prevalence of Phantom Pain in Patients with Lower Limb Amputation in District Swabi
DOI:
https://doi.org/10.55735/0yngc246Keywords:
Amputation , McGill pain questionnaire , Pain severity , Phantom limb painAbstract
Background: Phantom limb pain is a complex phenomenon experienced by many individuals following amputation. It is often described as painful sensations perceived in the absent limb, with varying intensity and duration. PLP not only affects the physical well-being of amputees but also has psychological and social consequences that can compromise overall quality of life. Despite its clinical importance, limited data are available on the prevalence and severity of phantom limb pain in lower-limb amputees within District Swabi. Objective: To determine the prevalence and severity of phantom limb pain among lower-limb amputees in District Swabi using the McGill pain questionnaire. Methodology: Following the approval of the research proposal by the relevant institute, ethical clearance for the study was obtained from the Ethical Committee of NCS University, Swabi campus. This investigation employed a cross-sectional study design, and data were collected over six months from lower-limb amputees experiencing phantom pain in District Swabi. Informed consent was secured from participants, and a total of 250 individuals aged 20 years who had undergone amputation were initially enrolled consecutively. Written information about the study was provided to all eligible amputees across different areas of Swabi, including the Chal Foundation Swabi and District Headquarters Hospital Swabi. The McGill pain questionnaire was administered, and informed consent was obtained before participants completed the survey. The qualitative variables were presented as frequencies and percentages. Results: Of the 180 participants, 5 (2.8%) reported mild phantom pain, 64 (35.6%) experienced moderate pain, 105 (58.3%) were categorised as having severe pain, and 6 (3.3%) reported extreme phantom pain. The majority of participants, particularly females, were observed to be suffering from severe phantom pain following lower-limb amputation. Conclusion: It concludes that phantom limb pain is highly prevalent among lower-limb amputees in District Swabi, with most individuals reporting a moderate to severe level of pain. These emphasise the need for improved clinical awareness, effective pain management strategies, and larger-scale studies to develop targeted interventions aimed at reducing the burden of phantom limb pain in amputee populations.
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1 Kalsoom U, Amjad T, Bairam S. Quality of life among lower limb prosthesis users attending Artificial Limb Center of Fauji Foundation Hospital, Rawalpindi. Pakistan Armed Forces Medical Journal. 2018; 68(1): 114-118.
2 Ahanger AG WM, Lone RA, Singh S, Hussain Z, Mir IA, et al. Missile vascular injuries: 19-year experience. Turkish Journal of Trauma and Emergency Surgery. 2010; 16(2): 135-138.
3 Kim Y PC, Kim D, Kim T, Shin J. Statistical analysis of amputations and trends in Korea. Prosthetics and Orthotics International. 1996; 20(2): 88-95.
https://doi.org/10.3109/03093649609164424
4 Baldridge D C, Beatty J E, Boehm S, Kulkarni M, Moore M E. Persons with Disabilities. 2015.
https://doi.org/10.1093/oxfordhb/9780199363643.013.9
5 Varma P SM, Dillingham TR. Epidemiology of limb loss. Physical Medicine and Rehabilitation Clinics. 2014; 25(1): 1-8.
https://doi.org/10.1016/j.pmr.2013.09.001
6 Mitra S PA, Vick B. Disability and poverty in developing countries: A snapshot from the World Health Survey: World Bank; 2011.
https://doi.org/10.2139/ssrn.1908128
7 Soomro N BR, Ahmed SI, Kamran B, Minhas MA, Siddiqui KY. Epidemiology of amputation. The Professional Medical Journal. 2013; 20(2): 261-5.
https://doi.org/10.29309/TPMJ/2013.20.02.685
8 Wurdeman SR SP, Campbell JH. Mobility Analysis of AmpuTees (MAAT I): Quality of life and satisfaction are strongly related to mobility for patients with a lower limb prosthesis. Prosthetics and Orthotics International. 2018; 42(5): 498-503.
https://doi.org/10.1177/0309364617736089
9 Dillingham TR YJ, Pezzin LE. Determinants of post-acute care discharge destination after dysvascular lower limb amputation. Physical Medicine and Rehabilitation Journal. 2011; 3(4): 336-344.
https://doi.org/10.1016/j.pmrj.2010.12.019
10 Wu H, Saini C, Medina R, Hsieh SL, Meshkati A, Sung K. Pain without presence: a narrative review of the pathophysiological landscape of phantom limb pain. Frontiers in Pain Research (Lausanne). 2025; 6: 1419762.
https://doi.org/10.3389/fpain.2025.1419762
11 Wall R, Novotny-Joseph P, Macnamara TE. Does preamputation pain influence phantom limb pain in cancer patients? South Medical Journal. 1985; 78(1): 34-6.
https://doi.org/10.1097/00007611-198501000-00009
12 Sin EI, Thong SY, Poon KH. Incidence of phantom limb phenomena after lower limb amputations in a Singapore tertiary hospital. Singapore Medical Journal. 2013; 54(2): 75-81.
https://doi.org/10.11622/smedj.2013028
13 Nikolajsen L, Staehelin Jensen T. Phantom limb pain. Current Review of Pain. 2000; 4(2): 166-170.
https://doi.org/10.1007/s11916-000-0052-0
14 Nikolajsen L, Ilkjær S, Krøner K, Christensen JH, Jensen TS. The influence of preamputation pain on postamputation stump and phantom pain. Pain. 1997; 72(3): 393-405.
https://doi.org/10.1016/s0304-3959(97)00061-4
15 van der Schans CP, Geertzen JH, Schoppen T, Dijkstra PU. Phantom pain and health-related quality of life in lower limb amputees. Journal of Pain and Symptom Management. 2002; 24(4): 429-36.
https://doi.org/10.1016/s0885-3924(02)00511-0
16 Jensen TS, Krebs B, Nielsen J, Rasmussen P. Immediate and long-term phantom limb pain in amputees: incidence, clinical characteristics and relationship to pre-amputation limb pain. Pain. 1985; 21(3): 267-78.
https://doi.org/10.1016/0304-3959(85)90090-9
17 Jensen TS, Krebs B, Nielsen J, Rasmussen P. Phantom limb, phantom pain and stump pain in amputees during the first 6 months following limb amputation. Pain. 1983; 17(3): 243-256.
https://doi.org/10.1016/0304-3959(83)90097-0
18 Manchikanti L, Pampati S, Cash KA. Making sense of the accuracy of diagnostic lumbar facet joint nerve blocks: an assessment of the implications of 50% relief, 80% relief, single block, or controlled diagnostic blocks. Pain Physician. 2010; 13(2): 133-143.
19 Ramachandran VS, Rogers-Ramachandran D, Cobb S. Touching the phantom limb. Nature. 1995; 377(6549): 489-490.
https://doi.org/10.1038/377489a0
20 Jackson MA, Simpson KH. Pain after amputation. Continuing Education in Anaesthesia, Critical Care & Pain. 2004; 4(1): 20-23.
https://doi.org/10.1093/bjaceaccp/mkh007
21 Giummarra MJ, Moseley GL. Phantom limb pain and bodily awareness: current concepts and future directions. Current Opinion in Anesthesiology. 2011; 24(5): 524-531.
https://doi.org/10.1097/ACO.0b013e32834a105f
22 Subedi B, Grossberg GT. Phantom limb pain: mechanisms and treatment approaches. Pain Research Treatment. 2011; 2011: 864605.
https://doi.org/10.1155/2011/864605
23 Hanley MA, Ehde DM, Campbell KM, Osborn B, Smith DG. Self-reported treatments used for lower-limb phantom pain: descriptive findings. Archives of Physical Medicine and Rehabilitation. 2006; 87(2): 270-277.
https://doi.org/10.1016/j.apmr.2005.04.025
24 Giummarra MJ, Georgiou-Karistianis N, Nicholls ME, Gibson SJ, Chou M, Bradshaw JL. The menacing phantom: What pulls the trigger? European Journal of Pain. 2011; 15(7): 691. e1-e8.
https://doi.org/10.1016/j.ejpain.2011.01.005
25 Limakatso K, Madden VJ, Manie S, Parker R. The effectiveness of graded motor imagery for reducing phantom limb pain in amputees: a randomised controlled trial. Physiotherapy. 2020; 109: 65-74.
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