Phantom limb sensations and phantom limb pain in child and adolescent amputees

Abstract

Objective: To provide a better understanding of the prevalence, correlates and quality of phantom sensations and phantom pain in child and adolescent amputees.

Design: Retrospective survey study.

Setting: Recruitment through the War Amputations of Canada.

Participants: Sixty child and adolescent amputees aged 8-18 years who were missing a limb due to a congenital limb deficiency (n = 27) or surgery/trauma (n = 33).

Main outcome measure(s): Questionnaire to assess the occurrence and correlates of phantom sensations and phantom pain.

Results: Forty-two percent of the total sample reported phantom sensations; 7.4% of the congenital group and 69.7% of the surgical group (chi2 = 23.70 with 1 df, P < 0.01.) Twenty-nine percent of the total sample reported phantom pain; 3.7% of the congenital group and 48.5% of the surgical group (chi2 = 14.67, with 1 df, P < 0.01). Eighty-eight percent of the amputees with phantom pain had stump pain, while 35.3% had phantom pain that was similar to pre-operative pain and 76.5% experienced pains other than phantom pain (e.g. headaches). Amputees identified exercise, objects approaching the stump, cold weather and 'feeling nervous' as the primary triggers of phantom sensations and/or phantom pain.

Conclusion(s): Less than half of the sample experienced phantom sensations and phantom pain; however, the loss of a limb due to surgery is associated with an increase in the likelihood of experiencing these phenomena.