Characteristics of phantom limb pain in U.S. civilians and service members

Sarah C. Griffin, Aimee L. Alphonso, Monica Tung, Sacha Finn, Briana N. Perry, Wendy Hill, Colleen O'Connell, Steven R. Hanling, Brandon J. Goff, Paul F. Pasquina, Jack Tsao*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objectives: The population of Americans with limb loss is on the rise, with a different profile than in previous generations (e.g., greater incidence of amputation due to diabetes). This study aimed to identify the key characteristics of phantom limb sensation (PLS) and pain (PLP) in a current sample of Americans with limb loss. Methods: This cross-sectional study is the first large-scale (n=649) study on PLP in the current population of Americans with limb loss. A convenience sample of military and civilian persons missing one or more major limbs was surveyed regarding their health history and experience with phantom limb phenomena. Results: Of the participants surveyed, 87% experienced PLS and 82% experienced PLP. PLS and PLP typically first occurred immediately after amputation (47% of cases), but for a small percentage (3-4%) onset did not occur until over a year after amputation. Recent PLP severity decreased over time (β=0.028, 95% CI: -0.05-0.11), but most participants reported PLP even 10 years after amputation. Higher levels of recent PLP were associated with telescoping (β=0.123, 95% CI: 0.04-0.21) and higher levels of pre-amputation pain (β=0.104, 95% CI: 0.03-0.18). Those with congenitally missing limbs experienced lower levels of recent PLP (t (37.93)=3.93, p<0.01) but there were no consistent differences in PLP between other amputation etiologies. Conclusions: Phantom limb phenomena are common and enduring. Telescoping and pre-amputation pain are associated with higher PLP. Persons with congenitally missing limbs experience lower levels of PLP than those with amputation(s), yet PLP is common even in this subpopulation.

Original languageEnglish
Pages (from-to)125-132
Number of pages8
JournalScandinavian Journal of Pain
Issue number1
StatePublished - 1 Jan 2022
Externally publishedYes


  • learned paralysis
  • limb loss
  • missing limb
  • phantom limb pain (PLP)
  • phantom limb sensation (PLS)
  • telescoping


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