Correlates of Phantom Limb Pain in Young Individuals With Lower Limb Loss

Objective: To identify factors associated with the presence of phantom limb pain (PLP) such as demographics, limb loss characteristics, rehabilitation, sleep disturbance, anxiety, fatigue, and pain interference in younger individuals with lower limb loss. Design: Cross-sectional cohort study. Setting: Recruitment and data collection occurred at military treatment facilities, community events, and local prosthetic clinics. Participants: A volunteer sample of 163 individuals (N=163) with lower limb loss (age range, 20-60y) was included in this analysis. Interventions: Not applicable. Main Outcome Measures: Data were collected via questionnaires. Questions included participant characteristics, rehabilitation characteristics, pain information; self-reported sleep disturbance, anxiety, depression, fatigue, and pain interference were assessed via Patient-Reported Outcomes Measurement Information System subscales. Results: In this cohort, 68.1% of individuals reported having PLP. In those who reported PLP, average pain intensity in the last 7 days was reported as 4.6±2.4 of 10 on the numeric pain rating scale. The relationships between the presence of PLP and demographic characteristics revealed that only greater body mass was correlated with PLP presence (P=.02). Differences were seen between individuals with and without PLP for self-reported sleep disturbance, anxiety, fatigue, and pain interference (all P<.02), with the individuals with PLP reporting higher levels (worse scores) on all subscales. Conclusions: The PLP is highly prevalent among younger individuals with lower limb loss, with nearly 70% of participants reporting its presence. Among the factors examined, higher body mass, as well as greater levels of sleep disturbance, anxiety, fatigue, and pain interference were associated with PLP, suggesting that PLP is linked to broader psychosocial impairments.