Pain and disability following lower limb amputation - a quantitative and qualitative study

A retrospective study was undertaken to determine the frequency of chronic pain and the relationship with disability following lower limb amputation. All individuals in North-East Scotland who had a lower limb amputation between 1989 and 1995 were identified using the Scottish Morbidity Records SMR1 form. Current vital status was then obtained from regional health board records. A total of 82 out of 280 patients were identified as living. A questionnaire was sent to 61 patients asking about details of home circumstances, type of amputation, pain experienced and the effect of pain on lifestyle. This included an assessment of pain-related disability. Ten patients were selected for interview to determine the characteristics of the pain and the relationship between pain and quality of life. It was found that 31/40 (77.5%) of lower limb amputees experience both phantom limb sensation and phantom limb pain, in addition stump pain was experienced by 27/40(67.5%). Four (10%) were moderately to severely limited by pain. Pain after amputation is common but a smaller proportion find that pain has a considerable detrimental impact on quality of life. Efforts should be directed at pain relief and rehabilitation services for these individuals to improve their quality of life.