Veteran Perspectives on Phantom Limb Pain and Non-Drug Interventions

Abstract

Background

Phantom limb pain (PLP) commonly occurs post-amputation and can negatively affect the daily functioning of persons with amputation. Best practices for medication and non-drug management remain unclear.

Objective

To better understand the PLP experience and patients’ familiarity with treatments, phone interviews were conducted at the Minneapolis Veterans Affairs Regional Amputation Center in Veterans with amputations.

Methods

Fifty Veteran participants (average age 66, 96% male) with lower limb amputation were recruited for phone-based data collection of patient-reported outcomes (ie, demographics using the Trinity Amputation and Prosthesis Experience Scales-Revised (TAPES-R) and pain experience using the Phantom Phenomena Questionnaire) to characterize the population and a semi-structured interview. Notes taken during interviews were analyzed using the Krueger and Casey constant comparison analysis method.

Results

Participants had an average of 15 years since amputation, and 80% reported PLP as identified with the Phantom Phenomena Questionnaire. Investigators identified several core themes from the qualitative interviews including 1) high variability in the experience of PLP, 2) acceptance and resilience, and 3) PLP treatment perceptions. The majority of participants reported trying common non-drug treatments with none endorsed consistently as highly effective.

Conclusion

More research is needed to inform identification and implementation of clinical best practices for non-drug interventions for PLP and understand the factors that influence engagement in non-drug interventions. The participants in this study were largely male, so these results may not be generalizable to females.

Keywords:

• amputation
• phantom limb pain
• rehabilitation
• non-drug interventions
• pain

Abbreviations

ASoC, Amputation System of Care; COREQ, Consolidation criteria for reporting qualitative studies; PLP, Phantom limb pain; RAC, Regional Amputation Center; TAPES-R, Trinity Amputation and Prosthesis Experience Scales-Revised; VA, Veterans Affairs.

Acknowledgments

We thank the Veterans that participated in our study. We thank Julie Toth, RN, CCRC, CIP for her guidance on this study.

Disclosure

The authors declare they have no competing interests.

Additional information

Funding

This work was supported in part by the US Department of Veterans Affairs Rehabilitation Research and Development Career Development Award 1IK1RX003216-01A2 and was conducted at the Minneapolis VA Health Care System. The materials presented here solely represent the views of the authors and do not represent the view of the US Department of Veterans Affairs or the United States Government.