Chronic low back pain in traumatic lower limb amputees

Area of Science:

• Rehabilitation Medicine
• Biomechanical Engineering
• Pain Management

Background:

• Low back pain (LBP) is a prevalent issue among individuals with lower limb loss.
• Understanding the etiology of LBP in amputees is crucial for effective management.

Purpose of the Study:

• To determine the prevalence of LBP in traumatic lower limb amputees.
• To identify potential causes contributing to LBP in this population.

Main Methods:

• A semi-structured questionnaire was administered to traumatic lower limb amputees.
• Comparative analysis included physical examination, gait analysis, and magnetic resonance imaging (MRI) for subgroups with and without LBP.
• Gait and standing stability analyses were performed.

Main Results:

• Transfemoral amputees reported higher LBP prevalence (81%) than transtibial amputees (62%).
• Severe LBP correlated with severe phantom limb and stump pain.
• Individuals with LBP had a higher body mass index (BMI) ratio; however, MRI revealed no significant degenerative differences.
• Greater impact ground reaction forces and walking speed were observed in pain-free individuals, while standing stability measures were poorer in the LBP group.

Conclusions:

• LBP is a significant problem for lower limb amputees, comparable to phantom limb pain.
• A biomechanical (myofascial) etiology is suggested for LBP in amputees, rather than a degenerative cause.