Neuropathic Pain after Major Limb Amputation: A Cross-Sectional Study

Area of Science:

• Amputation and Pain Management
• Neurology
• Rehabilitation Medicine

Background:

• Residual limb pain (RLP) and phantom limb pain are common post-amputation complications.
• These conditions may necessitate further medical intervention or surgical procedures.
• Identifying prevalence and prognostic factors for neuropathic RLP is crucial for effective management.

Purpose of the Study:

• To determine the prevalence of neuropathic RLP following limb amputation.
• To identify prognostic factors associated with the development of neuropathic RLP.
• To assess the impact of neuropathic RLP on the quality of life in amputees.

Main Methods:

• A cross-sectional study included 121 patients with upper or lower extremity amputations (1990-2021).
• Neuropathic RLP was defined by pain score (≥4/10) and Douleur Neuropathic 4 questionnaire score (≥4).
• Multivariable linear regression analyzed prognostic factors for neuropathic RLP.

Main Results:

• Neuropathic RLP prevalence was 21.5%; nonneuropathic RLP was 10.7%.
• Smoking and complex regional pain syndrome (CRPS) as amputation indications correlated with more severe neuropathic pain.
• Patients with neuropathic RLP reported significantly lower quality of life.

Conclusions:

• Neuropathic RLP is a prevalent and impactful condition post-amputation.
• The scarcity of manageable prognostic factors highlights the need for early consideration of prophylactic measures.
• Interventions during amputation may mitigate the development and impact of neuropathic RLP.