• Sarah C Griffin, Aimee L Alphonso, Monica Tung, Sacha Finn, Briana N Perry, Wendy Hill, Colleen O'Connell, Steven R Hanling, Brandon J Goff, Paul F Pasquina, and Jack Tsao.
• Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham, NC, USA.
• Scand J Pain. 2021 Sep 17.

ObjectivesThe population of Americans with limb loss is on the rise, with a different profile than in previous generations (e.g., greater incidence of amputation due to diabetes). This study aimed to identify the key characteristics of phantom limb sensation (PLS) and pain (PLP) in a current sample of Americans with limb loss.MethodsThis cross-sectional study is the first large-scale (n=649) study on PLP in the current population of Americans with limb loss. A convenience sample of military and civilian persons missing one or more major limbs was surveyed regarding their health history and experience with phantom limb phenomena.ResultsOf the participants surveyed, 87% experienced PLS and 82% experienced PLP. PLS and PLP typically first occurred immediately after amputation (47% of cases), but for a small percentage (3-4%) onset did not occur until over a year after amputation. Recent PLP severity decreased over time (β=0.028, 95% CI: -0.05-0.11), but most participants reported PLP even 10 years after amputation. Higher levels of recent PLP were associated with telescoping (β=0.123, 95% CI: 0.04-0.21) and higher levels of pre-amputation pain (β=0.104, 95% CI: 0.03-0.18). Those with congenitally missing limbs experienced lower levels of recent PLP (t (37.93)=3.93, p<0.01) but there were no consistent differences in PLP between other amputation etiologies.ConclusionsPhantom limb phenomena are common and enduring. Telescoping and pre-amputation pain are associated with higher PLP. Persons with congenitally missing limbs experience lower levels of PLP than those with amputation(s), yet PLP is common even in this subpopulation.© 2021 Walter de Gruyter GmbH, Berlin/Boston.

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