Pain site and impairment in individuals with amputation pain

OBJECTIVE: To determine the association between pain site and pain interference with activities of daily living (ADLs) among persons with acquired amputation. DESIGN: Survey. SETTING: Community-based survey from clinical databases, flyer postings, and an advertisement in the inMotion magazine. PARTICIPANTS: Persons with lower-limb amputations (N=478). INTERVENTIONS: Six or more months after lower-limb amputation, participants completed an amputation pain questionnaire that included several standardized pain measures. MAIN OUTCOME MEASURES: Numeric rating scale measures of average phantom limb, residual limb, and back pain and pain-related impairment as measured by a modified version of the Pain Interference Scale of the Brief Pain Inventory. RESULTS: Phantom limb, residual limb, and back pain intensity ratings, as a group, accounted for 20% of the variance in pain interference. The pain intensity ratings associated with each individual pain site made a statistically significant contribution to the prediction of pain interference with ADLs even after controlling for the pain intensity of the other 2 sites. CONCLUSIONS: Pain in each of 3 sites (phantom limb, residual limb, back) appears to be important to pain-related impairment and function. Measurement of the intensity of pain at each site appears to be required for a thorough assessment of amputation pain-related impairment.