Chronic Pain Associated with Upper-Limb Loss
| Autor: | Lawrence R. Robinson, Joseph M. Czerniecki, Mark P. Jensen, Dawn M. Ehde, Marisol A. Hanley, Douglas G. Smith |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Washington medicine.medical_specialty Adolescent medicine.medical_treatment Phantom limb Physical Therapy Sports Therapy and Rehabilitation Amputation Surgical Article Upper Extremity Young Adult Prevalence medicine Back pain Humans Pain Measurement Neck pain Neck Pain business.industry Mortality rate Rehabilitation Chronic pain Prostheses and Implants Middle Aged medicine.disease Health Surveys body regions Cross-Sectional Studies medicine.anatomical_structure Phantom Limb Amputation Back Pain Quality of Life Physical therapy Upper limb Female Pain catastrophizing medicine.symptom business |
| Zdroj: | American Journal of Physical Medicine & Rehabilitation. 88:742-751 |
| ISSN: | 0894-9115 |
| DOI: | 10.1097/phm.0b013e3181b306ec |
| Popis: | Chronic pain is a common secondary condition affecting many individuals with limb loss. In addition to other challenges posed by amputation, pain can have serious consequences for health and functioning, including reduced likelihood of employment and participation in social activities1,2 and interference in prosthetic training.3 Chronic pain associated with amputation has been associated with higher affective distress4 and disability5 as well as lower health-related quality-of-life6 when compared with persons with amputation who do not report pain. The majority of the amputation literature has focused on lower-limb loss, possibly because of the greater incidence of lower-limb amputation. However, the number of individuals with upper-limb loss in the community may be greater than suggested by incidence data, given the younger average age of upper-limb loss and the higher mortality rate of individuals with lower-limb loss.7 Individuals with upper-limb loss tend to live and work with an amputation for more of their lifespan than those with lower-limb loss. Therefore, the impact of pain on functioning may be especially important for this group and requires further study. The few studies on pain after upper-limb loss have focused mainly on the characteristics and impact of phantom limb pain (PLP), and to an even lesser degree, residual-limb pain (RLP). Chronic PLP is common after upper-limb loss, occurring in anywhere from 41%8 to 69%9 of individuals with upper-limb loss. Chronic RLP is also common in persons with upper-limb loss, ranging from 49%10 to 66%11 of community samples. However, pain may occur in sites other than the phantom or residual limb. A handful of studies have examined other types of pain associated with upper-limb loss and have reported significant rates of pain ranging from 33% to 64% in the back,7,11 nonamputated arm,7,11 and neck.7 However, only one study, to our knowledge, included all of these pain locations,7 and none has examined quality-of-life or the relative levels of pain interference and disability associated with each pain type or site. The purpose of this study was to examine the prevalence, characteristics, and associations with functioning of a number of pain problems in persons with upper-limb loss, including PLP, RLP, neck pain, back pain, and nonamputated-limb pain. Based on previous research, we hypothesized that PLP and RLP would be the most common types of amputation-related pain. However, we also hypothesized that the other types of pain examined would be common and associated with significant disability for a subset of the sample. |
| Databáze: | OpenAIRE |
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