ABILITY Encourages Education to All of Their Patients in Prosthetic & Orthotic Care.
Educating is a key role in a patients treatment plan in helping them understand the process and getting their questions answered. Here is a great article discussing the relationship of low back pain with amputees. The article provides helpful insight on how to help remedy this side affect in amputees.
Back Again? Tracking Possible Causes of Low Back Pain after Lower-Limb Amputation
By Phil Stevens, MEd, CPO, FAAOP
Content provided by The O&P EDGE
Periodic low back pain (LBP) has reported prevalence rates of 20 to 40 percent in the general population. For people with lower-limb amputations, it’s an even bigger problem: Among those with transfemoral amputations, cited prevalence rates range from 50 to 87 percent.
For about half of these individuals, the occurrence is described as “occasional” or “a few times per month,” but for a quarter to a third of the individuals with transfemoral amputations who suffer from LBP, the pain is described as “frequent” or “several times a week.”1-4
The effect of the level of amputation as a risk factor for LBP is inconsistent, with some studies citing increased prevalence rates among individuals with amputations at the transfemoral level while others suggest comparable rates at the more distal knee disarticulation and transtibial levels.1-4
The studies examined in this article have largely focused their observations on subjects with transfemoral amputations, but likely have broader application for those with more distal amputation levels. This article presents different factors and considerations that may or may not influence LBP in individuals with lower-limb amputations.
Clinically, one of the first considerations associated with reports of LBP is the height of the prosthesis. If there is a leg-length discrepancy (LLD) between the sound and prosthetic sides, logic suggests this would create a nonlevel pelvis and associated strains on the lower back. However, while this is commonly suspected in clinical practice, there is limited published evidence to confirm this relationship.
To address the clinical utility of this theory, a 2009 study was performed through the VA Puget Sound Health Care System - Seattle Division.5 Drawing from a local database of people with transfemoral amputations, the authors excluded those individuals whose back pain might stem from outside influences. Thus, individuals undergoing tumor treatment, those with elevated BMI levels, those whose back pain predated their amputations, and those with significant depressive symptoms were excluded from the study.
The remaining 17 subjects who met the authors’ inclusion criteria were then asked a simple question that would place them in one of two comparison groups: “Since your amputation, have you experienced persistent, bothersome back pain?” Those who said yes comprised the “amputee pain” group, while those who said no comprised the “amputee no-pain” group.8 The two groups were otherwise similar; average years since amputation, daily hours of prosthetic usage, age, and BMI demonstrated no significant differences.
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