• Nisler J
• Bowe Fisher V
• Gogineni V
• Kirk E

• Aged
• Amputees
• Male
• Mirror Movement Therapy
• Open Access Document
• Phantom Limb

Objective: To describe a patient with phantom limb pain (PLP) experienced while undergoing treatment for low back pain (LBP) with radicular symptoms into the residual limb.

Clinical Features: A 66-year-old male with a left-sided below-knee amputation presented with LBP and radicular symptoms to the left residual limb. Aggravating factors included standing, walking, and sleeping. Pain medications reduced the pain. He also reported PLP that began 2 days after amputation performed 5 years prior to him seeking chiropractic treatment.

Intervention and Outcome: Lumbar long-axis distraction and soft-tissue therapy were initiated to address the LBP and radicular symptoms. He self-reported 2 weeks of complete symptomatic relief from PLP at visit 5. He noted a flare-up of LBP and PLP at visit 6. However, he chose to discontinue care, citing insurance limitations. At discharge from care, scores on the Numeric Pain Rating Scale (NPRS) improved from 8/10 to 4/10 and the Defense and Veterans Pain Rating Scale (DVPRS) supplemental questions score improved from 32/40 to 18/40.

Conclusion: This case illustrates an unexpected favorable response to the patient’s PLP while undergoing chiropractic care for low back and radicular symptoms. Further investigation into the effects of lumbar spine long-axis distraction and soft-tissue therapy on PLP is warranted.

Author keywords: Phantom Limb Pain; Amputation; Back Pain; Radiculopathy; Below-Knee Amputation; Residual Limb, Mirror Therapy, Chiropractic

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