Low Back Pain in People with Lower Limb Amputation: A Cross-sectional Study

STUDY DESIGN: A cross-sectional study based on an online questionnaire.

OBJECTIVE: To investigate the prevalence and intensity of low back pain (LBP) in people with lower limb amputation (LLA) and to analyse the association factors that can influence the genesis of LBP.

SUMMARY OF BACKGROUND DATA: It is still unclear whether LBP is more prevalent in the amputated population than in its non-amputated counterpart. Given the multifactorial nature of LBP, it is necessary to explore possible factors that can influence its presence and intensity, to build a solid background to define a better rehabilitation pathway for the management of these people.

METHODS: The online questionnaire included six sections: informed consent of the study, demographic information, comorbid conditions, history of lower limb amputation, history of LBP and acceptance of the amputation.

RESULTS: Between March and June 2021, 239 participants (mean age (SD): 49.2 (11.5); female 11%) completed the survey (response rate: 32%). From the results of this study, LBP in LLA showed a prevalence of 82% post-amputation and 70% in the last year. A logistic regression with a backward method showed that participants who had problems in the not affected leg presented 1.58 [CI 95%:0.70; 2.45] times higher odds to have LBP after the amputation.

CONCLUSION: This study shows that the prevalence of LBP in lower limb amputees appears to be higher than in the general population, with similar levels of pain intensity and frequency. The highest percentage of people with a sedentary lifestyle not practising any kind of sports emphasises the importance of educating this population on the importance of physical activity. New strategies to invest in the education of this population in terms of physical activity are needed.

LEVEL OF EVIDENCE: 4a.