The lived complexity of phantom limb telescoping: insights from a qualitative study.
Andrea Aternali, Heather Lumsden-Ruegg, Nicole Dimitrova and 4 others
PMID 42553149WHAT IT FOUND
Twelve amputees described phantom limb shortening as strange but not painful.
Most had never mentioned it to a clinician, and one was told it was imagined. Asking about this sensation and normalizing it may reduce patients' sense of being alone with it.
Key findings
01Most participants described telescoping as an unusual but non-distressing sensation, often overshadowed by phantom limb pain and the broader adjustment to limb loss rather than being a source of worry in its own right.
02Several participants had never told a medical professional about telescoping, and at least one was told by a chiropodist that the sensation was 'made-up or invented'; the paper notes that clinicians did not typically ask about it.
03The onset of telescoping varied from immediately after amputation to 12 years later, and the way it was perceived differed greatly between individuals, from a few inches shorter to the phantom limb retracting completely into the residual limb.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Twelve participants, eleven of whom were men, limits how far the findings can be generalised, particularly to women and to people from different cultural or socioeconomic backgrounds. All participants were recruited from a single rehabilitation centre in Toronto with access to post-amputation health services, so the experience of someone without that support is not represented. Coding and theme development were led by one researcher; although a second coder reviewed three transcripts, the interpretive process remains subjective and not fully reproducible. Participants were asked to recall when telescoping first appeared, and for some this was more than six years after amputation, so timing details may be unreliable. Anxiety and depression were not directly assessed in this study, even though the authors reference other work linking telescoping to higher levels of both. Transcripts were not returned to participants for comment or correction, and participants were not consulted on the findings.
Declared interests
Funded by a Canadian Institutes of Health Research (CIHR) Canada Graduate Doctoral Award (A.A.), a CIHR Canada Research Chair in Health Psychology (J.K.), and a grant from The War Amps to J.K. No industry funding or conflicts of interest were declared.
The easy way to misread this
Do not read this as evidence that telescoping is universally benign. While most of these twelve participants (predominantly men) described it as a non-distressing oddity, two expressed concern that it might affect prosthetic use or muscle strength, and the authors themselves cite other studies in which people reporting telescoping had significantly higher anxiety and depression than those with a normal-length phantom. This is a small, single-site qualitative study; it cannot tell you what proportion of your amputee patients will be distressed, and the absence of distress in this sample should not be taken as a reason to skip asking about the sensation.