Understanding Low Back Pain in Traumatic Lower Limb Amputees: A Systematic Review.
Biranavan Sivapuratharasu, Anthony M J Bull, Alison H McGregor
PMID 33543047WHAT IT FOUND
Low back pain is common in traumatic amputees, affecting 52.8% to 64%.
Biomechanical studies show altered trunk motion and higher spinal loads, but the link to pain is unclear due to small sample sizes and inconsistent reporting.
Key findings
01The prevalence of low back pain in traumatic lower limb amputees ranges from 52.8% to 64% across included studies.
02Biomechanical modeling indicates that amputees exhibit increased trunk motion and higher spinal loads compared to able-bodied controls, particularly as walking speed increases.
03The evidence linking these biomechanical changes directly to low back pain is weak because few studies compared amputees with pain to those without pain during physical testing.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The included studies were of low to moderate quality, with small sample sizes in the biomechanical cohorts. Most physical testing studies did not distinguish between amputees with and without low back pain, making it difficult to link mechanics to symptoms. Key confounders like body mass index and smoking status were rarely reported or controlled for. Definitions of low back pain varied across studies, with some failing to specify the timeframe or location of pain. The population was overwhelmingly male (94.4%), limiting generalizability to female amputees.
Declared interests
No specific funding sources or conflicts of interest were detailed in the provided text.
The easy way to misread this
Do not assume that the observed biomechanical changes, such as increased spinal loads, are the proven cause of low back pain in this population. The studies showed these mechanics exist, but did not consistently link them to pain presence or severity, leaving the mechanism unclear.