The prevalence of post-amputation pain in amputees: a systematic review and meta-analysis

To systematically estimate the worldwide prevalence of post-amputation pain phenotypes, including phantom limb pain (PLP), residual limb pain (RLP), low back pain (LBP), and contralateral limb pain (CLP), among individuals with limb amputation. We searched PubMed, Embase, Web of Science, Chinese Biomedical Database (CBM), China Knowledge Resource Integrated Database (CNKI), and Wanfang Database from inception to 22 February 2026 (PROSPERO ID: CRD420251042011). Observational cross-sectional or cohort studies reporting prevalence data were included. Two reviewers independently screened the records, extracted data, and assessed risk of bias. Meta-analyses of prevalence were conducted using random-effects models in Stata 17.0, with results expressed as pooled prevalence and 95% confidence intervals (CIs). A total of 51 studies involving 13,053 participants were included. Pooled prevalence estimates were: PLP 61% (95% CI: 56%–65%), RLP 58% (95% CI: 52%–65%), LBP 62% (95% CI: 55%–69%), and CLP 43% (95% CI: 24%–61%). Between-study heterogeneity was high across outcomes (I² > 90%), nevertheless, pooled estimates were generally stable in sensitivity analyses. Funnel plots and Egger’s tests suggested a low likelihood of small-study effects. Post-amputation pain is highly prevalent and multidimensional, with LBP emerging as the most frequent phenotype in this review. These findings support comprehensive pain assessment in routine practice, with evaluation of LBP and CLP alongside PLP and RLP to better characterize pain burden and inform individualized management. Given the substantial heterogeneity, pooled estimates should be interpreted cautiously.