Post Amputation Pain Management
Residual limb pain
Many people experience localised pain in the residual limb after amputation. This is called residual limb pain, or nociceptor pain and may be acute or chronic. Always tell your medical team about any pain you are experiencing after amputation. Acute pain is always a warning sign of a physical disorder. Chronic pain lasts more than six months.
Some common causes for pain after amputation include:
- Pressure points due to poorly fitting prostheses
- Neuromas (benign nerve nodes at the site of a severed nerve)
- Bone infection
- Soft tissue infections
- Necrotic muscle area
- Not enough rounded bone edge
- Wear of adjacent joints
- Circulatory disorders
- Venous congestion
- Vasodilatation
- Poor soft tissue coverage, soft tissue overhang
- Adhesions of the skin and bones
- Wart-like tissue enlargement or other skin changes
If you continue to experience pain even after your prosthesis has been adjusted or taking painkillers, your doctor may suggest corrective surgery.
Phantom Pain
Phantom pain happens when people experience pain in a body part that has been amputated. A study shows that 74.5%* of amputees who were surveyed reported experiencing phantom pain.
The causes of phantom pain are not entirely understood, but it is known that phantom pain tends to occur more frequently the longer the person was in pain before their amputation. This is called "pain memory." Phantom pain can occurs at different times. Some influencing factors include stress, weather changes, exposure to cold, mechanical irritations, urinating or defecating.
Undergoing pain management prior to amputation surgery, and/or certain surgical techniques performed under general anesthesia, have been documented to reduce phantom pain. The best precautions against phantom pain is a well-executed operation and early, consistent pain management.
Treatment for phantom pain depends on its intensity and duration. Medicine, massage and compression therapy may be used to treat pain episodes. Phantom pain also may be reduced by using a well-fitting prosthesis because of the favorable feedback between the skin nerves to the brain. In addition, there are other therapeutic and pharmacological treatment options.
If the phantom pain occurs after a painless period of time, it could be other underlying conditions, such as having a herniated disc that radiates into the affected limb. Incidentally, children are less likely to suffer from phantom pain.
Patients suffering from phantom pain should look for facilities or medical professionals who have experience in treating phantom pain.
Phantom Sensations
Phantom sensations are different from phantom pain. Phantom sensations are perceived, non-painful feelings in the amputated body part. Due to the central body schema of the brain, patients may feel tingling (kinesthetic), pressure, proprioceptive and temperature-related phantom sensations.
Depending on a person‘s age, the sensations can have different effects. In older patients, they occur more frequently.
Phantom sensations usually don‘t require therapy, but patients should be aware of them, and communicate their experiences about them to their medical team.
Psychological Considerations
Once you have recovered from surgery and are adapting to life with an amputation, you may discover that focusing solely on your physical recovery is not enough.
During these times, you can turn to other resources, like family and friends, your spiritual beliefs and support groups. It will make things easier if you and your loved ones recognise that experiencing an intense range of emotions can be a natural part of the healing process.
Psychological counselling can be a wonderful aid in your recovery process and help enhance the overall quality of your life. Maintaining an open and honest dialog with your support team is imperative to fostering your emotional well-being as well as your physical recovery.