Managing Pain

Pain in the area of the wound is common following any operation, especially as you start to move around and the tissue starts to heal. This pain should improve during the first few weeks and will usually require some medication in the short term. 

Everyone’s experience of pain is different. Some pain is worse than other pain. Unique to some amputees is phantom pain and/or phantom sensation – pain or feelings in the limb that is no longer there. 

Phantom Sensation

Phantom sensation is a feeling in the limb which is absent. Some people feel like their limb is still there, even after surgery. This is normal. You may have feelings or sensations in parts of the limb such as: the toes or the fingers, the shin, elbow or even the knee which have been amputated. You may experience sensations such as: pins and needles, an itch or tingling sensations.

Phantom sensation is common following amputation.  One theory to explain this is that the brain has developed a recorded image of the limb, and when normal messages from the limb are lost (due to amputation) the brain attempts to reconstruct an image of the limb, and send messages; hence phantom sensation.

The good news is that the brain has an amazing way to re-learn, and this is helped by increasing normal input, for example: moving, touching or best of all, using the residual limb (with the help of a prosthesis) to enable a ‘new image’ of the limb to be created in the brain.

If you do experience phantom sensation, take care. Many lower limb amputees report trips and falls especially during the night. It is easy to think that your limb is still there and when you’re feeling sleepy, or when it’s dark, you may try to use it. (For example: getting out of bed during the night (like you did before) to go to the toilet.
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If you are experiencing pain of any kind, speak to your healthcare provider.

Phantom Pain

Phantom pain sometimes occurs in the weeks following amputation and, like phantom sensation, can reduce over time. Some people find this pain very uncomfortable.  It can be similar to a shooting or sharp pain, cramp, burning or feel like a mild electric shock. Phantom pain can usually be managed by a variety of treatments and medication. If you experience phantom pain speak to your healthcare team so that they can work with you to decide which pain management solution will work best for you.  

Phantom pain may return on occasions, for example: when you are unwell, over tired, feeling ‘stressed’ if your prosthesis is not fitting correctly and if there are problems with your residual limb (stump). Some amputees experience more pain due to a change in weather conditions and surrounding environments. 

Reducing the Pain

One of the successful ways to manage phantom pain is diversion therapy. Diversion therapy is when you try to focus your attention on doing something different. Such as: moving if you have been sitting still for a while, or touching and massaging your residual limb. Some people use things like: listening to music, talking to a friend or playing a game, to help take their mind off the pain. Basically anything that takes the focus of your mind away from the phantom pain can be a useful way for the pain to stop. 

The use of other therapies can be helpful, these can include: massage or stretching and mirror therapy. Other people are comforted by the use of heat or cold packs; (these should only be used if you can feel hot or cold sensations well). Transcutaneous Electrical Nerve Stimulation (TENS) machines generate electrical impulses through the skin surface that are transmitted to the spinal cord and brain. These different messages from your residual limb (stump) can create a diversion and therefore disrupt and reduce the pain. It is always recommended to speak with your healthcare team to discuss the use of other treatments for phantom pain to make sure you are using a method that is safe for you.