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 has been amputated. Some people feel like their limb is still there, even after surgery. This is normal. You may have feelings or sensations in the whole limb or in parts of the limb (e.g. the toes or the fingers, shin, elbow or the knee). 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. As a result, when normal messages from the limb are lost (due to amputation) the brain attempts to reconstruct an image of the limb and send messages – leading to phantom sensation.

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, you may get out of bed during the night (as you did before your amputation) to go to the toilet, leading to a fall.

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 feel similar to a shooting or sharp pain, cramp, burning or 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/or if there are problems with your residual limb (stump). Some amputees may experience more phantom pain due to changes in weather conditions and surrounding environments.

Reducing Phantom 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 (e.g. moving if you have been sitting still for a while, or touching and massaging your residual limb). Some people engage in activities such as listening to music, talking to a friend or playing a game, to help take their mind off the pain. Put simply, diversion is anything that helps to take your mind away from the phantom pain and can be a useful way to assist in reducing or stopping the pain.

The use of other therapies can be helpful as well. It may include massage, stretching and/or mirror therapy. Other people are comforted by the use of heat or cold packs but do not use heat or cold packs if you have a lack of sensation in your limb. 

Some people also find Transcutaneous Electrical Nerve Stimulation (TENS) machines assist in reducing pain. TENS machines generate electrical impulses through the skin surface which are then transmitted as messages to the spinal cord and brain. The different messages sent from your residual limb (stump) can create a diversion and therefore disrupt and reduce the pain.

It is always recommended that you speak with your healthcare team to discuss the use of treatments for phantom pain to ensure you are using a method that is safe for you.