Pain After Amputation
Sadly, pain is a long-term issue which follows after an amputation and it is more common than it is not. It is also important to distinguish between residual limb pain from phantom limb pain and phantom limb sensation. In the medical field of prosthetics and orthotics, periodic episodes of pain are very common following an amputation procedure. Residual limb pain is most commonly located on the residual limb itself while the phantom limb pain is mostly located in the phantom foot or hand. Phantom limb sensation is not very painful. It is the feeling that an absent limb is still intact and right in its place.
- Residual Limb Pain
After a surgical procedure, it’s natural that the body’s response to this trauma would be a pain response one. Pain is often associated with swelling, so the basic principles of RICE (rest, ice, compression, elevation) can be applied. A sudden increase in pain and swelling during healing could be a sign of infection and immediate attention by a doctor is needed.
However, at this stage of rehabilitation, a moderate level of pain is expected, especially along the patient’s suture line. If the pain is intolerable, it’s a sign that you may be overdoing it and that you need to reduce the wear time of your prosthesis or the amount of weight you are bearing on the prosthetic side. It could also mean that you need some modifications to be done on your socket., especially if the pain is located in a specific area.
- Phantom Limb Pain
Though these pains are called “phantom,” they are very much real and are mostly not well understood. Phantom limb pain is fairly common and can be a very debilitating experience. It’s logical that sensation and sometimes pain would occur following amputation surgery because many of the neural pathways are still being reestablished and are partially in place. People who have phantom limb pain say that it comes and goes. It may happen more during times of stress or when the environment’s weather is changing.
- Phantom Limb Sensation
Phantom limb sensation is normal and can be helpful when it is time to start using a prosthesis. It will be used with regard to proprioception, which is a feeling of where the phantom limb is in space. A High caution must be taken with phantom limb sensation, especially in the beginning stage of usage, as there is an increased risk of falls when a person senses the leg and thinks the leg is there when it’s actually not there.
A helpful tip is to park your wheelchair or a chair right beside your bed to serve as a reminder for you until you get a better sense of your new normal.
A new generation of prosthetic and orthotic devices allows patients to control their prosthetic arms with their thoughts! Wait, something is missing. Every amputee knows it, and it is more than the arm or leg they have lost. Replacements can be made for those limbs: substitutes made from metal and plastic materials, controlled by advanced computer chips, with the ability to grip, to turn and step. On the outside part, the limbs can appear lifelike while on the inside, they are amazing machines.
Zac Vawter, at the Willis Tower in Chicago in October of 2012, was the first person to climb 103 flights of stairs wearing a prosthesis controlled with his mind.
Thought Amplifiers
To further enhance the responsive sense of a prosthetic as an organic part of its wearer, doctors and engineers have developed artificial limbs that respond seamlessly to the patient’s own thoughts.
Computer chips inside the prosthetics are connected to sensors that pick up motor signals from the nerves in a patient’s stump that formerly commanded a hand to open. No wires penetrate the skin. A method called targeted muscle reinnervation is used. The nerves have first been rerouted by a trained surgeon into the large muscles at the end of the stump. Muscles are electrically active. They act as amplifiers for the projecting nerve signals, strengthening them enough for the prosthetic sensors to pick them up. The signals are then sent on to motors that move the hand.
Pain is an undesired consequence that is common immediately after amputation has been done and for some people, it lasts for a long time. Understanding differences in the types of pain residual limb pain and phantom limb pain and also the cause of pain which can be mechanical or nonmechanical can influence treatment modality. This can aid in choosing the best treatment plan. Keeping a well-documented pain journal is helpful when talking with your healthcare team about your specific problem. When making decisions on the best possible treatment plan, a well documented journal can assist for the prosthetics and orthotics procedures.