The risk of healing disorders and infections is high in the period of time following amputation operations. That is why it is very important to monitor the wound daily. If the skin around the residual limb turns red or pain is felt, something must be done immediately. Bandaging the residual limb to generate a certain compression is also very important. Physical therapy, physiotherapy and ergotherapy should begin right after the operation if possible.
Since the body is suddenly no longer complete after an amputation, the patient may have to make internal adjustments as well. In many cases, a confidential conversation between the physician and the patient can help; sometimes including a psychologist may also make sense.
The physician can differentiate between phantom pain and phantom sensation. Phantom pain is sudden pain in the area of the extremity that no longer exists. There is also the emergence of pain similar to what was felt during an accident involving a serious contusion or ripping injury. The phantom fingers can then claw, burn or itch, for example.
Phantom pain can emerge from time to time or repeatedly. The phantom sensation, on the other hand, is viewed as something completely normal. Phantom sensation, for example, may involve the patient still feeling the fingers from his amputated limb.
One perceives that they are still able to move it. With their eyes closed, patients can also describe how they are holding their hand at the moment. Only some patients suffer from phantom pain in the long term.
If the patient feels such pain, there are different treatment possibilities. Quite often one finds nerve ends that are too long and “ride” on the bone especially in cases involving traumatically amputated patients. Such problems can often be eliminated in an operative correction of the residual limb by shortening the nerves and vessels. Other possibilities – immediately after an operation – include local pain blockage as well as medication with calcitonin infusions.
The correct wrapping of the residual limb with mild pressure can also bring about a significant reduction in phantom pain. Phantom pain can usually be treated well by undergoing special physiotherapy and ergotherapy.
Physical therapy has also been shown to have a good effect. Finally, wearing a prosthesis can also contribute to the alleviation of pain. Especially the intensive use of myoelectric prostheses helps the brain adapt to the altered situation.
Dr. med Hartmut Stinus, Orthopedist, Northeim