Pain is a normal part of surgery recovery, but if you’ve had a limb amputation procedure, you might find your pain differs from the healing process of other surgical procedures. Once your initial post-surgical pain improves, you might be left with a variety of sensations.
What is Post-Amputation Nerve Pain?
Post-amputation pain is common among amputees. You might feel sensations in part of the limb that remains after amputation, or you could experience phantom pain in the area of amputation. You may experience any of the following:
Phantom sensation or pain: The Amputee Coalition describes these sensations as sensations you continue to feel in the amputated limb, despite the fact it is no longer there. You might feel tingling, itching, pins and needles, pressure or temperature changes. Phantom pain occurs when these phantom sensations become painful.
Neuroma pain: A neuroma is a collection of nerve endings that form a bundle at the end of your amputated limb. It can become very sensitive and uncomfortable, especially if the neuroma is pressing against a prosthesis.
Residual limb pain: This type of pain occurs in the remaining part of your limb and can be caused by a variety of factors including surgical trauma, muscle or bone pain, neuroma formation, skin issues, or infection.
Why is the Pain Happening?
Post-amputation pain can happen as a result of mixed signals from the brain or spinal cord. A neuroma can also send pain signals to your brain as the nerves in the area of amputation attempt to regenerate.
How to Cope with Post-Amputation Nerve Pain
Living with post-amputation pain can be difficult, however, there are things you can do to cope. Pain can be managed in a variety of ways including: Medications: Many different medications can help manage your pain including pain relievers, like acetaminophen or ibuprofen, or medications to treat nerve pain like gabapentin. Opioid medications are not commonly prescribed to treat this type of pain. Biofeedback: Biofeedback can help you reduce pain by making subtle bodily changes, like relaxing muscles for example. Electrical sensors are placed on your body, which provides information to the patient and physical therapist about what’s happening in your body. Biofeedback can give information on a patient’s brainwaves, breathing, heart rate, muscle contraction, temperature regulation and sweat gland activity. Relaxation techniques: If you’re anxious or stressed, you’ve probably noticed that your pain increases as your distress increases. But relaxation techniques can help bring your pain to a more manageable level by reducing your mental distress. Techniques like deep breathing, progressive muscle relaxation or guided imagery can all be done in the comfort of your home. Targeted muscle reinnervation (TMR): TMR is a surgical procedure that reassigns the nerves that once controlled your amputated limb. When a nerve is injured, it attempts to regenerate. If it can’t — like in cases of amputation — painful neuromas can form. TMR reroutes these nerves to new muscles to innervate, allowing the nerves to regenerate and reduce pain. Nerve blocks: Nerve blocks are an injection of anesthetic and/or steroids into the area of a painful nerve. They can help with pain control and improve function. If your pain is difficult to manage, speak with your care team about your options. You may also want to consider finding a surgeon who specializes in TMR.
TMR is not a treatment option for patients with spinal cord injuries, brachial plexus injuries, or who are generally not healthy enough for surgery. The procedure does present typical risks of surgery. Your physician will help you determine whether TMR is right for you.