The 3 Areas of Amputee Pain - #1: Intrinsic
There are 3 areas of pain:
1) Intrinsic Pain - The pain following the amputation surgery
2) Phantom Pain - Pain that you feel in the portion of your limb that has been removed
3) Extrinsic Pain - Pain when using a prosthesis or pain that you experience by bumping your limb or falling, etc.
Today I'm touching briefly on intrinsic pain.
First, I want to emphasize this fact:
I believe that no amputee should experience pain as a natural consequence of having an amputation.If the surgery is done as best it can, and if the prosthesis is fit as best it can, you should experience no pain.
Intrinsic pain is a natural course, you will feel that pain. Your surgeon will work with you to determine the appropriate drugs to relieve that following surgery.
Of those who experience this kind of pain following surgery, 50-60% will see improvement without treatment. Once you are out of the hospital, that pain will slowly subside and drugs will be weaned.
Of the remaining 40-50%, there are several treatment options, both drug-oriented and other mechanical options.
It's very important to determine the source of your pain in order to recommend treatment. The source can be skin, muscle, nerve, or bone. There will be specific treatments for each of these. Keep your surgeon and family doctor informed of your condition. Often, pain is attributed to the manner in which your amputation was performed. Treating each of the tissues is important. In addition, in trauma situations, amputation could be a less important procedure in maintaining your overall health and well-being; and may require a revision or reconstruction at a later time when you regain strength.
8 weeks post-surgery is the average time in which somebody is fit with a temporary prosthesis. Now we introduce a different kind of pain - the pressure on your residual limb supporting your body weight within the socket of the prosthesis (Extrinsic pain, which I will cover later).
That kind of pain will also subside as you acclimate to that new environment of pressure - the tissues that are not normally pressurized; the bottom of your foot is used to pressure, but the sides of your limb are not. But again, that will acclimate.
My experience and our experience here has been that people do not experience pain when they have their prosthesis on and when they are carrying on their daily activities, whatever they are; whether it's just walking, going to the gym, or performing some sports or recreational activity whether its competitively or just recreationally.
In fact there are a number of people who run marathons, ultra marathons, 100-mile runs, and 50-mile runs without skin sores, without pain, and without skin breakdown.
The process of fitting is very complex, there are many procedures; and we go through all of these procedures so that the prosthesis and the fitting will last as long as possible.
We have patients that have been wearing the same prosthesis for 15-20 years. That's well past the average of 3-5 years.
It's important that, as an amputee, you have the patience to go through each of these steps, so you don't have to visit your prosthetist any more than necessary.