And what helps against it?

A possible cause of pain in the amputated limb can, on the one hand, be due to internal pain such as bone, vascular, nerve and wound pain and neuromas, and, on the other hand, due to external pain such as pressure and chafing in the prosthesis socket, while phantom pain is also a possibility. In order to provide those affected with successful treatment, it is first necessary to distinguish between the various types of pain because these are treated differently.

Phantom sensations (feelings)

These are non-painful sensations in the amputated part of the body that are really felt. They occur almost regularly after amputation in 50 - 90% of those affected, and can affect people differently depending on their age, i.e. they occur more often at an advanced age. The forms of phantom sensations we know about are sensations of pressure and cold, so-called kinetic (= moving) phantom movements, and direct postural and positional sensations. These are attributable to the central scheme of the body stored in the brain. After bilateral amputations, the phantom sensations occur more frequently on the dominant side and they persist longest in the hands and feet. This is due to the fact that these regions of the locomotor apparatus are present more often in the brain. However, the memory in the brain fades, and patients develop so-called "telescoping", "shrinkage" of the phantom limb.

Residual limb pain

Residual limb pain occurs very often, and immediately after the amputation. Pain therapists call this "nociceptor pain" in professional jargon. The cause of this pain is found directly in the affected area. The pain is transmitted to the brain by the skin, the soft tissues and via the spinal cord. This may be due to, for example, benign nerve nodules (neuromas), pain caused by wear-and-tear on the adjacent joints or venous congestion. It is also often caused by circulatory disorders, vascular dilatation or bone and soft-tissue infections that can trigger pain in the residual limb. Less often, residual limb pain is caused by wart-shaped tissue proliferation or other skin changes. Medical examinations may reveal inadequate soft-tissue cover, a soft-tissue overhang, adhesions between skin and bone or between scar tissue and nerves. Residual limb pain must first be thoroughly investigated with X-rays and intensive examinations.

Phantom pain

Phantom pain was described in the literature as early as the middle of the 16th century when it was already a known phenomenon after an amputation. Between 10 and 90%, but at least 70% of amputees had phantom pain some of the time, depending on the literature source. Phantom pain is defined as the transmission of painful sensation from parts of the body that are no longer there. Those affected often describe the pain as shooting, burning, stabbing and cramp-like, and can regress or be persistent. For many of those affected, the pain occurs for different periods of time. Phantom pain can occur after a nerve has been torn out, as happens in serious motorcycle accidents. Factors that influence phantom pain are emotional stress, changes in the weather, cold stimulus, mechanical irritation, passing water and bowel movements. The longer the patient had pain before the operation, the more frequently phantom pain occurs. This is called the pain memory.