HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

What Causes Constant Pain In Amputated Leg?

Posted on Thu, 30 Apr 2015

Question: my left leg was amputated in 2004, since then I have been in pain 24/7 - most times it a ranges from 6 to 10 on the pain range. Right now, I had a bruise in the bottom on the stump which turned into a booboo, which got infected. My stump is now swollen and as it is already touch sensitive, this time is it worse to touch, I cannot wear my prosthetic, because of the swelling, pain... please help

Answered by Dr. Sabiha Banu (54 minutes later)

Brief Answer:
surgical opinion

Detailed Answer:
HI
Thanks for using HCM.

I really feel very much concerned about your condition.
Chronic pain in the stump after 11 years of amputation is really due to neuralgia(due to the nerve endings cut & destroyed during the amputation).
Was this an above knee or below knee amputation?
Are you on any pain medications? Please let me know.

As concerned with your present problem,it seems like the stump has been infected with progression to cellulitis.
Are there any intermittent or continuous episodes of raised temperature.

Please do not wear your prosthetic, as this can cause more trauma & increase the infection, with extreme pain.

Please go for a complete haemogram,renal function tests, if required for blood & wound(on the stump) culture.

I would suggest you to consult your treating doctor or a surgeon,to start you on antibiotics,painkillers & anti-edema medications.

Your stump(infection) also requires regular sterile dressing under monitored surgical care.

Hoping for your speedy recovery & good health.

please get back to me for any related doubts.

All the best, take care.

Above answer was peer-reviewed by : Dr. Neel Kudchadkar

Follow up: Dr. Sabiha Banu (49 minutes later)

Yes, I am on pain medication which I hoped I could stop at some point, it is not. I am on oxycodone 30 x 4 times a day - 75mcg Fentanil patch every 48 hours, and Neurontin (generic gaba..) 600 mg x 3 times a day, and finally Lidocaine patches 12 hours on 12 off. I am not a crier, neither do I complain so much, nor whine, but the pain has been getting worse over time. For the 2nd question, my amputation was below the knee. I really appreciate your help in this matter, I think I would hug you right now, because, I cannot get any answers, here after all these years.I forgot to answer the temperature question - yes, the temperature has been up and down since the operation, but worse now than ever.

Answered by Dr. Sabiha Banu (31 minutes later)

Brief Answer:
treatment for cellulitis/infection

Detailed Answer:
Hi
Thanks again for following up in HCM.

As per you details regarding pain medications, you are almost on all levels with opiods, gabapentins & local anaesthetics, except for neurolytic block.
With all these pain medications i would suggest you to take regular methylcobalamine at least 1000mcg/day, which either help in regeneration or rejuvenation of the nerve-endings.

With your present inflammatory condition,local patches of lidocaine do not work due to the PH variation in infection.
This pain & swelling reduces only with receeding infection.

Please make sure that you keep the stump elevated, to improve the blood flow.
local application of ointment like mupimet(mupirocin) with maintaining a sterile
environment of the wound.

Antibiotics like Clavulinic acid added with amoxycillin (625)twice daily for 5 days, added with anti-edema drugs chymoral forte or seratiopeptidase with your regular oral pain medications will help in reducing the infection.
If the infection & temperature is persistent please go ahead with the blood tests (complete haemogram, renal function test, blood & wound culture),for specific treatment.

Hoping my answer could help you in the best.

Please get back to me for any related doubts.

Wishing you good health & progressive relief from pain.

All the best, take care

Above answer was peer-reviewed by : Dr. Pradeep Vitta

Follow up: Dr. Sabiha Banu (45 minutes later)

You are an XXXXXXX thank you.

Answered by Dr. Sabiha Banu (10 minutes later)

Brief Answer:
thanks again

Detailed Answer:
Hi.
Thanks you so much.

I know i could`nt help you in anyways more than this.

As a doctor and your well wisher at the most, i can pray for your pain relief and suffering.

May the Almighty provide you with strength & courage of maximum tolerance,the best of health & happiness always.

All the best, Thank you.

Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Prasad