Phantom Petra — Amputation Care: The Limb That Is Gone but Still Hurts
Phantom pain is real nerve pain — treat it, never dismiss it
Petra's foot aches in the night though the foot is gone — and her nurse treats that pain like any other, because the nerves still carry it.
Petra lost her leg, but her nerves did not get the message. After amputation, severed nerves keep sending signals, and the client feels burning, cramping or stabbing pain in a limb that is no longer there — phantom limb pain. It is real, it is common, and telling the client it is imaginary is never the answer. Residual-limb care follows clear rules: elevate the limb only for the first 24 hours to control swelling, then keep it flat — prolonged elevation or a pillow under the knee causes a hip flexion contracture that ruins prosthetic fitting. Early and often, the client lies prone to stretch the hip. The limb is wrapped in a figure-eight bandage, rewrapped several times a day, and shrinker shaping prepares it for a prosthesis. Phantom pain responds to prescribed analgesics and nerve-pain agents like gabapentin, plus mirror therapy and tapping or massaging the residual limb.
Read Phantom Petra's full story →The story arc
The setup
On the first day after a below-knee amputation, the residual limb is elevated on a pillow.
The turn
Petra reports burning pain in the foot that was amputated and is embarrassed to say so.
The crisis
Two weeks later she has been lying with a pillow under her knee, and her hip will no longer fully straighten.
The save
Pillows come out, prone time begins, the figure-eight wrap shapes the limb, and gabapentin calms the phantom burning.
NCLEX study section — Amputation Care: The Limb That Is Gone but Still Hurts
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Critical Care
Take this chapter into practice questions on the same topic.