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The Beyond Pain Foundation

Conditions we support

Conditions guide

Amputation and phantom limb pain

After losing part of a limb, many people feel pain in the part that is no longer there, or in the limb that remains. This pain is real, not imagined, and brain scans have confirmed it. This guide explains the different kinds of pain after amputation, how they change over time, the treatments and prosthetic services available in the UK, and your rights at work.

Major limb amputations in the UK each year
5,000 to 6,000
People with amputation who have phantom limb pain
About 6 in 10
People who feel phantom sensations
Nearly everyone
People using NHS prosthetic services in England each year
About 25,000

This guide is general information, not medical advice. Medicines and treatments must be prescribed or recommended for you by a doctor or pharmacist. We do not give doses here.

What it is

An amputation is the removal of all or part of a limb by surgery, or its loss through injury. In the UK the most common reason for a leg amputation is poor blood supply, often linked to diabetes or smoking. Arm amputations are most often caused by injury. Other reasons include severe infection, cancer and limbs that don't work and cause pain. Some people are born with a limb difference.

More than half of people who have an amputation are 70 or older, and men have amputations about twice as often as women. People with diabetes are many times more likely to need one than people without.

After amputation, the brain and nerves still "expect" the missing limb. Nerve endings at the site can also become sensitive. This can cause sensations and pain that feel as if they come from the missing part, as well as pain in the remaining limb.

Types of pain and sensation

These often happen together, but they are treated differently, so it helps to tell them apart.

Phantom sensation

Feeling that the missing limb is still there: itching, tingling, warmth, pressure or movement, without pain. Nearly everyone has this at some point. It is normal.

Phantom limb pain

Pain felt in the part of the limb that is gone. It can burn, stab, cramp, throb or feel like electric shocks. The missing limb may feel twisted or stuck in an awkward position. It is more common after leg amputation and after amputation higher up the limb.

Residual limb pain

Also called stump pain. Pain in the part of the limb that remains. It can come from the wound, a badly fitting socket, skin problems, bone spurs or a sensitive nerve ending (a neuroma).

Pain elsewhere

Using a limb differently puts strain on other parts of the body. Back pain, and pain in the other leg, hips or shoulders, are common.

Pain before the amputation, pain in the residual limb and strong phantom sensations all make phantom limb pain more likely.

Recovery and time frames

Every recovery is different. It depends on the type of amputation and your general health. This is a rough guide for a leg amputation.

  1. First days

    Hospital

    Strong pain relief, often through a drip or pump at first. Physiotherapy starts the day after surgery. Phantom sensations often start soon after the operation.

  2. Around 2 to 3 weeks

    Wound healing

    Stitches or clips usually come out at around 3 weeks. Many people go home within a couple of weeks. Swelling of the residual limb is normal.

  3. Weeks to months

    Prosthetic rehab

    If a prosthesis is right for you, the limb centre measures and casts your residual limb. A first limb is often made in about 2 weeks, then you learn to walk with it. Getting fully fitted can take several months.

  4. Months to years

    Living well

    The residual limb shrinks and changes shape for months, so sockets need adjusting. Phantom pain often eases over time, but for some people it lasts many years.

Timings are typical, from NHS patient leaflets, not exact rules. Not everyone is suited to a prosthesis.

When to get urgent help

Call 999 if you have

  • chest pain, or sudden shortness of breath. This can be a blood clot in the lungs
  • fast breathing, confusion, slurred speech, or blue, pale or blotchy skin. These can be signs of sepsis
  • heavy bleeding from the wound that won't stop
  • signs of a heart attack or stroke

Call NHS 111 or your amputation team if

  • the wound is red, hot, swollen, smelly or leaking pus
  • the wound starts to open
  • you have a high temperature, or feel hot, cold or shivery
  • your other leg is throbbing, swollen or warm. This can be a blood clot (DVT)
  • you notice a wound, blister or colour change on your remaining foot, if you have diabetes or poor circulation

See your GP or limb centre if

  • phantom or residual limb pain is getting worse or stopping you sleeping
  • your socket rubs, causes sores, or no longer fits
  • you have a tender lump in the residual limb
  • you feel low, anxious or can't cope

Diagnosis and referral

Phantom limb pain is diagnosed from what you describe. It is important to also check the residual limb, because some pain there has a fixable cause, such as a poorly fitting socket, a skin problem, an infection, a bone spur or a neuroma. You may have an X-ray or ultrasound scan.

After an amputation in hospital, you are usually referred to a specialist NHS limb centre (also called a prosthetic or disablement services centre) before you go home. If you already use a limb centre, contact them directly about socket or prosthesis problems. Your GP can refer you to an NHS pain clinic if pain isn't controlled.

1 to 2 million

The number of people each specialist prosthetic centre in England typically serves, according to NHS England. So your nearest limb centre may be some distance away. Ask about help with travel costs to NHS appointments.

Treatments and medicines

No single treatment works for everyone, and good trials are limited. Most people find a mix of treatments helps most. Medicines for nerve pain usually need several weeks to judge.

Simple painkillers

From a pharmacy or supermarket

Paracetamol and anti-inflammatory painkillers such as ibuprofen can help residual limb pain and aches elsewhere. They help phantom pain less. Ask a pharmacist if they are safe for you.

Nerve pain medicines

Prescription

Phantom pain is a type of nerve pain. NICE recommends offering a choice of amitriptyline, duloxetine, gabapentin or pregabalin. They are started low and increased slowly. If one doesn't help after a fair trial, another can be tried.

Mirror therapy

Usually taught by a physiotherapist, then done at home

A mirror hides the residual limb and reflects your other limb, so it looks as if both are there. Moving the reflected limb can "retrain" the brain and ease phantom pain for some people. It is often done for short sessions every day over several weeks.

Graded motor imagery

Physiotherapist or pain clinic

A step-by-step programme that starts with recognising left and right limbs in pictures, then imagining movements, then mirror therapy.

Desensitisation, massage and TENS

Physiotherapist, then at home

Touching, tapping and rubbing the residual limb with different textures helps it get used to touch. Massage, heat or cold, and a TENS machine help some people.

Compression and a well-fitting socket

Limb centre

Compression socks or liners control swelling. A good socket fit is one of the most important ways to prevent residual limb pain.

Be cautious with long-term opioids

Strong painkillers such as morphine are used just after surgery. Taken for months, they rarely keep working well and the risks rise with the dose. If you have been taking them for a long time, ask your GP for a review. Don't stop suddenly without advice.

Prosthetics, rehab and pain clinics

  1. NHS limb centre

    Ongoing, with regular reviews

    A team of prosthetists, physiotherapists, doctors and occupational therapists. The NHS provides prostheses, makes and adjusts sockets, and repairs limbs. Tell them about pain: a socket change can make a big difference.

  2. Advanced prosthetics

    Depends on assessment

    In England, the NHS can fund microprocessor-controlled knees for some people with an above-knee amputation who can walk in the community and are at risk of falls. Sports and activity limbs are funded for children. Adults who want an activity limb often have to pay privately or seek charity funding.

  3. Pain clinic

    After GP or limb centre referral

    Specialists can review your medicines and may offer nerve block injections, other treatments, or a pain management programme that teaches ways to live better with pain.

  4. Surgery on the residual limb

    Recovery of weeks to months before refitting

    If a neuroma, bone spur or problem with the shape of the limb is causing pain, surgery may help. You may need time out of your prosthesis while it heals, and a new socket afterwards.

  5. Psychological support

    At any stage

    Coming to terms with limb loss matters as much as physical recovery. Ask your limb centre or GP about counselling or talking therapy. Peer support from others with limb loss helps many people.

Self-help

When phantom pain flares

  • Massage or tap the residual limb
  • Try "moving" the phantom limb in your mind to ease cramping
  • Put on, or take off, your prosthesis or compression sock
  • Try heat, a cool pack or TENS
  • Distract yourself with something absorbing

Day to day

  • Wash and dry the residual limb daily, and check the skin
  • Check your other foot every day if you have diabetes or poor circulation
  • Do your exercises to keep strength and stop joints stiffening
  • Keep a pain log to spot patterns and triggers
  • Stop smoking: it slows healing and harms circulation

If you drive, you must tell the DVLA and your insurer about your amputation. You may need a driving assessment and an adapted car.

Getting the best treatment

Help your team help you

  • Say clearly whether pain is in the missing part, the residual limb, or both
  • Describe it: burning, cramping, stabbing, electric shocks
  • Tell your prosthetist at once if your socket rubs or no longer fits
  • Ask for mirror therapy or graded motor imagery if you have phantom pain
  • Ask whether nerve pain medicines might help
  • Ask about a pain clinic if pain isn't controlled
  • Ask about peer support and counselling

Keep a pain log for a few weeks. It helps your team, and it is useful evidence for your employer and for a funding application.

Amputation and work

Losing all or part of a limb will usually count as a disability under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland), because it has a long-term, more than minor effect on daily life. The law looks at how you would be without your prosthesis or other aids.

Your employer must make reasonable adjustments. Talk to your rehabilitation team about when to return; it depends on your job. A phased return, building up hours over several weeks, is common. Adjustments might include:

  • A phased return and changed hours
  • A ground-floor workspace or accessible parking
  • A sit-stand desk, perching stool or supportive chair
  • A one-handed keyboard or voice recognition software
  • Adapted tools and controls
  • Less walking, standing or carrying
  • A private space to adjust or remove your prosthesis
  • Time off for limb centre and pain clinic appointments

Access to Work is a government grant in England, Scotland and Wales that can pay for specialist equipment, adapted vehicles for getting to work, support workers and extra travel costs, beyond what your employer must provide. Northern Ireland has its own scheme. For advice on your rights, contact Acas or Citizens Advice.

Up to £69,260 a year is the current maximum Access to Work grant. (GOV.UK, awards from April 2026)

Benefits

If you are an employee and off work, you may get Statutory Sick Pay for up to 28 weeks. You may also be able to get Personal Independence Payment (PIP), or Adult Disability Payment in Scotland, Universal Credit or Employment and Support Allowance. If you lost a limb in an accident at work while employed (not self-employed), look at Industrial Injuries Disablement Benefit. Veterans may be able to get help through the Armed Forces Compensation Scheme. Turn2us and Citizens Advice can help you check.

How The Beyond Pain Foundation can help

If NHS waits are too long, or the help you need isn't available to you on the NHS, we may be able to fund:

  • A private consultation with a pain specialist
  • Private physiotherapy, including mirror therapy or graded motor imagery
  • A pain management programme or course
  • A TENS machine or a mirror therapy box
  • Workplace or home equipment, such as a sit-stand desk, supportive seating, adapted tools or mobility aids
  • Home safety equipment, such as grab rails or bathing aids

We can't pay for everyday living costs or debts. If you are claiming compensation, tell us, and tell us about any help your insurer, employer or the NHS is already providing. Always get a written quote to include with your application.

Apply for funding Check the requirements

Support and sources

Limbless Association

UK charity for people with limb loss

Helpline 0800 644 0185, Monday to Friday, 9am to 5pm. Peer visitors, local hubs and a legal panel.

limbless-association.org

Douglas Bader Foundation

Charity for people with limb loss

Information on limb loss, Bader Grants for practical support, and activity programmes.

douglasbaderfoundation.co.uk

Blesma, The Limbless Veterans

Charity for serving and ex-Service people

Support for serving and former armed forces members with limb loss. Call 020 8590 1124, Monday to Friday, 9am to 5pm.

blesma.org
Sources for this guide

Last reviewed: October 2026.