Amputation

Also called Limb loss, Limb difference

Around 6,000 lower limb amputations a year in England. Most follow diabetes, and most of those were preventable.

What it is

Around 6,000 lower limb amputations are performed in England each year. The large majority follow vascular disease and type 2 diabetes, and the pathway is almost always the same: a foot ulcer that was not caught early enough.

That is worth stating plainly, because it means most amputations in this country are the end of a preventable sequence rather than a sudden event.

Other causes are trauma, cancer, and congenital limb difference.

Rehabilitation determines almost everything about the outcome, and access to it is uneven.

Signs you might notice

This entry is about what follows, so what matters is recognising the complications.

Phantom limb pain, which affects the majority of people after amputation and is real, neurological pain rather than imagination.

Stump problems: pressure areas, poor socket fit, skin breakdown, swelling.

Problems in the remaining limb, which now takes double the load and is at high risk of its own ulceration in diabetes.

Low mood, and grief for the limb, which is a genuine bereavement and is frequently unacknowledged.

How it can affect day-to-day life

Prosthetic fit is the whole practical story. A socket that no longer fits, because the stump has changed shape or the person's weight has changed, causes pain and skin damage and leads people to stop using the prosthesis.

The remaining limb needs the same daily foot care as the lost one did, and this is the most commonly neglected part of aftercare.

Housing, transport and employment all need adapting, and the delays in getting adaptations are a common source of avoidable dependence.

Supporting someone well

Protect the remaining limb obsessively. Daily foot checks, well-fitting footwear, and same-day help for any break in the skin.

Treat phantom limb pain as real and ask for proper treatment, including mirror therapy and nerve pain medication.

Check the socket fit regularly, and report any redness, sore or change in shape rather than pushing through.

Keep weight stable, because socket fit depends on it.

Ask for psychological support and do not treat grief for a limb as disproportionate.

Push for early and sustained rehabilitation, and for a named prosthetist.

Where to get help

Ask for referral to a specialist limb-fitting centre and for physiotherapy.

The Limbless Association and Limb Power both provide peer support, which people consistently rate as the most useful thing.

Any wound or ulcer on the remaining foot needs same-day specialist assessment.