Chronic pain in wound under foot

[salamander160]

I had my toes amputated last February 23, I am still having the wound dressed and the lower limb nurses are using compression bandages. When they clean under and on the inside of my foot, it really hurts, the pain is getting much worse and it seems like nothing really helps it. I also suffer from oedema, being in a wheelchair, my legs are down but have to elevate them as much as I can. The pressure from the fluid increases the pain and the pain is unbearable and again very little touches it. The last few weeks, the pain under my foot has got so bad, it is really affecting my mental health. I have spoken to my Gp about all of this twice this week, I have done an e consult, spoken to 111 twice tonight, they sent paramedics out, they wouldn't take me to hospital as there is no sign of an infection. I spoke to my neurologist last week, I am speaking to the pain clinic in a few weeks time. This pain is really getting me down, Something is obviously going on that they cannot see, there is nothing visible. I really don't know what else I can do to stop this burning pain. I am taking gabapentin, codeine, ibuprofen, paracetamol. and oramorph when i need it. I took 10ml tonight, the paramedics told me to take more. I am at a complete loss!!

[ftorres18]

I'm so sorry to hear about the pain you’re going through. I can’t imagine how frustrating and exhausting this must be for you, both physically and emotionally. From what you’ve described – the burning sensation, the pressure from the oedema, and the constant pain – it seems like there’s something else going on, and I completely understand your concern. I’d like to share what I think might be possible causes and some options that could help, though of course, the final word will always lie with the specialists.

Possible causes of the pain:

1. Neuropathic pain: It’s common after an amputation for the nerves to be affected, causing sensations like burning, stabbing, or intense pain. This might be related to what you’re experiencing.

2. Pressure from oedema: The fluid buildup in your legs could be increasing the pressure in your tissues and worsening the pain, especially when your legs are down.

3. Circulatory issues: There might be an issue with the blood flow in the affected area, which could be making the pain and swelling worse.

4. An undetected internal issue: Even though there are no visible signs of infection, there might be something deeper, like tissue damage or trapped nerves, which isn’t easily identified without more detailed examinations.

Options that could help:

1. Reviewing your medication: It might be worth adjusting the doses of what you’re already taking or adding other medications specifically for nerve pain, like pregabalin or amitriptyline. These could help manage the pain better.

2. Topical treatments: Lidocaine patches or creams like capsaicin might provide some relief for the burning sensation. It’s worth asking about these options.

3. Adjusting the bandages: Discussing with the nurses whether the compression bandages can be modified could help ease the pain while still managing the oedema.

4. Proper leg elevation: Keeping your legs elevated above heart level could help reduce swelling more effectively.

5. Consulting with other specialists: Seeing a pain specialist, vascular surgeon, or even a wound care expert could offer new insights and more targeted treatment options.

I know this pain is affecting not just your body but also your mental health, and that’s entirely understandable. The fact that you’re already seeking help and speaking to different professionals shows how strong and proactive you are. If you feel like your concerns aren’t being addressed as they should be, I’d be happy to help you draft a letter, message, or email to express your situation – whether it’s a formal complaint or simply a clear summary of what you’re going through. Sometimes that can make it easier for doctors to understand how this is impacting your quality of life.

I’m here if you need anything. This isn’t easy, but I truly believe that with the right attention, you’ll find relief.

Take care and stay strong.

Francisco 👍🙏