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Understandably, amputation is among the most emotive topics when discussing CRPS. It’s also hugely controversial, not least among medical professionals. However, if you’re suffering the full panoply of CRPS symptoms, which have proved resistant to therapy, it’s easy to see why this extreme ‘solution’ may at least cross your mind. Another factor is body perception disturbance (BPD), where you have a distorted visualisation of the affected limb. Sufferers typically perceive the limb as different to the other. Often, it appears significantly larger or longer or entirely detached from the rest of the body. BPD can fuel your desire to be free of the limb. But can amputation cure CRPS?
Can amputation cure CRPS?
Suppose a serious accident necessitates the immediate amputation of a limb. That’s a life-changing injury, physically and psychologically. Yet, with ongoing care and support, many amputees can eventually lead an active life, thanks in part to advances in prosthetic technology.
But among the most significant complications for all amputees is ‘phantom limb pain’ (PLP). PLP is the perception of pain (sometimes extreme) or discomfort in the missing limb. There are wildly conflicting reports on the prevalence of PLP among amputees, with estimates ranging from 29% to 85%. Suffice it to say that you’re very fortunate if you avoid PLP altogether.
Of course, PLP is also a significant consideration in elective amputation for CRPS. But, in addition, sufferers risk a cruel twist. A bizarre feature of CRPS that’s not clearly understood is its ability to spread beyond the initial site to another (sometimes entirely different) area of the body. So, while amputation of the affected limb may initially appear to have ‘cured’ your CRPS, it may suddenly reappear elsewhere. Both PLP and the spread of CRPS can also result in an inability to tolerate a prosthetic limb.
See: Symptoms of CRPS spreading
Will doctors amputate for CRPS?
Some people are determined to pursue amputation despite all the risks. Typically, however, the problem they encounter is finding a surgeon willing to carry out the procedure. Among the few amputees for CRPS I have spoken to, in all but one case, pain relief was not a factor in the decision to proceed. Instead, the decision was based on either a good chance of increasing residual function in the limb or addressing ongoing, severe infections.
In the other case, although pain relief was the main factor, the gentleman concerned had to travel to consult a sympathetic surgeon in the Netherlands. When I spoke to him, he was around twelve months post-surgery. He described himself as “pain-free” and mobilising well, although he acknowledged that could change at any time. Nevertheless, his firm opinion was that even if amputation only gave him two pain-free years, those were “bonus years” he wouldn’t otherwise have enjoyed.
Tragically, we still occasionally hear of cases where people desperate for amputation take matters into their own hands, sometimes with fatal consequences.