Coping With the Loss of a Limb

Image for loss of limb article Some people are born with a limb difference, for others it is the result of injury, or disease such as diabetes or peripheral artery disease (PAD). Regardless of the cause, losing all or part of a limb is a life-changing event that can cause grief and decreased self-esteem.

Grieving    TOP

When you lose a limb, you lose part of your physical self. Grieving, therefore, is both normal and expected. Everyone handles loss differently, but as a general rule, there are 5 stages that people go through.

  • Denial and isolation
  • Anger
  • Bargaining
  • Depression
  • Acceptance and hope

How long it takes a person to pass through these stages varies. Many pass through each phase quickly; others get stuck in one phase or go through one phase without going through the others. Also, stages can occur in different orders.

According to a study in the journal Behavioral Medicine, a person’s age, the site of limb loss, and the cause of amputation all affect how an individual copes with losing a limb. For example, people who lose their limb unexpectedly may be more likely to react with denial (characterized by the refusal to accept the situation and its impact on well-being) than an individual whose amputation was the result of a long-term disease. Furthermore, people in denial are less likely to seek the help they need to move towards the final stage of acceptance and hope.

Body Image    TOP

The loss of a limb can have a serious negative impact on a person’s body image, which is exacerbated by the perfect people we see in everyday media. Children, for example, may feel “differently” from their peers. Adults may find that their negative self-image affects their social and sexual relationships. Research has shown that when faced with a disfiguring medical condition, people who feel self-conscious about their disfigurement respond by avoiding social situations. Unfortunately, this can trigger depression. If you are feeling self-conscious about your limb loss, try to remember that your physical appearance does not matter to those who care about you.

Phantom Sensation and Phantom Limb Pain    TOP

Phantom limb syndrome occurs when the sensory experience, including pain, is still present in the limb that was amputated. It is natural to have that feeling and it occurs in most amputees. It may be caused by nerve cells that were altered after the amputation. The altered cells still continue to send and receive messages. Although phantom limb pain can be controlled with medications, it can still have a negative effect on quality of life.

Taking Action    TOP

Grieving is a normal part of coping with limb loss. Here are some steps you can take to help get through this difficult period.

  • Seek help. Let your family and friends help you out. This may be difficult because they do not know exactly what you are experiencing, but give them a chance. You may even help them by communicating your needs.
  • Exercise. The traditional benefits of exercising—strength, flexibility, and cardiovascular endurance—all still apply to a person with limb loss. Improving your balance and coordination and increasing circulation are especially helpful for regaining physical functioning. Research shows that exercise can help you learn to love and respect your body again. A study in the American Journal of Physical Medicine and Rehabilitation found that people with lower limb amputations were more likely to have a positive body image if they regularly participated in physical activity.
  • Talk. One of the first strategies when coping with limb loss is to talk with another amputee who has undergone a similar situation. They have been through it and can offer a different point of view than your nonaffected friends or family. Whenever possible, this should also be done before limb removal to help mentally prepare you for what lies ahead. Ask your doctor or physical therapist if they know of someone in your situation who you might be able to talk to. Or turn to a local or online support group. For more support, or in the case of clinical depression (depressive symptoms that last at least 2 weeks), there is professional therapy. Your doctor can provide you with a referral to a social worker or psychologist.
  • If possible, go back to work. Returning to work will help you rebuild your sense of self and purpose.

Achieving a Sense of Well Being    TOP

In the end, it is important to realize that although you may have lost a part of you, it does not change who you are. If you don’t already, you will soon realize the truth of the age-old saying, "beauty comes from within." Facing the challange may actually help let what you have on the inside shine through. You are still the same person, with the same mind and soul.

RESOURCES:

American Physical Therapy Association
http://www.apta.org
Amputee Coalition of America
http://www.amputee-coalition.org

CANADIAN RESOURCES:

Amputee Coalition of Canada
http://amputeecoalitioncanada.org
The College of Family Physicians of Canada
http://www.cfpc.ca

References

Axelrod, J. The 5 Stages of Loss and Grief. Psych Central website. Available at:
...(Click grey area to select URL)
Accessed April 29, 2015.
Coping with limb loss. Amputee Coalition website. Available at:
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Accessed April 29, 2015.
Fisher K, Hanspal RS, et al. Return to work after lower limb amputation. Int J Rehabil Res. 2003;26(1):51-56.
Gallagher P, MacLachlan M. Psychological adjustment and coping in adults with prosthetic limbs. Behavioral Medicine. 1999;25(3):117-124.
Maguire P, Parkes CM. Surgery and loss of body parts. BMJ. 1998;316(7137):1086-1088.
Pain: Hope through research. National Institute of Neurological Disorders and Stroke website. Available at:
...(Click grey area to select URL)
Updated April 17, 2015. Accessed April 29, 2015.
Wetterhahn KA, Hanson C, et al. Effect of participation in physical activity on body image of amputees. Am J Phys Med Rehabil. 2002;81(3):194-201.
Winchell E. Body image: Acceptance is step one. Amputee Coalition website. Available at
...(Click grey area to select URL)
Accessed April 29, 2015.
van der Schans CP, Geertzen, JH, et al. Phantom pain and health-related quality of life in lower limb amputees. J Pain Symptom Manage. 2002;24(4):429-436.
Last reviewed April 2015 by Michael Woods, MD
Last Updated: 4/29/2015

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