Assessment of localized pain sensitivity over the transtibial residual limb and its variability among male veterans with amputation

Localization of pain sensitization has clinical importance, however, rarely been assessed in amputees. The objective of this study was to investigate the sensitivity of pain over the residual limb and its variability among veterans with transtibial amputation. Pain sensitivity in 12 locations was explored twice in 19 veteran amputees using pressure algometry. The lowest pressure pain threshold (PPT) and pressure tolerance (PT) was recorded at the distal end of the residual limb (20.5 and 33 Ncm⁻², p=0.13), and the highest PPT and PT was recorded at the mid-patellar tendon (73.4 and 94.3 Ncm⁻², p=0.03). There was a significant moderate correlation (r=0.48-0.52) between pressure pain and daily hours of prosthesis use. A localized pattern for sensitivity to pain over the transtibial residual limb was obtained that can be used to improve the transtibial socket design and fit as well as the selection of prevention, evaluation, and treatment methods.