Residual limb neuropathic pain association with neuroma, prosthetic, function, and participation outcomes in individuals living with a transtibial amputation: an exploratory study.

Only 22 participants were included, so the associations are exploratory and may not be stable. The study design cannot show cause; prosthetic wear, walking aids, PDI, neuroma location and Tinel sign were measured as associations. Neuropathic pain was classified by participant description of burning, painful cold sensation or electric shocks rather than a validated neuropathic pain instrument such as DN4. Some nerve groups were too small for statistical comparison, especially the common fibular nerve group (4) and sural nerve group (1), where all affected participants reported moderate-to-extreme pain. PDI scores ranged from 0 to 22 out of 70, so the sample reported limited pain-related disability. Residual-limb pain can arise from causes beyond neuromas, and distinguishing neuropathic from somatic pain can be complex. No psychological measure was included, so the biopsychosocial context of pain was not assessed. Participants were adults with amputations more than one year prior and without broken skin, so findings may not apply to recently amputated patients or those with skin problems.

Declared funding included a Research Career Salary Award from FRSQ for Dany Gagnon, LRH Foundation funding for the Initiative for the Development of New Technologies and Practices in Rehabilitation (INSPIRE), and partial equipment funding from CFI. No other conflicts of interest are listed.

Do not conclude that wearing a prosthesis more often or using a walker reduces neuropathic pain. The study was exploratory and associational in 22 participants, so these factors may track with pain rather than cause it.