Researchers at the University of Colorado Anschutz have found that pain following lower limb amputation varies based on activity and the type of prosthetic used. The study, published in PM&R, involved 83 adults with unilateral transfemoral or transtibial amputations who reported their pain both at rest and during daily movement.
"Untreated or improperly treated pain can severely limit mobility, delay return to work, disrupt sleep and significantly diminish quality of life. This underscores the urgent need for a more precise, personalized approach to care," said Danielle Melton, MD, senior author of the study and professor of physical medicine and rehabilitation as well as co-director of amputation medicine and rehabilitation for the Osseointegration and Limb Restoration Program at the University of Colorado Anschutz.
The research revealed that most participants experienced multiple types of pain. Each type responded differently to activity levels, indicating that using a single overall pain score may not accurately reflect patient experiences.
The study compared users of traditional socket prostheses with those using bone anchored limb (BAL) systems. It found that people with socket prostheses often had increased musculoskeletal pain during higher levels of physical activity such as walking. In contrast, those with bone anchored limbs did not report increased pain with greater activity; their pain remained more stable regardless of movement level. This suggests that osseointegrated designs may provide a more consistent experience during everyday activities than socket systems.
By evaluating pain across different activity intensities rather than only at rest, researchers showed how prosthetic design affects comfort during real-world movement. These findings could influence future strategies for managing mobility and improving daily function among people living with limb loss.
"For many patients, pain determines whether they can stay active and independent," said Melton. "Different pains require different solutions. More detailed pain assessment may lead to better treatment decisions and improved daily functioning for people living with limb loss giving them a better quality of life."
For additional information about this research or related programs, visit the CU Anschutz Department of Physical Medicine and Rehabilitation or the CU Anschutz Limb Restoration Program.
