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What it measures:

Pain pressure threshold (PPT) is used to measure deep muscular tissue sensitivity. The test determines the amount of pressure over a given area in which a steadily increasing nonpainful pressure stimulus turns into a painful pressure sensation. A varying pressure is applied from 0.5 to 1 kg/sec in a perpendicular direction relative to the muscle. PPT has no standard protocol on administration and placement. Equipment used varies with many handheld electric algometers.

PPT has been used on a wide variety of patients and conditions, including musculoskeletal and neuromuscular disorders (eg, Parkinson disease, tension headaches, pelvic pain, low back pain, myofascial trigger points, sacroiliac joint pain, knee osteoarthritis, skin humidity, shoulder pain, lateral epicondylitis). This summary contains information on use of PPT testing in patients or clients with many varied diagnoses, conditions, and disabilities.1-27

ICF Domain

Body structure function of the many areas.

ICF Categories

Other PT/OT subsequent limitation

Taskforce Recommendations:

A clinical practice guideline for neck and low back pain recommends the use of PPT to quantify pain levels. (29) Breast Cancer EDGE highly recommends PPT in those with breast cancer. They recommend clinicians should decide the use of PPT depending on how they want to assess pain and whether to use a unidimensional or multidimensional tool. PPT is a unidimensional pain outcome tool because it measures the intensity of pain, without the quality or impact of pain. (30)

Clinical Insights:

PPT is a quick, objective measure used to quantify pain intensity and requires minimal to no training. Since minimal training is typical, those administering should be cautious to apply the algometer at the set rate recommended by the manufacturer. Since the technique is easy to perform, PPT may be a useful tool for quantifying pain, which allows researchers and clinicians to monitor treatment effects. (21) However, there are several potential limitations that could result in some clinicians not adopting the test, including the lack of formal training, normative values, and a standardized protocol. Pain is also easily quantifiable with other measures, such as the Visual Analog Scale.

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