Identification of neuropathic pain in patients with neck/upper limb pain

The Neuropathic Pain Special Interest Group (NeuPSIG) of the International Association for the Study of Pain has suggested a grading system for the presence of neuropathic pain (NeP) using the following categories: no NeP, possible, probable, or definite NeP. To further study this system, the authors investigated patients with neck/upper limb pain with a suspected nerve lesion, to explore: (i) the clinical application of this grading system; (ii) the suitability of 2 NeP questionnaires (Leeds Assessment of Neuropathic Symptoms and Signs pain scale [LANSS] and the painDETECT questionnaire [PD-Q]) in identifying NeP in this patient cohort; and (iii) the level of agreement in identifying NeP between the NeuPSIG classification system and 2 NeP questionnaires. Patients (n=152; age 52±12years; 53% male) completed the PD-Q and LANSS questionnaire and were given a comprehensive clinical examination. The NeuPSIG grading system proved feasible for application in this patient cohort, although it took a great deal of time and expertise. Both questionnaires failed to identify a large number of patients with clinically classified definite NeP (LANSS sensitivity 22%, specificity 88%; PD-Q sensitivity 64%, specificity 62%). These lowered sensitivity scores contrast with those from the original PD-Q and LANSS validation studies and may reflect differences in the clinical characteristics of the study populations.

The authors concluded that the diagnostic accuracy of LANSS and PD-Q for the identifying NeP in individuals with neck/upper limb pain seems to be limited.

Sensorimotor Impairment in Neck Pain

Join Chris Worsfold in this short online course to learn about the evaluation and rehabilitation of sensorimotor impairment in patients with neck pain.