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.