A rating system for use with patient pain drawings

Margolis, Ronald B.; Tait, Raymond C.; Krause, Steven J.

doi:10.1016/0304-3959(86)90026-6

Cited by 395 publications

(280 citation statements)

References 12 publications

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“…The pain score method used in this study was a simplified version of those used by Margolis et al [22] and Parker et al [32], much like the simplified method suggested by Ohnmeiss et al [30]. Such scoring methods have been shown to have a very high reliability/repeatability [22,28,32], and furthermore offer the advantage that nonexperts can perform scoring, as it involves no clinical judgement.…”

Section: Discussionmentioning

confidence: 99%

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Pain 5 years after instrumented and non-instrumented posterolateral lumbar spinal fusion

Andersen

Christensen

Hansen

et al. 2003

European Spine Journal

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IntroductionPosterolateral spinal fusion has become an evidence-based treatment of chronic low back pain caused by spondylolisthesis or spinal instability [12,26]. Although widely used, the beneficial effect on the clinical outcome of adding pedicle-screw fixation to the posterolateral spinal fusion has not yet been demonstrated [11,13,25,38]. All studies have shown reduction in pain and disability, but few have investigated the severity and localisation of residual pain several years after the procedure.Abstract Pain drawings have been used in spine surgery for diagnostic use and psychological evaluation of fusion candidates; they have rarely been used to evaluate pain status after spinal fusion. This study is a 5-year follow-up on a randomised clinical trial assigning patients to posterolateral spinal fusion with or without pedicle screw instrumentation. Patients were mailed a pain drawing and questionnaires including questions regarding work, social status, smoking status, the Dallas Pain Questionnaire (DPQ), and the Low Back Pain Rating Scale (LBPRS). Pain drawings were scored using a visual inspection method and a surfacebased point scoring and evaluated for the presence of donor site pain. Pain drawings from 109 patients (87% of the initially included patients), 56 men and 53 women, mean age at followup 51 years, were analysed. Fiftythree patients had undergone an instrumented fusion and 56 a non-instrumented fusion. Some presence of low back pain was marked by 79% and leg pain by 69%. Sixty-two percent of the pain drawings were classified as "organic" and 38% as "nonorganic". There was no difference between the instrumented and the uninstrumented group. DPQ and LBPRS scores were higher in the non-organic group (P=0.007). Using the point scoring, no difference between the instrumented and the uninstrumented group was seen. The results of the point scoring were found to correlate with the DPQ and LBPRS scores (P=0.001). Working patients (39%) had significantly better scores than the rest. Ten percent of the patients had donor site pain. Twenty percent of spinal fusion patients are totally pain free at 5-year follow-up. Ten percent still experience donor site pain. In general, instrumentation does not affect the amount and localisation of pain 5 years after lumbar spinal fusion surgery. The pain drawing seems to be a valuable tool when following spinal fusion patients, but its use as prognostic marker in connection with fusion surgery needs further investigation.

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Section: Discussionmentioning

confidence: 99%

“…The diagnostic value of the pain drawing is most often based on whether the pain markings correspond with relevant anatomical structures or not [3, 29,30,33,39]. Also, for evaluation and quantification of pain, several surface-based methods have been applied [20,22,27,30].…”

Section: Pain 5 Years After Instrumented and Non-instrumented Posteromentioning

confidence: 99%

Pain 5 years after instrumented and non-instrumented posterolateral lumbar spinal fusion

Andersen

Christensen

Hansen

et al. 2003

European Spine Journal

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“…Body pain diagrams, which have been used for more than 20 years in musculoskeletal pain research, provide a rapid and inexpensive way to measure the extent, distribution, and location of pain [14,18,21,24,28]. Widespread pain has been recognized as a poor prognostic factor in diseases such as rheumatoid arthritis, cancer, and chronic low back pain, and a poor prognostic factor for outcome of TKA [18,28].…”

Section: Introductionmentioning

confidence: 99%

“…Widespread pain has been recognized as a poor prognostic factor in diseases such as rheumatoid arthritis, cancer, and chronic low back pain, and a poor prognostic factor for outcome of TKA [18,28].…”

Section: Introductionmentioning

confidence: 99%

Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

Dave

Selzer

Losina

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Greater levels of self-reported pain, pain catastrophizing, and depression have been shown to be associated with persistent pain and functional limitation after surgeries such as TKA. It would be useful for clinicians to be able to measure these factors efficiently. Questions/purposes We asked: (1) What is the association of whole-body pain with osteoarthritis (OA)-related knee pain, function, pain catastrophizing, and mental health? (2) What is the sensitivity and specificity for different cutoffs for body pain diagram region categories in relation to pain catastrophizing? Methods Patients (n = 267) with knee OA undergoing elective TKA at one academic center and two community orthopaedic centers were enrolled before surgery in a prospective cohort study. Questionnaires included the WOMAC Pain and Function Scales, Pain Catastrophizing Scale (PCS), Mental Health Inventory-5 (MHI-5), and a pain body diagram. The diagram documents pain in 19 anatomic areas. Based on the distribution of the anatomic areas, we established six different body regions. Our analyses excluded the index (surgically treated) knee. Linear regression was used to evaluate the association between the total number of nonindex painful sites on the whole-body pain diagram and measures of OA-related pain and function, mental health, and pain catastrophizing. Generalized linear regression was used to evaluate the association between the number of painful nonindex body regions (categorized as 0; 1-2; or 3-6) with our measures of interest. All models were adjusted for age, sex, and number of comorbid conditions. The cohort included 63% females and the mean age was 66 years (SD, 9 years). With removal of the index knee, the median pain diagram score was 2 (25 th , 75 th percentiles, 1, 4) with a range of 0 to 15. The median number of painful body regions was 2 (25 th , 75 th percentiles, 1, 3). Results After adjusting for age, sex, and number of comorbid conditions, we found modest associations between painful body region categories and mean scores for WOMAC physical function (r = 0.22, p \ 0.001), WOMAC pain (r = 0.20, p = 0.001), MHI-5 (r = À0.31, p\ 0.001), and PCS (r = 0.27, p \ 0.001). A nonindex body pain region score greater than 0 had 100% (95% CI, 75%-100%) sensitivity for a pain catastrophizing score greater than 30 but a specificity of just 23% (95% CI, 18%-29%) . A score of 3 or greater had greater specificity (73%; 95% CI, 66%-79%) but lower sensitivity (53%; 95% CI, 27%-78%). Conclusions We found modest associations between the number of painful sites on a whole-body pain diagram and the number of painful body regions and measures of OArelated pain, function, pain catastrophizing, and mental health. Patients with higher self-reported body pain region scores might benefit from further evaluation for depression and pain catastrophizing. Level of Evidence Level III, therapeutic study.

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“…Dermatome Pain Map: The Dermatome Pain Map (DPM) (5,6) includes two line drawings of the human body and is designed to assess anatomical pain location. Patients were asked to shade in the spatial distribution of their pain or discomfort.…”

Section: Instrumentsmentioning

confidence: 99%

Detection of exercise-induced myocardial ischemia from symptomatology experienced during testing in men and women

DʼAntono¹,

Dupuis²,

Fortin³

et al. 2006

Canadian Journal of Cardiology

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A rating system for use with patient pain drawings

Cited by 395 publications

References 12 publications

Pain 5 years after instrumented and non-instrumented posterolateral lumbar spinal fusion

Pain 5 years after instrumented and non-instrumented posterolateral lumbar spinal fusion

Is There an Association Between Whole-body Pain With Osteoarthritis-related Knee Pain, Pain Catastrophizing, and Mental Health?

Detection of exercise-induced myocardial ischemia from symptomatology experienced during testing in men and women

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