Pain Drawings Improve Subgrouping of Low Back Pain Patients

Hüllemann, Philipp; Keller, Thomas; Kabelitz, Maria; Freynhagen, Rainer; Tölle, Thomas R.; Baron, Ralf

doi:10.1111/papr.12470

Cited by 27 publications

(27 citation statements)

References 26 publications

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“…Pain drawings offer a practical way of quantifying pain extent and have been used to quantify the distribution of pain in patients with hip and knee OA, greater trochanteric pain syndrome, low back pain, fibromyalgia, carpal tunnel syndrome, chronic spinal pain, whiplash‐associated disorder, migraine, and tension‐type headaches . To date, only 1 study has examined the association between pain extent and clinical features of central sensitization in patients with OA .…”

Section: Introductionmentioning

confidence: 99%

The Extent of Pain Is Associated With Signs of Central Sensitization in Patients With Hip Osteoarthritis

et al. 2019

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Background Central sensitization may be present in some patients with hip osteoarthritis (OA), often reflected as widespread pain. We examine the association between pain extent with signs of central sensitization and other clinical and psychological features in patients with hip OA. Methods Thirty patients with hip OA were recruited for this cross‐sectional observational study. Participants completed pain drawings on a digital tablet, which displayed frontal and dorsal views of the body. The pain extent (%) for each participant was determined by combining the frontal and dorsal pixels shaded and dividing by the total pixels of the body chart area. Participants completed patient‐reported outcome measures to assess for signs and symptoms of central sensitization and psychosocial factors. Quantitative sensory testing including pain pressure thresholds (PPTs) and thermal pressure thresholds was performed at points anatomically local and distant from the hip. Results Women had significantly greater pain extent (6.71%) than men (2.65%) (z = −2.76, P < 0.01). Across all participants, increased pain extent was significantly associated with higher scores on the Widespread Pain Index (r2 = 0.426, P < 0.05), painDETECT questionnaire (r2 = 0.394, P < 0.05), and Pain Catastrophizing Scale (r2 = 0.413, P < 0.05), and with lower PPTs at the thenar eminence (r2 = −0.410, P < 0.05), vastus lateralis (r2 = −0.530, P < 0.01), vastus medialis (r2 = 0.363, P < 0.05), and greater trochanter (r2 = −0.373, P < 0.05). Conclusions Greater pain extent was associated with several measures of signs and symptoms of central sensitization in patients with hip OA. These results support the utility of the pain drawing for identifying signs of central sensitization in patients with hip OA.

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Section: Introductionmentioning

confidence: 99%

The Extent of Pain Is Associated With Signs of Central Sensitization in Patients With Hip Osteoarthritis

et al. 2019

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“…Pain drawings are used to obtain a graphic representation of pain location and distribution in individuals with musculoskeletal pain, e.g., low back pain 9 . It is accepted that larger pain extent represents a clinical sign of central sensitization 10,11 and enlarged areas of pain have been associated with more severe pain 12 and greater pressure-pain hypersensitivity 13 in individuals with painful knee osteoarthritis.…”

Section: Introductionmentioning

confidence: 99%

Perceived Pain Extent is Not Associated With Widespread Pressure Pain Sensitivity, Clinical Features, Related Disability, Anxiety, or Depression in Women With Episodic Migraine

Fernández‐de‐las‐Peñas

Falla

Palacios‐Ceña

et al. 2018

The Clinical Journal of Pain

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“…Pain drawings are used to obtain an illustration of pain location and distribution in people with pain [3]. Several instruments are used to record the pain location and the most common method involves asking the patients to draw where they feel pain on a paper body chart [3,4]. The location of symptoms is heterogeneous in FMS since most patients report that localized pain was present before widespread pain.…”

Section: Introductionmentioning

confidence: 99%

Pain extent is associated with pain intensity but not with widespread pressure or thermal pain sensitivity in women with fibromyalgia syndrome

Barbero

Fernández‐de‐las‐Peñas

Palacios‐Ceña

et al. 2017

Clin Rheumatol

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Widespread pain is considered a sign of central sensitization in people with chronic pain. Our aim was to examine whether pain extent, assessed from the pain drawing, relates to measures from quantitative sensory testing in fibromyalgia syndrome (FMS). Thirty women with FMS and no other co-morbid conditions completed pain drawings (dorsal and ventral views) and clinical and related disability questionnaires. Pain extent and pain frequency maps were obtained from the pain drawings using a novel customized software. Pressure pain thresholds were assessed over the 18 tender points considered by the 1990 American College of Rheumatology criteria for FMS diagnosis and over two additional standardized points. Heat and cold pain thresholds were also assessed on the dorsal aspect of the neck, the dorsal aspect of the wrist, and the tibialis anterior. Spearman's correlation coefficients were used to assess the relationship between pain extent and quantitative sensory testing outcomes as well as clinical symptoms. Larger extent of pain was associated with a higher pain intensity (dorsal area: r = 0.461, P = 0.010; total area: r = 0.593, P = 0.001), younger age (ventral area: r = -0.544, P = 0.002; total area: r = -0.409, P = 0.025), shorter history of pain (ventral area: r = -0.367, P = 0.046), and higher cold pain thresholds over the tibialis anterior muscle (r = -0.406, P = 0.001). No significant association was observed between pain extent and the remaining outcomes. Pain drawings constitute an easy and accurate approach to quantify widespread pain. Larger pain extent is associated with pain intensity but not with signs of central sensitization in women with FMS.

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Pain Drawings Improve Subgrouping of Low Back Pain Patients

Cited by 27 publications

References 26 publications

The Extent of Pain Is Associated With Signs of Central Sensitization in Patients With Hip Osteoarthritis

The Extent of Pain Is Associated With Signs of Central Sensitization in Patients With Hip Osteoarthritis

Perceived Pain Extent is Not Associated With Widespread Pressure Pain Sensitivity, Clinical Features, Related Disability, Anxiety, or Depression in Women With Episodic Migraine

Pain extent is associated with pain intensity but not with widespread pressure or thermal pain sensitivity in women with fibromyalgia syndrome

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