Screening of neuropathic pain components in patients with chronic back pain associated with nerve root compression: a prospective observational pilot study (MIPORT)

Freynhagen, Rainer; Baron, Ralf; Tölle, Thomas R.; Stemmler, Edgar; Gockel, Ulrich; Stevens, Markus F.; Maier, Christoph

doi:10.1185/030079906x89874

Cited by 136 publications

(119 citation statements)

References 13 publications

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“…For example, in none of the above-mentioned studies screening for signs and symptoms indicative of neuropathic pain mechanisms was carried out. As physical treatment modalities are unlikely to have a beneficial effect in patients with neuropathic pain (which present a substantial proportion in patients with LBP [1]), a diluted estimate of treatment effects is likely. By classifying patients in defined, pathomechanism-based categories, homogenous samples of patients with a higher likelihood of positive response to neural mobilisation could be achieved.…”

Section: Discussionmentioning

confidence: 99%

“…Leg pain is a common complaint in relation to low back pain (LBP), present in up to 65% of all patients with LBP [1]. Radiating leg pain is an important predictor of chronicity of LBP and an indicator of the severity of the disorder [2], consequently patients with back and leg pain account for a disproportionate amount of the costs of medical care and disability compensation caused by LBP [3].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

et al. 2010

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The objective is to determine if pain and disability outcomes of patients treated with neural mobilisation differ for sub-classifications of low back and leg pain (LB&LP). Radiating leg pain is a poor prognostic factor for recovery in patients with LBP. To improve outcome, a new pathomechanism-based classification system was proposed: neuropathic sensitization (NS), denervation (D), peripheral nerve sensitization (PNS) and musculoskeletal (M). Seventy-seven patients with unilateral LB&LP were recruited. Following classification, all subjects were treated seven times with neural mobilisation techniques. A successful outcome was defined as achieving a minimal clinically important change in pain intensity (11-point numerical rating scale), physical function (Roland Morris disability questionnaire) and global perceived change (7-point Likert scale: from 1 = ''completely recovered'' to 7 = ''worse than ever''). The proportion of responders was significantly greater in PNS (55.6%) than the other three groups (NS 10%; D 14.3% and M10%). After adjusting for baseline differences, mean magnitude of improvement of the outcome measures were significantly greater in PNS compared to the other groups. Patients classified as PNS have a more favourable prognosis following neural mobilisation compared to the other groups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

et al. 2010

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“…Peripheral joints and extraarticular findings should also be seen (1). It is now known that mixed pain patterns may develop in chronic diseases by the addition of a neuropathic pain (NP) component to existing pain mechanisms (2,3).…”

Section: Introductionmentioning

confidence: 99%

e association of neuropathic pain and disease activity, functional level, and quality of life in patients with ankylosing spondylitis: a cross-sectional study

2018

Turk J Med Sci

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Background/aim: Increased neuropathic pain (NP) symptoms are seen in rheumatologic diseases such as fibromyalgia, osteoarthritis, and rheumatoid arthritis, but no studies have demonstrated a relationship between ankylosing spondylitis (AS) and NP except for a brain imaging study. The aim of this study was to estimate the presence of NP in patients with AS and to investigate how NP was related to disease activity, functional status, and quality of life.Materials and methods: A total of 100 AS patients (71 males and 29 females; median age: 37 years, range: 18-71 years) were included in the study. Pain (visual analog scale (VAS) and the painDETECT questionnaire), disease activity (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), Patient Global Assessment of Disease Activity (PGA), and Ankylosing Spondylitis Disease Activity Score (ASDAS)), functional level (Bath Ankylosing Spondylitis Functional Index (BASFI)), and health-related quality of life (36-Item Short Form Survey (SF-36)) were evaluated. Patients were divided into two groups. Group 1 included patients with possible or likely NP symptoms (painDETECT score of ≥13) and Group 2 included patients without NP symptoms (painDETECT score of <13).Results: Low back pain-VAS, peripheral joint-VAS, BASDAI, PGA, ASDAS, and BASFI scores were significantly higher in Group 1 compared to those of Group 2 (P < 0.05). The SF-36 physical component (PC) score was significantly lower in Group 1 compared to that of Group 2 (P < 0.05). There were no significant differences between the groups regarding SF-36 mental component (MC) scores, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) values and MASES scores. Total painDETECT scores correlated positively with low back pain-VAS, peripheral joint-VAS, morning stiffness-VAS, BASDAI, ASDAS-CRP, ASDAS-ESR, PGA, BASFI, and MASES scores and ESR values, and inversely with SF-36 PC scores. Conclusion:Our results suggest that AS patients should be evaluated in terms of NP in order not to underestimate NP. If clinicians find evidence of likely NP, they should treat the patient with drugs that target NP.

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“…Los opioides en España se utilizan relativamente poco en su tratamiento. En el año 2006, un estudio en Alemania puso de manifiesto que el 11 % de pacientes con dolor lumbar crónico recibían opioides frente al 31,7 % que recibían AINE, a pesar de que la satisfacción del paciente con los resultados del tratamiento fue moderada y pobre/muy pobre en el 34,3 %, (14). En la actualidad existe consenso, cada vez más fuerte, de que los opioides en periodos largos de tratamiento pueden ser de utilidad en pacientes con dolor crónico no oncológico (15).…”

Section: Correspondenciaunclassified

Dolor irruptivo en pacientes con dolor lumbar crónico

Oteo-Álvaro

2017

Rev. Soc. Esp. Dolor.

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Instrucciones de citación para el artículo:Oteo-Álvaro Ángel. Dolor irruptivo en pacientes con dolor lumbar crónico. Rev. Soc. Esp. Dolor. 2017. doi: 10.20986/resed.2017.3580/2017 Este es un archivo PDF de un manuscrito inédito que ha sido aceptado para su publicación en la Revista de la Sociedad Española del Dolor. Como un servicio a nuestros clientes estamos proporcionando esta primera versión del manuscrito en estado de prepublicación. El manuscrito será sometido a la corrección de estilo final, composición y revisión de la prueba resultante antes de que se publique en su forma final. Tenga en cuenta que durante el proceso de producción se pueden dar errores lo que podría afectar el contenido final. El copyright y todos los derechos legales que se aplican al artículo pertenecen a la Revista de la Sociedad Española de Dolor.

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Screening of neuropathic pain components in patients with chronic back pain associated with nerve root compression: a prospective observational pilot study (MIPORT)

Cited by 136 publications

References 13 publications

Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

Outcomes differ between subgroups of patients with low back and leg pain following neural manual therapy: a prospective cohort study

e association of neuropathic pain and disease activity, functional level, and quality of life in patients with ankylosing spondylitis: a cross-sectional study

Dolor irruptivo en pacientes con dolor lumbar crónico

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