Screening of neuropathic pain components in patients with chronic back pain associated with nerve root compression:: a prospective observational pilot study (MIPORT)
Screening of neuropathic pain components in patients with chronic back pain associated with nerve root compression:: a prospective observational pilot study (MIPORT)
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DOI：
10.1185/030079906x89874
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发表时间：
2006-03-01
影响因子：
2.3
通讯作者：
Maier, C
中科院分区：
文献类型：
--
作者：
Freynhagen, R;Baron, R;Maier, C
目的：慢性背痛的特征是疼痛产生的神经病理性和伤害性机制的结合。神经性疼痛的患病率尚不清楚。因此，在一项探索性研究的背景下，我们旨在确定骨科医生治疗的成年患者中表明神经性疼痛的体征和症状的患病率。我们还旨在评估手持计算机 (PDA) 在数据收集中的有用性。方法：对德国 18 个骨科诊所或中心进行前瞻性流行病学研究。对持续时间至少 3 个月的背痛患者进行医生和患者问卷调查（纸/笔或手持电脑、PDA），以及 von Korff 评分来评估疼痛强度（视觉模拟量表，VAS；0 = 无疼痛，10 = 可能最严重的疼痛）和疼痛特征，汉诺威功能能力问卷 (FFbH-R)，如果患者同意提供信息，则使用简短的患者健康问卷(PHQ-D) 抑郁症。结果：对于 717 名患者，患者和医生都有问卷调查。患者平均年龄为 56 岁；疼痛主要发生在腰部（87%）。 VAS 当前疼痛强度中位数为 5.0。已确认的关键体征和症状表明神经性疼痛很常见，例如。 g。根性疼痛从膝盖向足部放射（40.0%），拉塞格征阳性（18.4%），或缺乏髌骨反射（17.3%）。三分之一的患者 (33.5%) 有 3 种神经性疼痛的特征性体征。患者功能严重下降（中位数 43.3%）。使用纸/笔方法的患者 (47%) 与使用 PDA 的患者 (53%) 之间的结果没有相关差异。 结论：在这种情况下，通过简单的问卷和 PDA 量表筛查神经性疼痛是可行的。神经性疼痛是慢性背痛的主要原因，也是骨科医生就诊的患者中常见的症状。至少三分之一的患者应接受额外的诊断措施，以确认神经性疼痛的原因。
Objective: Chronic back pain is characterized by a combination of neuropathic and nociceptive mechanisms of pain generation. The prevalence of the neuropathic pain component is unknown. Thus, in the context of an explorative study, we aimed to determine the prevalence of signs and symptoms indicating neuropathic pain in adult patients treated by orthopaedists. We also aimed to assess the usefulness of handheld computers (PDAs) in data collection.Methods: Prospective epidemiological study in 18 orthopaedic practices or centres throughout Germany. Physician and patient questionnaires (paper/pencil or on handheld computers, PDAs) for patients with back pain of at least 3 months in duration were applied, as well as the von Korff score to assess pain intensity (visual analogue scale, VAS; 0 = no pain, 10 = worst possible pain) and pain characteristics, the Hannover Functional Ability Questionnaire (FFbH-R), and if patients agreed to provide information, the short-form Patient Health Questionnaire (PHQ-D) for depression.Results: For 717 patients, both patient and physician questionnaires were available. Mean patient age was 56 years; pain was predominantly located in the low back (87%). Median current pain intensity on the VAS was 5.0. Confirmed key signs and symptoms indicated neuropathic pain was frequent, e. g. radicular pain radiating beyond the knee towards the foot (40.0%), positive Lasegue sign (18.4%), or absent patellar reflex (17.3%). A third of all patients (33.5%) had = 3 characteristic signs for neuropathic pain. Patient functionality was severely reduced (median 43.3%). There were no relevant differences in outcomes between patients using the paper/pencil method (47%) versus those preferring PDAs (53%).Conclusion: Screening for neuropathic pain in this setting is feasible with simple questionnaires and scales on PDAs. Neuropathic pain is a major contributor to chronic back pain and a frequent component in patients seen by orthopaedists. At least one third of all patients should undergo additional diagnostic measures to confirm the cause of neuropathic pain.