Simple Test Better at Diagnosing Chronic Back Pain
Reported April 09, 2009
(Ivanhoe Newswire) There may a better way to diagnose chronic back pain than what is currently being used.
Researchers from Massachusetts General Hospital have developed a simple, new test to better distinguish neuropathic pain — pain from damage to the nervous system from other types of chronic back pain. Being able to more precisely determine whats causing the pain is key to choosing the best treatment.
Right now clinicians measure pain just by asking the patient how bad it is they use scales from mild to moderate to severe or rate their pain on a scale of one to 10.
Researchers developed the Standardized Evaluation of Pain (StEP) six questions and 10 physical tests. To find out how valid StEP was, they worked with Addenbrooke’s Hospital a teaching hospital of the University of Cambridge in the United Kingdom that enrolled 137 patients with chronic low back pain.
Results show the 10- to 15-minute StEP assessment accurately determined whether or not a participants back pain was neuropathic, and it was also better than an existing screening test for neuropathic pain and MR imaging of the spine, which can be misleading since many people have visible degeneration of spinal disks but may have little or no pain.
The treatment of neuropathic and nonneuropathic pain is quite different, and if a diagnosis is wrong, patients may receive treatment, including surgery, that does not improve their pain, lead author Joachim Scholz, M.D., Massachusetts General Hospital, was quoted as saying.
Scholz says the next step is to see how patients with different subtypes of pain respond to different treatments.
SOURCE: PLoS Medicine, published online April 7, 2009