In subjects with chronic low back pain, does neuropathia exclusively correlated to neuronal compression? A correlation study of PainDETECT questionnaire and corresponding MRI and X-ray findings

Stone Sima; Samuel Lapkin; Ashish D Diwan

doi:10.1007/s00586-024-08156-2

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In subjects with chronic low back pain, does neuropathia exclusively correlated to neuronal compression? A correlation study of PainDETECT questionnaire and corresponding MRI and X-ray findings

Stone Sima, Samuel Lapkin and Ashish D Diwan

European spine journal, Vol.33, pp.1465-1473

04/2024

DOI: https://doi.org/10.1007/s00586-024-08156-2

PMID: 38300298

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Abstract

Clinical imaging

Low back pain

PainDETECT

Degenerative intervertebral disk

Neuropathic pain

Introduction Understanding the complex nature of low back pain (LBP) is crucial for effective management. The PainDETECT questionnaire is a tool that distinguishes between neuropathic (NeP), nociceptive (NoP), and ambiguous pain. This study aimed to investigate the relationship between pain classification and lumbar intervertebral degenerative parameters obtained from imaging. Methods A cohort study was conducted involving 279 patients, aged 18 years and above, who completed PainDETECT questionnaires and underwent lumbar MRI and/or X-ray scans. Results The study included 102 patients with NoP, 78 with ambiguous pain, and 99 with NeP. The NeP group had lower mean age (58.21 vs. 53.63, p < 0.05) and higher mean numerical rating scale score (7.9 vs. 5.9, p < 0.001) compared to the NoP group. A negative correlation was found between PainDETECT scores and pelvic incidence (τ = − 0.177, p = 0.043). The NeP group exhibited significantly higher severity of foraminal stenosis (U = 18.962, p = 0.002), spinal stenosis (U = 14.481, p = 0.005), and Pfirrmann grade (U = 14.221, p = 0.028) compared to the NoP group. A higher proportion of NeP patients had intervertebral disk bulge (96% vs. 78% vs. 78%, p = 0.002) and high-intensity zones (51% vs. 41% vs. 19%, p < 0.001) compared to those with NoP and ambiguous pain. Conclusion NeP, as determined by the PainDETECT questionnaire, is associated with more severe neural compression, increased presence of discogenic disease and inflammatory disk severity, and decreased pelvic incidence. This pioneering study establishes a connection between pathological findings and pain categorization, providing clinicians with valuable guidance for formulating tailored management plans and reducing the need for unnecessary pharmacotherapy, imaging, and non-targeted surgical interventions.

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Title: In subjects with chronic low back pain, does neuropathia exclusively correlated to neuronal compression? A correlation study of PainDETECT questionnaire and corresponding MRI and X-ray findings
Creators: Stone Sima - University of New South Wales
Samuel Lapkin - Southern Cross University
Ashish D Diwan - University of New South Wales
Publication Details: European spine journal, Vol.33, pp.1465-1473
Publisher: Springer
Identifiers: 991013165313302368
Copyright: © The Author(s) 2024. This article is licensed under a Creative Commons Attribution 4.0 International License. Open Access funding enabled and organized by CAUL and its Member Institutions. This work was supported by a University Postgraduate Award from The University of New South Wales to SS.
Academic Unit: Faculty of Health; Nursing
Language: English
Resource Type: Journal article

In subjects with chronic low back pain, does neuropathia exclusively correlated to neuronal compression? A correlation study of PainDETECT questionnaire and corresponding MRI and X-ray findings

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