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pain DETECT : a new screening questionnaire to identify neuropathic components in patients with back pain
Open accessAbstract
OBJECTIVE: Nociceptive and neuropathic components both contribute to pain. Since these components require different pain management strategies, correct pain diagnosis before and during treatment is highly desirable. As low back pain (LBP) patients constitute an important subgroup of chronic pain patients, we addressed the following issues: (i) to establish a simple, validated screening tool to detect neuropathic pain (NeP) components in chronic LBP patients, (ii) to determine the prevalence of neuropathic pain components in LBP in a large-scale survey, and (iii) to determine whether LBP patients with an NeP component suffer from worse, or different, co-morbidities. METHODS: In co-operation with the German Research Network on Neuropathic Pain we developed and validated the painDETECT questionnaire (PD-Q) in a prospective, multicentre study and subsequently applied it to approximately 8000 LBP patients. RESULTS: The PD-Q is a reliable screening tool with high sensitivity, specificity and positive predictive accuracy; these were 84% in a palm-top computerised version and 85%, 80% and 83%, respectively, in a corresponding pencil-and-paper questionnaire. In an unselected cohort of chronic LBP patients, 37% were found to have predominantly neuropathic pain. Patients with NeP showed higher ratings of pain intensity, with more (and more severe) co-morbidities such as depression, panic/anxiety and sleep disorders. This also affected functionality and use of health-care resources. On the basis of given prevalence of LBP in the general population, we calculated that 14.5% of all female and 11.4% of all male Germans suffer from LBP with a predominant neuropathic pain component. CONCLUSION: Simple, patient-based, easy-to-use screening questionnaires can determine the prevalence of neuropathic pain components both in individual LBP patients and in heterogeneous cohorts of such patients. Since NeP correlates with more intense pain, more severe co-morbidity and poorer quality of life, accurate diagnosis is a milestone in choosing appropriate therapy.
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“Participants will be randomized to stratified blocks based on sex/gender and pain type (neuropathic, non-neuropathic, mixed or undetermined), assessed via the Pain DETECT[50] measure and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)[51] to ensure uniform distribution of these factors across the three conditions.”
From The chronic pain skills study: Protocol for a randomized controlled trial comparing hypnosis, mindfulness meditation and pain education in Veterans (2020) · cites this paper as [51]
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“This is a popular well-validated measure of pain severity used in research and clinical settings.”
From Risk Factors for Self-Harm Ideation among Persons Treated with Opioids for Chronic Low Back Pain (2023) · cites this paper as [33]
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Citations
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Cross‐Cultural Adaptation to the Dutch Language of the Pain DETECT‐ Questionnaire
Timmerman, H., Wolff, A. P., Schreyer, T., Outermans, J., Evers, A. W. M., Freynhagen, R., Wilder‐Smith, O. H. G., Zundert, J. H. M. V., & Vissers, K. C. P. (2012) · Pain Practice · doi:10.1111/j.1533-2500.2012.00577.x · Cited by 46
“The PDQ was until this moment only published in a German, English, and Spanish language version.(13,25) The quality of a questionnaire used in research is expected to be dependent on the quality of the chosen method for translation.”
Self-citationMulvey, M. R., Rolke, R., Klepstad, P., Caraceni, A. T., Fallon, M., Colvin, L., Laird, B. J. A., & Bennett, M. (2013) · Pain · doi:10.1016/j.pain.2013.11.010 · Cited by 46
“Similarly, a positive score on a NP screening tool (such as the Leeds Assessment of Neuropathic Symptoms and Signs [LANSS] [1], DN4 [6], or painDETECT [12]) serves to identify patients with possible NP and may be included as part of the clinical assessment [14] (see Appendix A).”
BackgroundKorean Version of the painDETECT Questionnaire: A Study for Cultural Adaptation and Validation
Sung, J. K., Choi, J., Jeong, J., Kim, W., Lee, D. J., Lee, S. C., Kim, Y. C., & Moon, J. Y. (2016) · Pain Practice · doi:10.1111/papr.12472 · Cited by 49
“applied to 8,000 patients with low back pain, and showed about 80% sensitivity and specificity.(8) In”
BackgroundMethodResultInfluentialHarrisson, S. A., Stynes, S. M., Dunn, K. M., Foster, N. E., & Konstantinou, K. (2017) · Journal of Pain · doi:10.1016/j.jpain.2017.04.012 · Cited by 49
Chronic Pain and Neuropathy Following Adjuvant Chemotherapy
Ventzel, L., Madsen, C. S., Karlsson, P., Tankişi, H., Isak, B., Fuglsang‐Frederiksen, A., Jensen, A. B., Jensen, A. R., Jensen, T. S., & Finnerup, N. B. (2017) · Pain Medicine · doi:10.1093/pm/pnx231 · Cited by 46
Using stratified medicine to understand, diagnose, and treat neuropathic pain
Themistocleous, A. C., Crombez, G., Baskozos, G., & Bennett, D. (2018) · Pain · doi:10.1097/j.pain.0000000000001301 · Cited by 47
“Screening questionnaires, such as the DN4 [12], painDETECT [43] and LANSS[7; 8] are”
Pain pathogenesis in rheumatoid arthritis—what have we learned from animal models?
Krock, E., Jurczak, A., & Svensson, C. I. (2018) · Pain · doi:10.1097/j.pain.0000000000001333 · Cited by 46
“reported to improve RA associated pain in patients [42,56,60], even before disease modification in one study [171].”
BackgroundMethodDose Conversion Between Tapentadol Immediate and Extended Release for Low Back Pain
Etropolski, M. S. (2010) · Pain Physician · doi:10.36076/ppj.2010/13/61 · Cited by 46
Martinez, V., Attal, N., Vanzo, B., Vicaut, E., Gautier, J. M., Bouhassira, D., & Lantéri-Minet, M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0093855 · Cited by 45
“We focused on four etiologies of peripheral neuropathic pain frequently encountered in general medical practice: painful diabetic polyneuropathy, cancer chemotherapy-induced peripheral neuropathy [22], typical radicular pain [23] and post-operative neuropathic pain [24–26].”
BackgroundNeuropathic pain in individuals with sickle cell disease
Sharma, D., & Brandow, A. M. (2019) · Neuroscience Letters · doi:10.1016/j.neulet.2019.134445 · Cited by 45
Individualized Pharmacological Treatment of Neuropathic Pain
Helfert, S. M., Reimer, M., Höper, J., & Baron, R. (2014) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.19 · Cited by 45
Self-citationTreede, R., Wagner, T., Kern, K., Husstedt, I., Arendt, G., Birklein, F., Cegla, T. H., Freynhagen, R., Gockel, H.-H., Heskamp, M. ‐. S., et al. (2013) · Current Medical Research and Opinion · doi:10.1185/03007995.2013.781019 · Cited by 45
Self-citationGálvez, R., Schäfer, M., Hans, G. H., Falke, D., & Steigerwald, I. (2013) · Advances in Therapy · doi:10.1007/s12325-013-0015-6 · Cited by 45
“pain over time [33], it was not validated when this study was conducted [30].”
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“[11], participants were classified into three groups: a group ‘‘likely’’ to have neuropathic pain (neuropathic pain group with scores C19), a group ‘‘unlikely’’ to have neuropathic pain (nociceptive pain group with scores B12), and an intermediate ‘‘mixed’’ group (scores 13–18).”
BackgroundMethodCottam, W. J., Condon, L. A., Alshuft, H., Reckziegel, D., & Auer, D. P. (2016) · NeuroImage Clinical · doi:10.1016/j.nicl.2016.06.022 · Cited by 45
“Directly before the scan session, all subjects underwent questionnaire assessments studying levels of education (where a score of 1 represents the attainment of a higher degree and 8 represents no educational attainment, adapted from Egerton and Mullan (2008)), pain severity (Visual Analogue Scale, VAS; 0–100), anxiet…”
BackgroundHandbook of Pain and Palliative Care
Moore, R. J. (2012) · Springer eBooks · doi:10.1007/978-1-4419-1651-8 · Cited by 116
“…et al. 2005b ) , Neuropathic Pain Questionnaire (NPQ) 12-item version (Krause and Backonja 2003 ) and the substantially shorter 3-item NPQ-SF (Backonja and Krause 2003 ) , painDetect (Freynhagen et al. 2006 ) , and the StEP (Standardized Evaluation of Pain) (Scholz et al. 2009 ) (Table 6.6 ).”
BackgroundInfluentialNeuropathic pain in patients with rotator cuff tears
Karasugi, T., Ide, J., Kitamura, T., Okamoto, N., Tokunaga, T., & Mizuta, H. (2016) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-016-1311-5 · Cited by 45
“The PDQ is not only a simple and efficient screening tool to identify the likelihood of NeP, but also demonstrates higher sensitivity and specificity than that of other screening tools for NeP [3, 6].”
BackgroundMethodInfluentialPersson, M. S. M., Stocks, J., Váradi, G., Hashempur, M. H., van Middelkoop, M., Bierma‐Zeinstra, S., Walsh, D. A., Doherty, M., & Zhang, W. (2020) · Lara D. Veeken · doi:10.1093/rheumatology/keaa113 · Cited by 45
Hiyama, A., Katoh, H., Sakai, D., Tanaka, M., Sato, M., & Watanabe, M. (2020) · Scientific Reports · doi:10.1038/s41598-020-76028-y · Cited by 45
The complex syndrome of functional neurological disorder
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Stable cortical body maps before and after arm amputation
Schone, H. R., Maimon-Mor, R. O., Kollamkulam, M., Szymanska, M. A., Gerrand, C., Woollard, A., Kang, N., Baker, C. I., & Makin, T. R. (2025) · Nature Neuroscience · doi:10.1038/s41593-025-02037-7 · Cited by 50
“Therefore, all comparisons to the Ctrl cohort are focused on the 6-month post-amputation time point.”
Consistence and discrepancy of neuropathic pain screening tools DN4 and ID-Pain
Padua, L., Briani, C., Truini, A., Aprile, I. G., Bouhassira, D., Cruccu, G., Jann, S., Nobile‐Orazio, E., Pazzaglia, C., Morini, A., et al. (2012) · Neurological Sciences · doi:10.1007/s10072-012-1011-3 · Cited by 44
Tapentadol immediate release for the relief of moderate-to-severe acute pain
Hartrick, C. T. (2009) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656560903313734 · Cited by 44
“This is an important consideration when developing treatment strategies for the management of acute pain that may be a mixture of nociceptive and neuropathic pain [21,23,77].”
BackgroundRifbjerg-Madsen, S., Wæhrens, E. E., Danneskiold‐Samsøe, B., & Amris, K. (2017) · Health and Quality of Life Outcomes · doi:10.1186/s12955-017-0681-1 · Cited by 44
“The PDQ was originally developed and validated for pain classification purposes [9] and has been translated into several languages, including Danish (www.”
BackgroundMethodInfluentialAnatomical study of middle cluneal nerve entrapment
Konno, T., Aota, Y., Saito, T., Qu, N., Hayashi, S., Kawata, S., & Itoh, M. (2017) · Journal of Pain Research · doi:10.2147/jpr.s135382 · Cited by 44
Assessing and Treating Chronic Pain in Patients with End-Stage Renal Disease
Coluzzi, F. (2018) · Drugs · doi:10.1007/s40265-018-0980-9 · Cited by 44
Kobayashi, S., Niki, Y., Harato, K., Nagura, T., Nakamura, M., & Matsumoto, M. (2018) · The Journal of Arthroplasty · doi:10.1016/j.arth.2018.11.003 · Cited by 44
Psychological and pain profiles in persons with patellofemoral pain as the primary symptom
Maclachlan, L., Collins, N. J., Hodges, P. W., & Vicenzino, B. (2020) · European Journal of Pain · doi:10.1002/ejp.1563 · Cited by 46
Freynhagen, R., Grond, S., Schüpfer, G., Hagebeuker, A., Schmelz, M., Ziegler, D., von Giesen, H. ‐., JUNKER, U., Wagner, K. J., & Konrad, C. (2007) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2007.01589.x · Cited by 44
Self-citationVagaská, E., Litavcová, A., Šrotová, I., Vlčková, E., Keřkovský, M., Jarkovský, J., Bednařík, J., & Adamová, B. (2019) · Medicine · doi:10.1097/md.0000000000015377 · Cited by 44
“Our study demonstrated no radiological predictors of NP; however, female sex and the mean pain intensity in the previous 4 weeks with a cut-off of 4.5 appeared as significant independent predictors of NP.”
BackgroundInfluentialHansen, I. M. J., Andreasen, R. A., Hansen, M., & Emamifar, A. (2016) · JCR Journal of Clinical Rheumatology · doi:10.1097/rhu.0000000000000469 · Cited by 43
“The painDETECT score ranges from 0 to 38, in which a score of 19 or greater indicates that central sensitization has likely happened; 13 to 18, uncertain results; and a score of 12 or less shows that central sensitization has unlikely occurred.(24,25) It is particularly relevant when rheumatologists is confronted with…”
BackgroundPain sensitivity and pain scoring in patients with morbid obesity
Torensma, B., Oudejans, L. C. J., van Velzen, M., Swank, D. J., Niesters, M., & Dahan, A. (2017) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2017.01.015 · Cited by 43
AAPT Diagnostic Criteria for Central Neuropathic Pain
Widerström-Noga, E. G., Loeser, J. D., Jensen, T. S., & Finnerup, N. B. (2017) · Journal of Pain · doi:10.1016/j.jpain.2017.06.003 · Cited by 43
Walton, D. M., & Elliott, J. M. (2018) · Musculoskeletal Science and Practice · doi:10.1016/j.msksp.2018.03.006 · Cited by 48
Paterson, K. L., Hunter, D. J., Metcalf, B., Eyles, J. P., Duong, V., Kazsa, J., Wang, Y., Buchbinder, R., Cicuttini, F., Forbes, A. B., et al. (2018) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-018-2205-5 · Cited by 43
“ii) Descriptive data: including participant height, body mass index, age, gender, duration of symptoms, radiographic disease severity, knee alignment (measured from the knee x-ray and reported in degrees [34]), current employment, symptom laterality, symptoms in other joints, treatment expectation on a 5 point Likert…”
MethodRelieving phantom limb pain with multimodal sensory-motor training
Nunzio, A. M. D., Schweisfurth, M. A., Ge, N., Falla, D., Hahne, J. M., Gödecke, K., Petzke, F. W., Siebertz, M. W., Dechent, P., Weiß, T., et al. (2018) · Journal of Neural Engineering · doi:10.1088/1741-2552/aae271 · Cited by 47
“No clear indications could be determined [45, 63] for the other four participants since their PainDETECT scores fell between 12 and 19.”
BackgroundMethodMorsø, L., Olsen, K. R., Schiøttz‐Christensen, B., Sowden, G., Søndergaard, J., & Christiansen, D. H. (2021) · European Journal of Pain · doi:10.1002/ejp.1818 · Cited by 43
“There are several theories and methods of subgrouping and stratifying people with LBP (Foster et al., 2011; Freynhagen et al., 2006; Fritz et al., 2007; Hartvigsen et al., 2018; Hodges, 2019; Konstantinou et al., 2018; Molgaard Nielsen et al., 2017; Oliveira, 2019).”
BackgroundMethodInfluentialDecreased food pleasure and disrupted satiety signals in chronic low back pain
Geha, P., DeAraujo, I. E., Green, B. G., & Small, D. M. (2014) · Pain · doi:10.1016/j.pain.2013.12.027 · Cited by 43
“the McGill Pain Questionnaire (MPQ) [67], the Washington Neuropathic Pain Scale (NPS) [34], and the pain DETECT questionnaire [33].”
MethodCohen, S. P. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.593 · Cited by 42
“(%) (95% CI) 44 (50) (39-61) (n=88) 6 (29) (11-52) (n=21) .”
InfluentialNeck Pain During Combat Operations
Cohen, S. P., Kapoor, S. G., Nguyen, C., Merritt, V. C., Brown, C. H., Schiffer, D., Turabi, A., & Plunkett, A. (2010) · Spine · doi:10.1097/brs.0b013e3181bb11a8 · Cited by 42
“to their pain, which is higher than prospective prevalence studies for both chronic cervical and low back pain.(22,23)”
BackgroundMadani, S. P., Fateh, H. R., Forogh, B., Fereshtehnejad, S., Ahadi, T., Ghaboussi, P., Bouhassira, D., & Raissi, G. R. (2013) · Pain Practice · doi:10.1111/papr.12088 · Cited by 42
Abnormal Quantitative Sensory Testing is Associated With Persistent Pain One Year After TKA
Wright, A., Moss, P., Sloan, K. E., Beaver, R. J., Pedersen, J. B., Vehof, G., Borge, H., Maestroni, L., & Cheong, P. (2014) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-014-3990-2 · Cited by 42
“They reported that more than 19% of an unselected community-based sample of individuals with chronic osteoarthritis had features of neuropathic-type pain according to the PainDETECT questionnaire [11].”
BackgroundMethodCancer-related neuropathic pain in out-patient oncology clinics: a European survey
Garzón-Rodríguez, C., Lyras, L., Gayoso, L. O., Sepúlveda-Sánchez, J. M., Samantas, E., Pelzer, U., Bowen, S., van Litsenburg, C., & Strand, M. (2013) · BMC Palliative Care · doi:10.1186/1472-684x-12-41 · Cited by 42
“Eligible participants enrolled in the study completed the PD-Q, which was used in conjunction with physician assessment to identify patients with chronic pain who also experienced CRNP [14].”
BackgroundMethodInfluentialProtocol for the Femoroacetabular Impingement Trial (FAIT)
Palmer, A. J. R., Gupta, V. A., Dutton, S., Rombach, I., Cooper, C., Pollard, T. C., Hollinghurst, D., Taylor, A. H., Barker, K. L., McNally, E., et al. (2014) · Bone and Joint Research · doi:10.1302/2046-3758.311.2000336 · Cited by 42
Furrer, A., Michel, G., Terrill, A. L., Jensen, M. P., & Müller, R. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1390614 · Cited by 46
“Regarding type of pain (assessed via PainDETECT [27]), 46% were classified as having nociceptive pain (n1⁄4 44), 25% were classified as having neuropathic pain (n1⁄4 24) and 28% were classified as having an unclear pain type (n1⁄4 27).”
BackgroundMethodInfluentialCai, G., Laslett, L. L., Aitken, D. A., Halliday, A., Pan, F., Otáhal, P., Speden, D. J., Winzenberg, T. M., & Jones, G. (2018) · Journal of Bone and Mineral Research · doi:10.1002/jbmr.3376 · Cited by 42
“Participants with at least one adverse event 35 (100) 27 (87) 25 (68) Acute phase reactions, n 85 33 26 Constipation 0 (0) 0 (0) 1 (3) Diarrhea 3 (9) 0 (0) 1 (3) Flu-like 22 (63) 5 (16) 7 (19) Headache-dizzy 20 (57) 10 (32) 8 (22) Musculoskeletal pain and stiffness 18 (51) 8 (25) 2 (5) Psychological effects 21 (60) 10…”
MethodInfluentialCannabidivarin for HIV‐Associated Neuropathic Pain: A Randomized, Blinded, Controlled Clinical Trial
Eibach, L., Scheffel, S., Cardebring, M., Lettau, M., Celik, M. Ö., Morguet, A. J., Roehle, R., & Stein, C. (2020) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.2016 · Cited by 44
Current Considerations for the Treatment of Severe Chronic Pain: The Potential for Tapentadol
Pergolizzi, J. V., Alegre, C., Blake, D. R., Alén, J. C., Caporali, R. F., Casser, H., Correa‐Illanes, G., Fernandes, P., Eugenio Galilea, M., Jany, R., et al. (2011) · Pain Practice · doi:10.1111/j.1533-2500.2011.00487.x · Cited by 42
“because there may be no close correlation between the mechanism(s) and the symptoms experienced.(71,72) Many analgesic drugs are available, which act at”
BackgroundCanfora, F., Calabria, E., Pecoraro, G., D’Aniello, L., Aria, M., Marenzi, G., Sammartino, P., Mignogna, M. D., & Adamo, D. (2022) · Journal of Oral Rehabilitation · doi:10.1111/joor.13343 · Cited by 40
The Role of Screening Tools in Diagnosing Neuropathic Pain
Mulvey, M. R., Bennett, M., Liwowsky, I., & Freynhagen, R. (2014) · Pain Management · doi:10.2217/pmt.14.8 · Cited by 42
Self-citationThe words patients use to describe chronic pain: Implications for measuring pain quality
Jensen, M. P., Johnson, L. E., Gertz, K. J., Galer, B. S., & Gammaitoni, A. R. (2013) · Pain · doi:10.1016/j.pain.2013.08.003 · Cited by 41
“They included 8 measures that were designed to assess pain qualities in general (to describe pain populations or assess treatment outcome) and 6 measures designed to screen or classify patients as having neuropathic vs nonneuropathic pain: the PQAS-R [15]; the PQAS [13]; the Revised Short-Form McGill Pain Questionnair…”
BackgroundNeuropathic Pain, Depressive Symptoms, and C-Reactive Protein in Sciatica Patients
Uher, T., & Bob, P. (2012) · International Journal of Neuroscience · doi:10.3109/00207454.2012.746335 · Cited by 41
“These findings are in agreement with current data documented in nonselected LBP patients that have shown significant association between neuropathic pain and the higher ratings of pain intensity, more severe depression, and panic and/or anxiety symptoms [5].”
BackgroundMethodResultInfluentialNeuropathic Pain Components in Patients with Lumbar Spinal Stenosis
Park, S.-Y., An, H. S., Moon, S. H., Lee, H., Suh, S. W., Chen, D., & Jeon, J. H. (2015) · Yonsei Medical Journal · doi:10.3349/ymj.2015.56.4.1044 · Cited by 42
“No: normal sensation in both area (0) Yes: allodynia in painful area only (5)”
BackgroundInfluentialVrana, A., Boendermaker, S. H., Stämpfli, P., Hänggi, J., Seifritz, E., Humphreys, B. K., & Meier, M. L. (2015) · PLoS ONE · doi:10.1371/journal.pone.0142391 · Cited by 41
“In the chronic LBP group, the Pain Detect Questionnaire showed an overall mean score of 11.2 (SD 6.6) and indicated a mean pain intensity of 4.8 (SD 1.9, range 1.0-7.0).”
MethodInfluentialMeyer‐Frießem, C. H., Wiegand, T., Eitner, L., Maier, C., Mainka, T., Vollert, J., & Enax‐Krumova, E. (2018) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000661 · Cited by 41
Predicting factors of outcome in multidisciplinary treatment of chronic neuropathic pain
Shaygan, M., Böger, A., & Kröner‐Herwig, B. (2018) · Journal of Pain Research · doi:10.2147/jpr.s175817 · Cited by 41
Heitmann, H., Haller, B., Tiemann, L., Mühlau, M., Berthele, A., Tölle, T. R., Salmen, A., Ambrosius, B., Bayas, A., Asseyer, S., et al. (2020) · Pain · doi:10.1097/j.pain.0000000000001767 · Cited by 47
“Pain symptoms were assessed using the PainDETECT Questionnaire (PDQ).(11) Pain of any type (unspecified pain [UP]) was screened for using3Visual AnalogueScales (VASs) on thePDQaskingpatients to rate their respective “current” as well as “worst” and “average” pain during the last 4weeksonascale from0 (“nopain”) to 10 (…”
MethodSelf-citationWluka, A. E., Yan, M. K., Lim, K. Y., Hussain, S. M., & Cicuttini, F. (2020) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2020.07.010 · Cited by 41
Bačkonja, M., Williams, L. J., Miao, X., Katz, N. P., & Chen, C. (2017) · Pain · doi:10.1097/j.pain.0000000000000983 · Cited by 40
Kumar, A., Soliman, N., Gan, Z., Cullinan, P., Vollert, J., Rice, A. S. C., & Kemp, H. I. (2023) · Pain · doi:10.1097/j.pain.0000000000003094 · Cited by 40
“24,31,32,74 It is helpful to differentiate neuropathic pain (pain arising as a direct consequence of a lesion or disease affecting the somatosensory system 35 ) from nociceptive and nociplastic pain, as different underlying mechanisms necessitate different therapeutic strategies.”
Small fibre pathology, small fibre symptoms and pain in fibromyalgia syndrome
Marshall, A., Rapteas, L., Burgess, J., Riley, D. R. J., Anson, M., Matsumoto, K., Bennett, A., Kaye, S. B., Marshall, A. G., Dunham, J., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-54365-6 · Cited by 45
Natori, A., Ogata, T., Sumitani, M., Kogure, T., Yamauchi, T., & Yamauchi, H. (2015) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-14-2775 · Cited by 40
“PainDETECT is a screening questionnaire used to identify peripheral neuropathy and neuropathic pain (26).”
BackgroundMeasurement properties of painDETECT by average pain severity
Sadosky, A., Cappelleri, J. C., Bienen, E. J., & Koduru, V. (2014) · ClinicoEconomics and Outcomes Research · doi:10.2147/ceor.s68997 · Cited by 40
Browne, A. L., Appleton, S., Fong, K., Wood, F. M., Coll, F., Munck, S. M. D., Newnham, E. A., & Schug, S. A. (2012) · Disability and Rehabilitation · doi:10.3109/09638288.2012.721047 · Cited by 42
“The painDETECT questionnaire [37] was also administered to assess neuropathic pain.”
BackgroundMethodInfluentialCesa, S. L., Tamburin, S., Tugnoli, V., Sandrini, G., Paolucci, S., Lacerenza, M. R., Marchettini, P., Cruccu, G., & Truini, A. (2015) · Neurological Sciences · doi:10.1007/s10072-015-2382-z · Cited by 39
Kim, H., Kim, J. H., Park, Y. S., Suk, K., Lee, J. H., Park, M. S., & Moon, S.-H. (2016) · The Spine Journal · doi:10.1016/j.spinee.2016.02.049 · Cited by 40
Improving patients’ experience and outcome of total joint replacement: the RESTORE programme
Blom, A. W., Artz, N. J., Beswick, A. D., Burston, A., Dieppe, P. A., Elvers, K. T., Gooberman‐Hill, R., Horwood, J. P., Jepson, P., Johnson, E. C., et al. (2016) · Programme Grants for Applied Research · doi:10.3310/pgfar04120 · Cited by 44
Konno, T., Aota, Y., Kuniya, H., Saito, T., Qu, N., Hayashi, S., Kawata, S., & Itoh, M. (2017) · Journal of Pain Research · doi:10.2147/jpr.s142115 · Cited by 41
Pascal, M. M. V., Themistocleous, A. C., Baron, R., Binder, A., Bouhassira, D., Crombez, G., Finnerup, N. B., Gierthmühlen, J., Granovsky, Y., Groop, L., et al. (2018) · Wellcome Open Research · doi:10.12688/wellcomeopenres.14576.2 · Cited by 45
Self-citationKretzschmar, M., Reining, M., & Schwarz, M. (2020) · Neuromodulation (Malden, Mass.) · doi:10.1111/ner.13222 · Cited by 53
“Baseline PNI characteristics were recorded, including pain location, quality of neuropathic pain syndrome (painDETECT questionnaire, PD-Q (27, 28)), pain duration, and prior pain management strategies.”
BackgroundPain, depression, and quality of life in adults with MOG‐antibody–associated disease
Asseyer, S., Henke, E., Trebst, C., Hümmert, M. W., Wildemann, B., Jarius, S., Ringelstein, M., Aktaş, O., Pawlitzki, M., Korsen, M., et al. (2021) · European Journal of Neurology · doi:10.1111/ene.14729 · Cited by 40
“PDQ score from 13 to 18 is considered to be possibly neuropathic [18].”
BackgroundJespersen, A., Amris, K., Bliddal, H., Andersen, S., Lavik, B., Janssen, H., & Poulsen, P. B. (2010) · Current Medical Research and Opinion · doi:10.1185/03007995.2010.502748 · Cited by 39
Ali, U. A., Issa, Y., van Goor, H., van Eijck, C. H. J., Nieuwenhuijs, V. B., Keulemans, Y. C. A., Fockens, P., Busch, O. R., Drenth, J. P. H., Dejong, C. H. C., et al. (2014) · Pancreatology · doi:10.1016/j.pan.2014.11.002 · Cited by 39
“- PainDETECT questionnaire [16]: is used to screen for presence of neuropathic pain.”
Validation of the Greek Version of the DN 4 Diagnostic Questionnaire for Neuropathic Pain
Sykioti, P., Zis, P., Vadalouca, A., Siafaka, I., Αrgyra, E., Bouhassira, D., Stavropoulou, E., & Karandreas, N. (2014) · Pain Practice · doi:10.1111/papr.12221 · Cited by 39
Gudala, K., Ghai, B., & Bansal, D. (2016) · The Korean journal of pain · doi:10.3344/kjp.2017.30.1.51 · Cited by 39
“tionnaires are calculated using 2 × 2 tables obtained by utilizing the cut-off levels recommended by the original developers (≥ 12 for painDETECT, ≥ 4 for DN4 and ≥ 2 for ID Pain and ≥ 12 points for S-LANSS) [5-8] and cut-off levels obtained in the cross-cultural phase (≥ 3 for DN4, ≥ 2 for ID Pain, ≥ 12 for painDETEC…”
MethodDisrupted offset analgesia distinguishes patients with chronic pain from healthy controls
Kobinata, H., Ikeda, E., Zhang, S., Li, T., Makita, K., & Kurata, J. (2017) · Pain · doi:10.1097/j.pain.0000000000000989 · Cited by 39
Mercieri, M., Palmisani, S., Blasi, R. A. D., D’Andrilli, A., Naccarato, A., Silvestri, B., Tigano, S., Massullo, D., Rocco, M., & Arcioni, R. (2017) · British Journal of Anaesthesia · doi:10.1093/bja/aex174 · Cited by 39
“To distinguish between non-neuropathic and neuropathic components of postoperative pain reported at one and three months, we used the PainDETECT Questionnaire (PD-Q), a validated, easy to use, patient-based (self-report) screening tool that quantifies to what extent neuropathic components contribute to chronic pain.(2…”
Methodten Klooster, P. M., de Graaf, N., & Vonkeman, H. E. (2019) · Arthritis Research & Therapy · doi:10.1186/s13075-019-2042-4 · Cited by 40
Kim, J. A., Bosma, R. L., Hemington, K. S., Rogachov, A., Osborne, N. R., Cheng, J. C., Oh, J., Dunkley, B. T., & Davis, K. D. (2020) · NeuroImage Clinical · doi:10.1016/j.nicl.2020.102230 · Cited by 41
“Those in the MS group also completed the painDETECT questionnaire (Freynhagen et al., 2006) to distinguish those with a component of neuropathic pain (scores ≥13) from those with only non-neuropathic pain (scores <13).”
Acevedo, J. C., Amaya, A., Casasola, O. D. L., Chinchilla, N., de Giorgis, M., Flórez, S., Genis, M. Á., Gómez-Barrios, J. V., Castro, J. J. H., Ibarra, E., et al. (2009) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.1080/15360280903098572 · Cited by 39
Fauchon, C., Kim, J. A., El‐Sayed, R., Osborne, N. R., Rogachov, A., Cheng, J. C., Hemington, K. S., Bosma, R. L., Dunkley, B. T., Oh, J., et al. (2021) · Pain · doi:10.1097/j.pain.0000000000002491 · Cited by 38
Marziani, L. D., Boffa, A., Angelelli, L., Andriolo, L., Martino, A. D., Zaffagnini, S., & Filardo, G. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12062319 · Cited by 38
“This was investigated with the painDETECT questionnaire, a score evaluating the contribution of neuropathic pain in the pain perceived by the patient [47,48].”
MethodDiagnostic Accuracy of the Slump Test for Identifying Neuropathic Pain in the Lower Limb
Urban, L. M., & Macneil, B. J. (2015) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2015.5414 · Cited by 38
Amtmann, D., Liljenquist, K. S., Bamer, A. M., Bocell, F. D., Jensen, M. P., Wilson, R., & Turk, D. C. (2017) · Patient · doi:10.1007/s40271-017-0269-1 · Cited by 42
“0 [39], SelfAdministered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) [40], PainDETECT Questionnaire [41], and the PROMIS Pain Quality-Neuropathic Pain [42] Short Form.”
MethodInfluentialStreckmann, F., Balke, M., Lehmann, H. C., Rustler, V., Koliamitra, C., Elter, T., Hallek, M. J., Leitzmann, M. F., Steinmetz, T., Heinen, P., et al. (2018) · BMC Cancer · doi:10.1186/s12885-017-3866-4 · Cited by 38
“Pain DETECT is a validated and reliable screening tool with high sensitivity, specificity and positive predictive accuracy [41, 42].”
MethodFitzsimmons, M., Carr, E., Woodhouse, L. J., & Bostick, G. P. (2018) · PM&R · doi:10.1016/j.pmrj.2018.01.010 · Cited by 38
“The clinical diagnosis of neuropathic pain primarily involves the use of subjective screening instruments such as the S-LANSS, painDETECT, or the DN-4 [11-13].”
MethodMcPhee, M. E., & Graven‐Nielsen, T. (2019) · Pain · doi:10.1097/j.pain.0000000000001679 · Cited by 38
“Additional questionnaires were also completed including: the Roland-Morris Disability Questionnaire, which scores daily function impacted by the back pain (maximum score5 24, highest disability)(49); and the Pain-DETECT Questionnaire, which characterises the presence of neuropathic pain-like symptoms.(15) Participants…”
MethodProtective role of natural killer cells in neuropathic pain conditions
Lassen, J., Stürner, K. H., Gierthmühlen, J., Dargvainiene, J., Kixmüller, D., Leypoldt, F., Baron, R., & Hüllemann, P. (2021) · Pain · doi:10.1097/j.pain.0000000000002274 · Cited by 38
Self-citationWilliams, R. M., Day, M. A., Ehde, D. M., Turner, A. P., Ciol, M. A., Gertz, K. J., Patterson, D. R., Hakimian, S., Suri, P., & Jensen, M. P. (2022) · Pain · doi:10.1097/j.pain.0000000000002586 · Cited by 41
Chadwick, A. L., Frazier, A., Khan, T. W., & Young, E. E. (2021) · Journal of Pain Research · doi:10.2147/jpr.s320863 · Cited by 46
Rockel, J. S., Sharma, D., Espin‐Garcia, O., Hueniken, K., Sandhu, A., Pastrello, C., Sundararajan, K., Potla, P., Fine, N. A., Lively, S. S., et al. (2025) · Annals of the Rheumatic Diseases · doi:10.1016/j.ard.2025.01.012 · Cited by 39
Smoking increases risk of pain chronification through shared corticostriatal circuitry
Petre, B., Torbey, S., Griffith, J. W., Oliveira, G. D., Herrmann, K., Mansour, A. R., Baria, A. T., Baliki, M. N., Schnitzer, T. J., & Apkarian, A. V. (2014) · Human Brain Mapping · doi:10.1002/hbm.22656 · Cited by 41
“…completed the short form of the McGill pain questionnaire (MPQ; separated into sensory, MPQs, and affective, MPQa, components) [Melzack, 1987], the Neuropathic Pain Scale (NPS) [Galer and Jensen, 1997], painDETECT [Freynhagen et al., 2006], and Pain Disability Index (PDI) [Tait et al., 1987].”
Sadosky, A., Taguchi, T., Igarashi, A., WATT, S. J., Parsons, B., Hayakawa, K., Nozawa, K., Yoshiyama, T., Ebata, N., & Fujii, K. (2015) · Journal of Pain Research · doi:10.2147/jpr.s88642 · Cited by 36
“10,11 In Japan, it has been estimated that 29.4% of patients with CLBP have an NeP component (CLBP-NeP), 12 which is consistent with the rate of 37.0% that has been reported in a European population 13 and estimated in an evidence-based review.”
InfluentialHöper, J., Helfert, S. M., Heskamp, M. ‐. S., Maihöfner, C., & Baron, R. (2013) · Current Medical Research and Opinion · doi:10.1185/03007995.2013.869491 · Cited by 37
Self-citationMinocycline Does Not Decrease Intensity of Neuropathic Pain, but Improves Its Affective Dimension
Sumitani, M., Ueda, H., Hozumi, J., Inoue, R., Kogure, T., Ogata, T., & Yamada, Y. (2015) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.3109/15360288.2014.1003674 · Cited by 37
Neuropathic Pain in Patients with Upper-Extremity Nerve Injury
Novak, C. B., & Katz, J. D. (2010) · Physiotherapy Canada · doi:10.3138/physio.62.3.190 · Cited by 36
Painful polyneuropathy associated with restless legs syndrome. Clinical features and sensory profile
Gemignani, F., Vitetta, F., Brindani, F., Contini, M., & Negrotti, A. (2012) · Sleep Medicine · doi:10.1016/j.sleep.2012.08.013 · Cited by 37
Frequency of chronic pain descriptors: Implications for assessment of pain quality
Linl, C., Kupperl, A. E., Gammaitonil, A. R., Galerl, B. S., & Jensenl, M. P. (2011) · European Journal of Pain · doi:10.1016/j.ejpain.2010.11.006 · Cited by 37
Chronic Pain and Surgery: A Review of New Insights from Sensory Testing
Wilder‐Smith, O. H. G. (2011) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.3109/15360288.2010.505256 · Cited by 36
A longitudinal study of pain, personality, and brain plasticity following peripheral nerve injury
Goswami, R., Anastakis, D. J., Katz, J. D., & Davis, K. D. (2015) · Pain · doi:10.1097/j.pain.0000000000000430 · Cited by 41
Metadata
- Authors
- Freynhagen, R., Baron, R., Gockel, U., & Tölle, T. R.
- Affiliations
- Düsseldorf University Hospital (DE)
- University Hospital Schleswig-Holstein (DE)
- Pfizer (Germany) (DE)
- Technical University of Munich (DE)
- Corresponding author
- Freynhagen, Rainer
- Venue
- Current Medical Research and Opinion
- Publisher
- Informa UK Limited
- Published
- 2006-08-29
- Volume
- 22
- Issue
- 10
- Pages
- 1911-1920
- ISSN
- 0300-7995 (ISSN-L)
- 1473-4877
- OpenAlex
- W2154693681
- Cited by
- 2,280
- References
- 25
- Citations by year
- 2026: 158 · 2025: 182 · 2024: 187 · 2023: 177 · 2022: 172 · 2021: 179 · 2020: 149 · 2019: 121 · 2018: 161 · 2017: 128 · 2016: 130 · 2015: 99 · 2014: 99 · 2013: 102 · 2012: 68
- FWCI
- 12.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Current Medical Research and Opinion (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- neuropathic pain, low back pain, chronic pain, painDETECT questionnaire, screening questionnaire, prevalence, comorbidities, depression, anxiety, sleep disorders, pain intensity, quality of life, health care utilization, pain diagnosis
- MeSH terms
- Adult, Aged, Chronic Disease, Female, Humans, Male, Middle Aged, Prospective Studies, Surveys and Questionnaires, Sensitivity and Specificity, Comorbidity, Low Back Pain
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