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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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Cites
Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment
Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006) · European Journal of Pain · doi:10.1016/j.ejpain.2005.06.009 · Cited by 5,486
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Chapter 4 European guidelines for the management of chronic nonspecific low back pain
Airaksinen, O., Brox, J. I., Cedraschi, C., Hildebrandt, J., Klaber-Moffett, J., Kovacs, F., Mannion, A. F., Reis, S., Staal, J. B., Ursin, H., et al. (2006) · European Spine Journal · doi:10.1007/s00586-006-1072-1 · Cited by 2,594
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Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9
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Algorithm for neuropathic pain treatment: An evidence based proposal
Finnerup, N. B., Otto, M., McQuay, H. J., Jensen, T. S., & Sindrup, S. H. (2005) · Pain · doi:10.1016/j.pain.2005.08.013 · Cited by 1,337
Dworkin, R. H., Bačkonja, M., Rowbotham, M. C., Allen, R. R., Argoff, C., Bennett, G. J., Bushnell, M. C., Farrar, J. T., Galer, B. S., Haythornthwaite, J. A., et al. (2003) · Archives of Neurology · doi:10.1001/archneur.60.11.1524 · Cited by 1,213
The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs
Bennett, M. (2001) · Pain · doi:10.1016/s0304-3959(00)00482-6 · Cited by 1,165
O’Sullivan, P. (2005) · Manual Therapy · doi:10.1016/j.math.2005.07.001 · Cited by 985
Development and preliminary validation of a pain measure specific to neuropathic pain
Galer, B. S., & Jensen, M. (1997) · Neurology · doi:10.1212/wnl.48.2.332 · Cited by 778
Research works printed but not linked: 1
- Kohlmann TRH, 1996, Rehabilitation, 35, 1
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Colloca, L., Ludman, T., Bouhassira, D., Baron, R., Dickenson, A. H., Yarnitsky, D., Freeman, R. L., Truini, A., Attal, N., Finnerup, N. B., et al. (2017) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2017.2 · Cited by 2,271
Self-citationPrevalence of chronic pain with neuropathic characteristics in the general population
Bouhassira, D., Lantéri‐Minet, M., Attal, N., Laurent, B., & Touboul, C. (2007) · Pain · doi:10.1016/j.pain.2007.08.013 · Cited by 1,827
“Keywords: Chronic pain; Neuropathic pain; Epidemiology”
Neuropathic Pain: From Mechanisms to Treatment
Finnerup, N. B., Kuner, R., & Jensen, T. S. (2020) · Physiological Reviews · doi:10.1152/physrev.00045.2019 · Cited by 1,727
Neuropathic pain: an updated grading system for research and clinical practice
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Self-citationNociplastic pain: towards an understanding of prevalent pain conditions
Fitzcharles, M.-A., Cohen, S. P., Clauw, D. J., Littlejohn, G., Usui, C., & Häuser, W. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00392-5 · Cited by 1,253
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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