(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 what’s 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 participant’s 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