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New tests for back pain

9th April 2009

Researchers suggest that a simple technique could lead to improved treatment for back pain.

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A study has devised a bedside test to distinguish between neuropathic – nerve damage – pain and other causes of pain.

It has been devised by a team of researchers from Addenbrooke’s Hospital in Cambridge working with the Massachusetts General Hospital in the United States.

They recruited more than 300 patients with chronic back pain – some of whom had a history of nerve damage caused by diabetes or shingles, while others had low back pain with or without evidence of spinal nerve root damage.

From conducting comparisons, the researchers formulated a set of six questions and 10 physical tests which distinguished between the two groups.

Writing in the journal PLoS Medicine, they believe the tests were superior to existing screening tests for neuropathic pain and even to MRI scanning of the spine.

Lead author Joachim Scholz said: "Currently clinicians measure pain only by asking how bad it is, using scales from mild to moderate to severe or asking patients to rate their pain from one to 10.

"This approach misses key characteristics that reflect the mechanisms causing the 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."

Dries Hettinga, head of research and policy at the charity BackCare, said the diagnostic tool that the researchers have developed could make a big difference to many people with back pain.

 

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