Low back related leg pain: An investigation of construct validity of a new classification system
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Low back related leg pain: An investigation of construct validity of a new classification system. / Schäfer, Axel G M; Hall, Toby M; Rolke, Roman; Treede, Rolf-Detlef; Lüdtke, Kerstin; Mallwitz, Joachim; Briffa, Kathryn N.
In: J BACK MUSCULOSKELET, Vol. 27, No. 4, 10.03.2014, p. 409-418.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Low back related leg pain: An investigation of construct validity of a new classification system
AU - Schäfer, Axel G M
AU - Hall, Toby M
AU - Rolke, Roman
AU - Treede, Rolf-Detlef
AU - Lüdtke, Kerstin
AU - Mallwitz, Joachim
AU - Briffa, Kathryn N
PY - 2014/3/10
Y1 - 2014/3/10
N2 - BACKGROUND: Leg pain is associated with back pain in 25-65% of all cases and classified as somatic referred pain or radicular pain. However, distinction between the two may be difficult as different pathomechanisms may cause similar patterns of pain. Therefore a pathomechanism based classification system was proposed, with four distinct hierarchical and mutually exclusive categories: Neuropathic Sensitization (NS) comprising major features of neuropathic pain with sensory sensitization; Denervation (D) arising from significant axonal compromise; Peripheral Nerve Sensitization (PNS) with marked nerve trunk mechanosensitivity; and Musculoskeletal (M) with pain referred from musculoskeletal structures.OBJECTIVE: To investigate construct validity of the classification system.METHODS: Construct validity was investigated by determining the relationship of nerve functioning with subgroups of patients and asymptomatic controls. Thus somatosensory profiles of subgroups of patients with low back related leg pain (LBRLP) and healthy controls were determined by a comprehensive quantitative sensory test (QST) protocol. It was hypothesized that subgroups of patients and healthy controls would show differences in QST profiles relating to underlying pathomechanisms.RESULTS: 77 subjects with LBRLP were recruited and classified in one of the four groups. Additionally, 18 age and gender matched asymptomatic controls were measured. QST revealed signs of pain hypersensitivity in group NS and sensory deficits in group D whereas Groups PNS and M showed no significant differences when compared to the asymptomatic group.CONCLUSIONS: These findings support construct validity for two of the categories of the new classification system, however further research is warranted to achieve construct validation of the classification system as a whole.
AB - BACKGROUND: Leg pain is associated with back pain in 25-65% of all cases and classified as somatic referred pain or radicular pain. However, distinction between the two may be difficult as different pathomechanisms may cause similar patterns of pain. Therefore a pathomechanism based classification system was proposed, with four distinct hierarchical and mutually exclusive categories: Neuropathic Sensitization (NS) comprising major features of neuropathic pain with sensory sensitization; Denervation (D) arising from significant axonal compromise; Peripheral Nerve Sensitization (PNS) with marked nerve trunk mechanosensitivity; and Musculoskeletal (M) with pain referred from musculoskeletal structures.OBJECTIVE: To investigate construct validity of the classification system.METHODS: Construct validity was investigated by determining the relationship of nerve functioning with subgroups of patients and asymptomatic controls. Thus somatosensory profiles of subgroups of patients with low back related leg pain (LBRLP) and healthy controls were determined by a comprehensive quantitative sensory test (QST) protocol. It was hypothesized that subgroups of patients and healthy controls would show differences in QST profiles relating to underlying pathomechanisms.RESULTS: 77 subjects with LBRLP were recruited and classified in one of the four groups. Additionally, 18 age and gender matched asymptomatic controls were measured. QST revealed signs of pain hypersensitivity in group NS and sensory deficits in group D whereas Groups PNS and M showed no significant differences when compared to the asymptomatic group.CONCLUSIONS: These findings support construct validity for two of the categories of the new classification system, however further research is warranted to achieve construct validation of the classification system as a whole.
U2 - 10.3233/BMR-140461
DO - 10.3233/BMR-140461
M3 - SCORING: Journal article
C2 - 24614828
VL - 27
SP - 409
EP - 418
JO - J BACK MUSCULOSKELET
JF - J BACK MUSCULOSKELET
SN - 1053-8127
IS - 4
ER -