Possible Neuropathic Pain in Clinical Practice—Review on Selected Diagnostic Tools and Its Further Challenges

Abstract

Background: Neuropathic pain (NeP) is a wide group of conditions provoked by many different causes and with different patterns. The creation of a grading system was intended to determine the level of certainty that the pain is of neuropathic nature. Methods: The aim of this review is to update previously published data on some NeP questionnaires and their measurement properties. The selection of articles is based on the basic neurological units. To assess the usefulness and credibility of the questionnaires, the authors searched for a commonly used measure of reliability, as well as sensitivity and specificity. Results: Studies regarding the usefulness and credibility of questionnaires used in NeP were realized. Different patient cohorts, etiologies and sample sizes, do not allow for an unambiguous comparison of the presented scales; however, all of these studies found good measures of reliability, specificity and sensitivity. Conclusions: NeP tools seem to be beneficial screening instruments that should be utilized by specialists and general practitioners to improve the recognition of “possible” NeP and to determine the epidemiology of this disorder. They have been developed to distinguish perceived pain into neuropathic and non-neuropathic, and, therefore, patients with a mixed pain can still present a diagnostic challenge. Clinical examination and interview play an essential role in the diagnostic process and monitoring, and cannot be neglected.

Quality of Life in Patients with Lumbosacral Radicular Syndrome and Complete Rehabilitation Program (PRISUM PHSD/1/2022)

“…• We did not dose the level of vitamins prior to the PHSD administration because their concentration in the PHSD pill does not exceed the required daily dose. If the patients had needed post-dosing vitamin supplements, the results would not have been influenced only by the studied combination; • We did not use specific scales for the assessment of neuropathic pain [69] because the patients had mixed pain, as stated in other studies [70]. We considered that the McGill Pain Questionnaire offered a suggestive image of our patient's pain status, as other studies show [45].…”

Diagnosis and Management of Neuropathic Pain in Spine Diseases

“…The absence of a sensory disturbance and a good response to typically used analgesics make the diagnosis of neuropathic pain unlikely [ 90 ]. Various scales and questionnaires have been developed to help assess pain in patients and make the diagnosis of neuropathic pain, including the Leeds Assessment of Neuropathic Symptoms and Signs score (LANSS), the Northwick Park Neck Pain Questionnaire (NPQ), DN4 (Douleur Neuropathique 4 Questions) questionnaire, and painDETECT questionnaire [ 91 , 92 ].…”