Use of the painDETECT to discriminate musculoskeletal pain phenotypes

Bittencourt, Juliana Valentim; Bezerra, Márcia Cliton; Pina, Mônica Rotondo; Reis, Felipe José Jandre dos; Ferreira, Arthur de Sá; Nogueira, Leandro Alberto Calazans

doi:10.1186/s40945-022-00129-2

Cited by 3 publications

(2 citation statements)

References 62 publications

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“…A pre-planned secondary analysis of data collected from a previous study by the present group of authors was undertook 23 . The original study was a cross-sectional observational study that followed the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) criteria (Atachment 1) 24 .…”

Section: Methodsmentioning

confidence: 99%

Patients with fibromyalgia present different pain phenotypes compared to patients with generalized pain

Bittencourt¹,

Corrêa²,

Bezerra³

et al. 2022

BrJP

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BACKGROUND AND OBJECTIVES: Fibromyalgia and generalized pain represent a global health problem and are distinct musculoskeletal disorders, but there is an overlap in the clinical presentation between these conditions. However, no study has compared pain characteristics between patients with fibromyalgia and patients with generalized pain. Therefore, the present study aimed to compare pain characteristics and functional limitation of patients with fibromyalgia and patients with generalized pain. METHODS: A pre-planned secondary analysis of data collected from 311 patients with musculoskeletal pain was performed. Pain characteristics included pain intensity, pain duration, pain area, symptoms of central sensitization, presence of neuropathic-like symptoms, and the conditioned pain modulation. The Patient-Specific Functional Scale assessed functional limitation. RESULTS: 98 patients with generalized pain were identified, being 58 (59.18%) classified in the fibromyalgia group and 40 (40.82%) classified in the generalized pain group. Significant differences were found between groups for Widespread Pain Index, Symptom Severity Scale, and Polysymptomatic Distress Scale. Participants with fibromyalgia presented higher values of pain intensity (fibromyalgia = 7.29±2.07, generalized pain = Patients with fibromyalgia present different pain phenotypes compared to patients with generalized painPacientes com fibromialgia apresentam fenótipos de dor diferentes em comparação com pacientes com dor generalizada

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Section: Methodsmentioning

confidence: 99%

Patients with fibromyalgia present different pain phenotypes compared to patients with generalized pain

Bittencourt¹,

Corrêa²,

Bezerra³

et al. 2022

BrJP

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show abstract

“…Neuropathic pain leads to unfavourable outcomes and remains a major clinical challenge. People with neuropathic-like symptoms showed unfavourable pain features (i.e., pain intensity and functional limitation) compared to their counterparts [ 1 ]. Previous studies showed that neuropathic pain interferes with several aspects of an individual’s life, such as poor sleep quality [ 2 ], physical impairment [ 3 ], and a large psychosocial burden [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Does the painDETECT questionnaire identify impaired conditioned pain modulation in people with musculoskeletal pain? – a diagnostic accuracy study

Bittencourt,

Leivas,

de Sá Ferreira

et al. 2023

Arch Physiother

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Background People with neuropathic-like symptoms had more unfavourable pain features than people with nociceptive. Moreover, deficient conditioned pain modulation is common in people with neuropathic-like symptoms. PainDETECT questionnaire have been used to assess the central sensitisation sign and symptoms. However, whether the painDETECT questionnaire can identify the conditioned pain modulation's impairment is still unknown. Therefore, the current study aimed to evaluate the diagnostic accuracy of the painDETECT questionnaire in detecting the impairment of conditioned pain modulation in people with musculoskeletal pain. Methods We conducted a diagnostic accuracy comparing the painDETECT questionnaire (index method) with the cold pressor test, the psychophysical test used to assess the conditioned pain modulation (reference standard). We determined diagnostic accuracy by calculating sensitivity, specificity, predictive values, and likely hood ratios. Results We retrospectively enrolled 308 people with musculoskeletal pain in outpatient departments. Most participants were female (n 20 = 220, 71.4%) and had a mean age of 52.2 (± 15.0) years. One hundred seventy-three (56.1%) participants were classified as nociceptive pain, 69 (22.4%) as unclear, and 66 (21.4%) as neuropathic-like symptoms. According to the cold pressor test, 60 (19.4%) participants presented impairment of conditioned pain modulation. The cutoff point of 12 of the painDETECT questionnaire showed values of diagnostic accuracy below 70% compared to the cold pressor test, except for a negative predictive value [76.9 95% Confidence Interval (CI) 71.7 to 81.5]. The cutoff point 19 showed high specificity (78.6%, 95% CI 73.0 to 83.5), high negative predictive value (80.5%, 95% CI 78.1 to 82.7), and accuracy of 67.5% compared to the cold pressor test. Conclusion The painDETECT questionnaire seems valuable for ruling out people with musculoskeletal pain and impairment of conditioned pain modulation.

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

2022

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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.

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Use of the painDETECT to discriminate musculoskeletal pain phenotypes

Cited by 3 publications

References 62 publications

Patients with fibromyalgia present different pain phenotypes compared to patients with generalized pain

Patients with fibromyalgia present different pain phenotypes compared to patients with generalized pain

Does the painDETECT questionnaire identify impaired conditioned pain modulation in people with musculoskeletal pain? – a diagnostic accuracy study

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

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