Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with 'nociceptive', 'peripheral neuropathic' and 'central sensitisation' pain. The discriminant validity of mechanisms-based classifications of low back (±leg) pain.
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Affiliation
St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. k.smart@svuh.ieIssue Date
2012-04MeSH
Analysis of VarianceAnxiety
Central Nervous System Sensitization
Cross-Sectional Studies
Depression
Disability Evaluation
Discriminant Analysis
Female
Humans
Leg
Low Back Pain
Male
Musculoskeletal Pain
Pain Measurement
Peripheral Nervous System Diseases
Quality of Life
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Self-reported pain severity, quality of life, disability, anxiety and depression in patients classified with 'nociceptive', 'peripheral neuropathic' and 'central sensitisation' pain. The discriminant validity of mechanisms-based classifications of low back (±leg) pain. 2012, 17 (2):119-25 Man TherJournal
Manual therapyDOI
10.1016/j.math.2011.10.002PubMed ID
22074733Abstract
Evidence of validity is required to support the use of mechanisms-based classifications of pain clinically. The purpose of this study was to evaluate the discriminant validity of 'nociceptive' (NP), 'peripheral neuropathic' (PNP) and 'central sensitisation' (CSP) as mechanisms-based classifications of pain in patients with low back (±leg) pain by evaluating the extent to which patients classified in this way differ from one another according to health measures associated with various dimensions of pain. This study employed a cross-sectional, between-subjects design. Four hundred and sixty-four patients with low back (±leg) pain were assessed using a standardised assessment protocol. Clinicians classified each patient's pain using a mechanisms-based classification approach. Patients completed a number of self-report measures associated with pain severity, health-related quality of life, functional disability, anxiety and depression. Discriminant validity was evaluated using a multivariate analysis of variance. There was a statistically significant difference between pain classifications on the combined self-report measures, (p = .001; Pillai's Trace = .33; partial eta squared = .16). Patients classified with CSP (n = 106) reported significantly more severe pain, poorer general health-related quality of life, and greater levels of back pain-related disability, depression and anxiety compared to those classified with PNP (n = 102) and NP (n = 256). A similar pattern was found in patients with PNP compared to NP. Mechanisms-based pain classifications may reflect meaningful differences in attributes underlying the multidimensionality of pain. Further studies are required to evaluate the construct and criterion validity of mechanisms-based classifications of musculoskeletal pain.Item Type
ArticleLanguage
enISSN
1532-2769ae974a485f413a2113503eed53cd6c53
10.1016/j.math.2011.10.002
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