Mechanisms-based classifications of musculoskeletal pain: part 3 of 3: symptoms and signs of nociceptive pain in patients with low back (± leg) pain.

2.50
Hdl Handle:
http://hdl.handle.net/10147/251314
Title:
Mechanisms-based classifications of musculoskeletal pain: part 3 of 3: symptoms and signs of nociceptive pain in patients with low back (± leg) pain.
Authors:
Smart, Keith M; Blake, Catherine; Staines, Anthony; Thacker, Mick; Doody, Catherine
Affiliation:
Physiotherapy Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. k.smart@svuh.ie
Citation:
Mechanisms-based classifications of musculoskeletal pain: part 3 of 3: symptoms and signs of nociceptive pain in patients with low back (± leg) pain. 2012, 17 (4):352-7 Man Ther
Journal:
Manual therapy
Issue Date:
Aug-2012
URI:
http://hdl.handle.net/10147/251314
DOI:
10.1016/j.math.2012.03.002
PubMed ID:
22464885
Abstract:
As a mechanisms-based classification of pain 'nociceptive pain' (NP) refers to pain attributable to the activation of the peripheral receptive terminals of primary afferent neurones in response to noxious chemical, mechanical or thermal stimuli. The symptoms and signs associated with clinical classifications of NP have not been extensively studied. The purpose of this study was to identify symptoms and signs associated with a clinical classification of NP in patients with low back (± leg) pain. Using a cross-sectional, between-subjects design; four hundred and sixty-four patients with low back (± leg) pain were assessed using a standardised assessment protocol after which their pain was assigned a mechanisms-based classification based on experienced clinical judgement. Clinicians then completed a clinical criteria checklist indicating the presence/absence of various symptoms and signs. A regression analysis identified a cluster of seven clinical criteria predictive of NP, including: 'Pain localised to the area of injury/dysfunction', 'Clear, proportionate mechanical/anatomical nature to aggravating and easing factors', 'Usually intermittent and sharp with movement/mechanical provocation; may be a more constant dull ache or throb at rest', and the absence of 'Pain in association with other dysesthesias', 'Night pain/disturbed sleep', 'Antalgic postures/movement patterns' and 'Pain variously described as burning, shooting, sharp or electric-shock-like'. This cluster was found to have high levels of classification accuracy (sensitivity 90.9%, 95% CI: 86.6-94.1; specificity 91.0%, 95% CI: 86.1-94.6). Pattern recognition of this empirically-derived cluster of symptoms and signs may help clinicians identify an assumed dominance of NP mechanisms in patients with low back pain disorders.
Item Type:
Article
Language:
en
MeSH:
Adult; Aged; Analysis of Variance; Bayes Theorem; Cluster Analysis; Cross-Sectional Studies; Female; Humans; Ireland; Low Back Pain; Male; Middle Aged; Musculoskeletal Pain; Nociceptive Pain; Pain Measurement; Pain Threshold; Peripheral Nervous System Diseases; Physical Examination; Sensitivity and Specificity; Severity of Illness Index
ISSN:
1532-2769

Full metadata record

DC FieldValue Language
dc.contributor.authorSmart, Keith Men_GB
dc.contributor.authorBlake, Catherineen_GB
dc.contributor.authorStaines, Anthonyen_GB
dc.contributor.authorThacker, Micken_GB
dc.contributor.authorDoody, Catherineen_GB
dc.date.accessioned2012-11-07T14:52:40Z-
dc.date.available2012-11-07T14:52:40Z-
dc.date.issued2012-08-
dc.identifier.citationMechanisms-based classifications of musculoskeletal pain: part 3 of 3: symptoms and signs of nociceptive pain in patients with low back (± leg) pain. 2012, 17 (4):352-7 Man Theren_GB
dc.identifier.issn1532-2769-
dc.identifier.pmid22464885-
dc.identifier.doi10.1016/j.math.2012.03.002-
dc.identifier.urihttp://hdl.handle.net/10147/251314-
dc.description.abstractAs a mechanisms-based classification of pain 'nociceptive pain' (NP) refers to pain attributable to the activation of the peripheral receptive terminals of primary afferent neurones in response to noxious chemical, mechanical or thermal stimuli. The symptoms and signs associated with clinical classifications of NP have not been extensively studied. The purpose of this study was to identify symptoms and signs associated with a clinical classification of NP in patients with low back (± leg) pain. Using a cross-sectional, between-subjects design; four hundred and sixty-four patients with low back (± leg) pain were assessed using a standardised assessment protocol after which their pain was assigned a mechanisms-based classification based on experienced clinical judgement. Clinicians then completed a clinical criteria checklist indicating the presence/absence of various symptoms and signs. A regression analysis identified a cluster of seven clinical criteria predictive of NP, including: 'Pain localised to the area of injury/dysfunction', 'Clear, proportionate mechanical/anatomical nature to aggravating and easing factors', 'Usually intermittent and sharp with movement/mechanical provocation; may be a more constant dull ache or throb at rest', and the absence of 'Pain in association with other dysesthesias', 'Night pain/disturbed sleep', 'Antalgic postures/movement patterns' and 'Pain variously described as burning, shooting, sharp or electric-shock-like'. This cluster was found to have high levels of classification accuracy (sensitivity 90.9%, 95% CI: 86.6-94.1; specificity 91.0%, 95% CI: 86.1-94.6). Pattern recognition of this empirically-derived cluster of symptoms and signs may help clinicians identify an assumed dominance of NP mechanisms in patients with low back pain disorders.en_GB
dc.language.isoenen
dc.rightsArchived with thanks to Manual therapyen_GB
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAnalysis of Variance-
dc.subject.meshBayes Theorem-
dc.subject.meshCluster Analysis-
dc.subject.meshCross-Sectional Studies-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshLow Back Pain-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshMusculoskeletal Pain-
dc.subject.meshNociceptive Pain-
dc.subject.meshPain Measurement-
dc.subject.meshPain Threshold-
dc.subject.meshPeripheral Nervous System Diseases-
dc.subject.meshPhysical Examination-
dc.subject.meshSensitivity and Specificity-
dc.subject.meshSeverity of Illness Index-
dc.titleMechanisms-based classifications of musculoskeletal pain: part 3 of 3: symptoms and signs of nociceptive pain in patients with low back (± leg) pain.en_GB
dc.typeArticleen
dc.contributor.departmentPhysiotherapy Department, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland. k.smart@svuh.ieen_GB
dc.identifier.journalManual therapyen_GB
dc.description.provinceLeinsteren
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