Clinical and neurological characteristics of patients with somatic referred back pain at the lumbosacral level

Abstract

Referred pain is a painful sensation in the peripheral regions during pathological processes in deep tissues or viscera. There are two types of referred pain: 1) somatic referred pain (from spinal structures to adjacent areas); 2) visceral referred pain (from pelvic and abdominal viscera). Patients and methods. The investigation enrolled 80 patients with nonspecific chronic and subacute lumbosacral spine pain. All the patients underwent standard neurological examination. Pain intensity was determined on a visual analog scale (VAS) using the DN4, PainDETECT, and short-form McGill questionnaires; the wind-up phenomenon was evaluated; the degree of muscular tonic syndrome was estimated applying the Khabirov questionnaire. The health-activity-mood (HAM), SF-36, and Roland-Morris questionnaires were used to assess quality of life. Results. Somatic referred pain was found in 62% of the examinees. In these patients, the clinical picture showed a set of characteristics for neuropathic (allodynia (31%), hyperesthesia (12%), and nociceptive (grades 1 and 2 muscular tonic syndrome 41 and 59%, respectively) pain; a high wind-up index was noted in 89% of the patients.