Abstract
BackgroundSomatosensory testing could be useful in stratifying pain patients and improving pain treatment guidelines. Bedside-suitable techniques are searched for application in daily clinical practice. This study aimed to characterize chronic unilateral lumbosacral radiculopathy (LSR) patients with radicular pain using multimodal bedside-suitable somatosensory testing.Materials and methodsWe evaluated 50 chronic unilateral LSR patients with radicular pain (LSR group) and 24 controls (Control group). Sensory testing was performed using a battery of bedside sensory tests (10g monofilament, 200–400 mN brush, Lindblom rollers with controlled 25°C and 40°C temperature, and 40g neurological pin and investigator’s finger pressure). Participants had to rate their sensory perceptions on both legs at multiple test points within L3 to S2 dermatomes. Characteristics of the testing process and sensory disturbances were analyzed.ResultsLSR group showed sensory disturbances in 82% of patients. The Control group showed no sensory disturbances. Sensory testing took longer (p < 0.001) in the LSR group (29.3 ± 6.5 minutes per patient) than in the Control group (20.5 ± 5.2). Nine sensory phenotypes were detected in the LSR group according to individual sensory disturbances within 5 superficial tests.ConclusionsThe applied multimodal bedside-suitable somatosensory testing battery is suitable for sensory evaluation and characterization of LSR patients. Grouping of allied sensory phenotypes revealed some tendencies in pain intensity characteristics.
Highlights
Low back pain (LBP) is a leading cause of disability defined by the global all-age years lived with disability (YLDs) index in 2017 [1]
We evaluated 50 chronic unilateral lumbosacral radiculopathy (LSR) patients with radicular pain (LSR group) and 24 controls (Control group)
Nine sensory phenotypes were detected in the LSR group according to individual sensory disturbances within 5 superficial tests
Summary
Low back pain (LBP) is a leading cause of disability defined by the global all-age years lived with disability (YLDs) index in 2017 [1]. Classic LBP treatments vary from passive to active, from noninterventional to surgical, and from traditional to modern. There is a tendency of phenotyping pain patients to characterize them more accurately and facilitate the selection of available treatments [3]. Quantitative sensory testing (QST) is used to evaluate sensory disturbances, and it is applicable in patients with back pain pathology [4]. Its application in daily clinical practice remains limited due to the expensiveness of equipment, considerable consumption of time, and the need for personnel training. Somatosensory testing could be useful in stratifying pain patients and improving pain treatment guidelines. Bedside-suitable techniques are searched for application in daily clinical practice. This study aimed to characterize chronic unilateral lumbosacral radiculopathy (LSR) patients with radicular pain using multimodal bedside-suitable somatosensory testing
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