Use of pain drawing as an assessment tool of sciatica for patients with single level lumbar disc herniation.

Toshiya Tachibana,Kazuki Kusuyama,Fumihiro Arizumi,Keishi Maruo,Shinichi Inoue,Shinichi Yoshiya

doi:10.1186/s40064-016-2981-z

Toshiya Tachibana, Kazuki Kusuyama + Show 4 more

Open Access

https://doi.org/10.1186/s40064-016-2981-z

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Journal: SpringerPlus	Publication Date: Aug 9, 2016
Citations: 11	License type: CC BY 4.0

Affiliation: Hyogo Medical University

Abstract

The objectives of this study were to examine the diagnostic accuracy of pain drawing (PD) in determining the level of involvement and to investigate how the quantitative evaluation results of PD using a grid score (GS) correlates with the results of other clinical evaluation measures in diagnosis and assessment of patients with lumber disc herniation (LDH) involving a single nerve root. Thirty-one patients with single level LDH who were diagnosed and conservatively treated by the first author constituted the study population. In order to assess the diagnostic accuracy of PD, the level of involvement as determined by PD was compared to the final diagnosis. In 26 of the 31 patients who could be followed for more than 6 months of conservative treatment, the GS in PD evaluation was compared to the score assessed by the Japanese Orthopaedic Association scoring system for low back pain (JOA score) and the visual analog scale (VAS) both before and after the treatment. The overall diagnostic accuracy of PD for the determination of the affected level averaged 68.8 %, and the accuracy was higher at the L4/5 and L5/S levels than the L2/3 and L3/4 levels. The average values of VAS and GS significantly decreased and the JOA score significantly improved after the treatment. Moreover, a significant correlation was demonstrated between the scores derived from these three evaluation measures. The present study indicated the potential usefulness of PD in clinical assessment during the treatment course.

Highlights

In our clinical experiences, pain drawing (PD) has been effectively utilized to detect the affected level because the area of pain indicated in PD corresponds to the distribution of the affected nerve root
These previous reports mostly examined the efficacy of PD in psychological assessments (Dzioba and Doxey 1984; Gatchel et al 1986; McNeill et al 1986; Ohlund et al 1996; Ohnmeiss et al 1996; Ransford et al 1976; Taylor et al 1984; Uden et al 1988), and there have been no studies that have analyzed the efficacy of the use of PD in the clinical evaluation of patients with sciatica
grid score (GS) of all patients was evaluated from PD using a grid by the first author (Fig. 2)

Summary

Introduction

Pain drawing (PD) has been effectively utilized to detect the affected level because the area of pain indicated in PD corresponds to the distribution of the affected nerve root. There have been a number of studies examining the significance of PD in the diagnosis and evaluation of patients with various low back disorders. These previous reports mostly examined the efficacy of PD in psychological assessments (Dzioba and Doxey 1984; Gatchel et al 1986; McNeill et al 1986; Ohlund et al 1996; Ohnmeiss et al 1996; Ransford et al 1976; Taylor et al 1984; Uden et al 1988), and there have been no studies that have analyzed the efficacy of the use of PD in the clinical evaluation of patients with sciatica. The second objective was to determine how the quantitative assessment of PD using a grid score (GS) correlates with the results of other clinical evaluation measures such as validated clinical score and visual analog scale (VAS) treatments

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Discussion

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