Low back related leg pain: An investigation of construct validity of a new classification system
BACKGROUND: Leg pain is associated with back pain in 25–65% of all cases and classified as somatic referred pain or radicular pain. However, distinction between the two may be difficult as different pathomechanisms may cause similar patterns of pain. Therefore a pathomechanism based classification s...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
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IOS Press
2014
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| Online Access: | http://hdl.handle.net/20.500.11937/21291 |
| _version_ | 1848750549260828672 |
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| author | Schäfer, Axel Hall, Toby Rolke, R. Treede, R. Lüdtke, K. Mallwitz, J. Briffa, Kathy |
| author_facet | Schäfer, Axel Hall, Toby Rolke, R. Treede, R. Lüdtke, K. Mallwitz, J. Briffa, Kathy |
| author_sort | Schäfer, Axel |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | BACKGROUND: Leg pain is associated with back pain in 25–65% of all cases and classified as somatic referred pain or radicular pain. However, distinction between the two may be difficult as different pathomechanisms may cause similar patterns of pain. Therefore a pathomechanism based classification system was proposed, with four distinct hierarchical and mutually exclusive categories: Neuropathic Sensitization (NS) comprising major features of neuropathic pain with sensory sensitization; Denervation (D) arising from significant axonal compromise; Peripheral Nerve Sensitization (PNS) with marked nerve trunk mechanosensitivity; and Musculoskeletal (M) with pain referred from musculoskeletal structures. OBJECTIVE: To investigate construct validity of the classification system. METHODS: Construct validity was investigated by determining the relationship of nerve functioning with subgroups of patients and asymptomatic controls. Thus somatosensory profiles of subgroups of patients with low back related leg pain (LBRLP) and healthy controls were determined by a comprehensive quantitative sensory test (QST) protocol. It was hypothesized that subgroups of patients and healthy controls would show differences in QST profiles relating to underlying pathomechanisms. RESULTS: 77 subjects with LBRLP were recruited and classified in one of the four groups. Additionally, 18 age and gender matched asymptomatic controls were measured. QST revealed signs of pain hypersensitivity in group NS and sensory deficits in group D whereas Groups PNS and M showed no significant differences when compared to the asymptomatic group. CONCLUSIONS: These findings support construct validity for two of the categories of the new classification system, however further research is warranted to achieve construct validation of the classification system as a whole. |
| first_indexed | 2025-11-14T07:38:36Z |
| format | Journal Article |
| id | curtin-20.500.11937-21291 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T07:38:36Z |
| publishDate | 2014 |
| publisher | IOS Press |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-212912017-09-13T13:53:06Z Low back related leg pain: An investigation of construct validity of a new classification system Schäfer, Axel Hall, Toby Rolke, R. Treede, R. Lüdtke, K. Mallwitz, J. Briffa, Kathy classification system QST quantitative sensory testing leg pain validity Low back pain BACKGROUND: Leg pain is associated with back pain in 25–65% of all cases and classified as somatic referred pain or radicular pain. However, distinction between the two may be difficult as different pathomechanisms may cause similar patterns of pain. Therefore a pathomechanism based classification system was proposed, with four distinct hierarchical and mutually exclusive categories: Neuropathic Sensitization (NS) comprising major features of neuropathic pain with sensory sensitization; Denervation (D) arising from significant axonal compromise; Peripheral Nerve Sensitization (PNS) with marked nerve trunk mechanosensitivity; and Musculoskeletal (M) with pain referred from musculoskeletal structures. OBJECTIVE: To investigate construct validity of the classification system. METHODS: Construct validity was investigated by determining the relationship of nerve functioning with subgroups of patients and asymptomatic controls. Thus somatosensory profiles of subgroups of patients with low back related leg pain (LBRLP) and healthy controls were determined by a comprehensive quantitative sensory test (QST) protocol. It was hypothesized that subgroups of patients and healthy controls would show differences in QST profiles relating to underlying pathomechanisms. RESULTS: 77 subjects with LBRLP were recruited and classified in one of the four groups. Additionally, 18 age and gender matched asymptomatic controls were measured. QST revealed signs of pain hypersensitivity in group NS and sensory deficits in group D whereas Groups PNS and M showed no significant differences when compared to the asymptomatic group. CONCLUSIONS: These findings support construct validity for two of the categories of the new classification system, however further research is warranted to achieve construct validation of the classification system as a whole. 2014 Journal Article http://hdl.handle.net/20.500.11937/21291 10.3233/BMR-140461 IOS Press fulltext |
| spellingShingle | classification system QST quantitative sensory testing leg pain validity Low back pain Schäfer, Axel Hall, Toby Rolke, R. Treede, R. Lüdtke, K. Mallwitz, J. Briffa, Kathy Low back related leg pain: An investigation of construct validity of a new classification system |
| title | Low back related leg pain: An investigation of construct validity of a new classification system |
| title_full | Low back related leg pain: An investigation of construct validity of a new classification system |
| title_fullStr | Low back related leg pain: An investigation of construct validity of a new classification system |
| title_full_unstemmed | Low back related leg pain: An investigation of construct validity of a new classification system |
| title_short | Low back related leg pain: An investigation of construct validity of a new classification system |
| title_sort | low back related leg pain: an investigation of construct validity of a new classification system |
| topic | classification system QST quantitative sensory testing leg pain validity Low back pain |
| url | http://hdl.handle.net/20.500.11937/21291 |