Neuropathic Back Pain : Are There Any Practical Diagnostic Criteria?

Abstract

OBJECTIVE: A new point of view on the chronic back pain proposed which is, named neuropathic back pain(NBP). Some proposed a certain pain scale as an useful diagnostic tool. Before scientific verification, some doctors prescribed a new anticonvulsant for the NBP. We investigated diagnostic tools for NBP by a review of the literature. METHODS: A comprehensive computer search of the English literature concerning neuropathic low back pain was performed using the key words such as neuropathic back pain and diagnosis in the PubMed. RESULTS: In 1998, the term NBP was first used in a patient with lung cancer. In the English literature, there were two diagnostic methods for the NBP, Neuropathic pain scale(NPS) and a pharmacological test. NPS is a pain questionnaire, which depends on the patients'subjective reports on the given questions, such as 'how hot is your pain feel'. By the pharmacological test, NBP was defined as 50% or more decrease of pain on intravenous lidocaine and on local anesthetic epidurally. It also depends on the patients'subjective response to the therapy. CONCLUSION: There were still no reliable objective diagnostic criteria for the NBP. It seems to be better to reserve the new anticonvulsants for the NBP till scientific approval.