Deceased after completion of the study and analysis.
What Is the Evidence that Neuropathic Pain Is Present in Chronic Low Back Pain and Soft Tissue Syndromes? An Evidence-Based Structured Review
Article first published online: 4 OCT 2013
Wiley Periodicals, Inc
Volume 15, Issue 1, pages 4–15, January 2014
How to Cite
Fishbain, D. A., Cole, B., Lewis, J. E. and Gao, J. (2014), What Is the Evidence that Neuropathic Pain Is Present in Chronic Low Back Pain and Soft Tissue Syndromes? An Evidence-Based Structured Review. Pain Medicine, 15: 4–15. doi: 10.1111/pme.12229
None of the authors had any direct or indirect funding in support of this study.
- Issue published online: 16 JAN 2014
- Article first published online: 4 OCT 2013
- Prevalence Neuropathic Pain;
- Chronic Low Back Pain;
- Soft tissue Syndromes;
- Evidence-Based Structured Review;
- Leeds Assessment of Neuropathic Symptoms and Signs (LANSS);
- Neuropathic Pain Diagnostic Questionnaire (DN4);
- Pain Detect Questionnaire
The objectives of this evidence-based review were to review the evidence for whether neuropathic pain (NP) is associated with chronic low back pain (CLBP) and soft tissue syndromes (STS), and review the reported prevalence percentages for NP within these syndromes.
Of 816 reports, 11 addressed the diagnosis of NP in CLBP and five of NP in STS. Studies were grouped by the method of arrival at an NP diagnosis, e.g., physical examination, type of NP inventory utilized, etc. The reported prevalence of NP was determined by aggregating all the patients in all the studies in each grouping. Similarly, the reported prevalence of NP within CLBP and STS was determined by aggregating all the patients with NP from all the studies in those groups. Each study was independently rated by two raters according to 11 quality criteria generating a quality score. The strength and consistency (SAC) of the evidence represented by each grouping was rated according to Agency for Health Care Policy and Research guidelines.
In each grouping, 100% of the studies reported some prevalence of NP (none reported zero prevalence). Aggregated NP prevalence for CLBP was 36.6% (SAC level A [consistent multiple studies]) and for STS 41.1% (SAC level A). There was significant variation in prevalence according to the method utilized to diagnose NP.
There is consistent evidence by all methods that NP is present in CLBP and STS. Reported prevalence percentages by all methods are substantial. This has significant implications for the treatment of CLBP and STS.