Use of the painDETECT to discriminate musculoskeletal pain phenotypes

Juliana Valentim Bittencourt; Márcia Cliton Bezerra; Mônica Rotondo Pina; Felipe José Jandre Reis; Arthur de Sá Ferreira; Leandro Alberto Calazans Nogueira

doi:10.1186/s40945-022-00129-2

Authors

Juliana Valentim Bittencourt Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Paris, 84, Bonsucesso, Rio de Janeiro, RJ CEP 21041-020, Brazil
Márcia Cliton Bezerra Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Paris, 84, Bonsucesso, Rio de Janeiro, RJ CEP 21041-020, Brazil
Mônica Rotondo Pina Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Paris, 84, Bonsucesso, Rio de Janeiro, RJ CEP 21041-020, Brazil
Felipe José Jandre Reis Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
Arthur de Sá Ferreira Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Paris, 84, Bonsucesso, Rio de Janeiro, RJ CEP 21041-020, Brazil
Leandro Alberto Calazans Nogueira Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil

DOI:

https://doi.org/10.1186/s40945-022-00129-2

Keywords:

Musculoskeletal pain, Neuropathic pain, Pain mechanisms, Central nervous system sensitization, Diffuse noxious inhibitory control

Abstract

Background: Musculoskeletal pain patients present similar pain characteristics regardless of the clinical diagnosis. PainDETECT questionnaire is useful for screening neuropathic-like symptoms in many musculoskeletal conditions. However, no previous studies compared pain phenotypes of patients with musculoskeletal pain using the painDETECT. Therefore, the current study aimed to compare the pain characteristics of patients with musculoskeletal pain classified according to the painDETECT as nociceptive pain, unclear, and neuropathic-like symptoms. Methods: A cross-sectional study was conducted in 308 participants with musculoskeletal pain. Demographic and clinical characteristics of the participants were examined. Neuropathic-like symptoms, pain intensity, pain area, Central Sensitization-related sign and symptoms, functional limitation, and conditioned pain modulation were assessed in patients with musculoskeletal pain. Independent one-way analysis of variance (ANOVA) was used to test for between-group differences for the outcome measures with continuous variables and Pearson chi-square test verified between-group differences on the efficiency of the conditioned pain modulation. Results: Participants had a mean age of 52.21 (±15.01) years old and 220 (71.42%) were females. One hundred seventy-three (56.16%) participants present nociceptive pain, 69 (22.40%) unclear, and 66 (21.42%) neuropathic-like symptoms. A one-way ANOVA showed differences for the pain intensity [F (2,305) = 20.097; p < .001], pain area [F (2,305) = 28.525; p < .001], Central Sensitization-related sign and symptoms [F (2,305) = 54.186; p < .001], and functional limitation [F (2,256) = 8.061; p < .001]. However, conditioned pain modulation was similarly impaired among the three groups (X2 = 0.333, p = 0.847). Conclusion: Patients with neuropathic-like symptoms revealed unfavorable pain characteristics compared to their counterparts, including pain intensity, generalized pain, Central Sensitization-related sign and symptoms, and functional limitation.