Development and internal validation of an easy-to-use tool for clinical pain assessment. The tool has to be applicable in any clinical practice and without the need for expensive and complicated hospital tools to identify the source of persistent pain after the treatment of cancer.
An adequate selection of physiotherapy treatment for persistent pain after the treatment of cancer, depends highly on the mechanism of the pain. Pain can arise from a damaged nerve or tissue (skin, lymphatic system...). But when pain becomes chronic, alterations to the central nervous system can occur, as regulations of the facilitating and inhibiting mechanisms. These alterations may cause central sensitization pain. The body is now sensitized and cannot distinct harmful from harmless stimuli. Each type of pain requires a specific treatment, therefore identification of the pain mechanism is crucial. Up till now, expensive and complex tests were performed in a hospital setting to determine if a patient suffers from neuropathic, nociceptive or central sensitization pain. This study aims for developping an assessment tool that does not require expensive devices but can be easily performed by any physiotherapist, within the timeframe of a standard consultation.
Study Type
OBSERVATIONAL
Enrollment
92
Easy-to-use screening tool to identify the dominant pain mechanism by using quick clinical tests and compare their accuracy and validity with complicated reference tests.
University Hospital Leuven
Leuven, Belgium
Douleur Neuropathic 4 questions (DN4) questionnaire
Neuropathic pain: pain that arises from a damaged nerve is assessed with a questionnaire (1)
Time frame: 2 minutes
Quantitative sensory testing
Neuropathic pain: pain that arises from a damaged nerve is assessed by measuring thermal thresholds (2)
Time frame: 20 minutes
Pain mapping
Neuropathic pain: pain that arises from a damaged nerve is assessed by painting affected areas on a body chart (3)
Time frame: 1 minute
Central Sensitization Inventory (CSI) questionnaire
Central sensitization pain: pain caused by changes in the central nervous system is assessed with a questionnaire (1)
Time frame: 5 minutes
Conditioned pain modulation
Central sensitization pain: pain caused by changes in the central nervous system is assessed with a thermal test (2)
Time frame: 10 minutes
Temporal summation
Central sensitization pain: pain caused by changes in the central nervous system is assessed with a series of touch stimuli (3)
Time frame: 2,5 minutes
Diffuse pain
Central sensitization pain: pain caused by changes in the central nervous system is assessed by painting affected areas on a body chart (4)
Time frame: 0,5 minute
Manual palpation
Central sensitization pain: pain caused by changes in the central nervous system is assessed by applying pressure with manual palpation (5)
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Time frame: 3 minutes
Evaluation of skin
Nociceptive pain: pain that arises from a damaged tissue is assessed by visual evaluation of the skin condition (1)
Time frame: 20 seconds
Lymphedema
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the presence of lymphedema by measuring the circumference of the arm (2)
Time frame: 4 minutes
Joint pain
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining if several joints are sore, especially in the morning (3)
Time frame: 30 seconds
Active mobility
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the movements the patient can perform (4)
Time frame: 2,5 minutes
Passive mobility
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the movements the clinician can perform on the patient (5)
Time frame: 3,5 minutes
Strength
Nociceptive pain: pain that arises from a damaged tissue is assessed by the strength the patient can perform in a specific movement (6)
Time frame: 1,5 minutes
Scar tissue
Nociceptive pain: pain that arises from a damaged tissue is assessed by examining the elasticity of the scar tissue by manual palpation of the clinician (7)
Time frame: 2 minutes
Axillary web syndrome
Nociceptive pain: pain that arises from a damaged tissue is assessed by visually examining the presence of lymph cords in the axilla (8)
Time frame: 2 minutes
Pain catastrophizing scale
Pain catastrophizing scale
Time frame: 6 minutes
Depression, anxiety and stress
Depression Anxiety and Stress Scale (DASS-21)
Time frame: 7 minutes
Pain Self-efficacy and Expectations: questionnaire
Pain self-efficacy and expectations questionnaire
Time frame: 5 minutes
Pain character: questionnaire
McGill Pain questionnaire
Time frame: 4 minutes
Pain disability: Pain Disability Index
Pain Disability Index
Time frame: 3 minutes
Pain intensity: Visual Analogue Scale
Visual Analogue Scale at the moment, worst and least pain during the past week
Time frame: 1 minute
Pain questionnaire
Brief Pain Inventory
Time frame: 30 seconds