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Neuropathic Pain Components Are Common in Patients With Painful Cervical Radiculopathy, but Not in Patients With Nonspecific Neck-Arm Pain

Tampin, Brigitte PhD*,†,‡; Slater, Helen PhD, FACP*,§; Briffa, Noelle K. PhD*

doi: 10.1097/AJP.0b013e318278d434
Original Articles

Objectives: The aim of this study was to investigate, using quantitative sensory testing (QST) parameters and the painDETECT (PD-Q) screening questionnaire, the presence of neuropathic pain (NeP) in patients with unilateral painful cervical radiculopathy (CxRAD) and in patients with unilateral nonspecific neck-arm pain associated with heightened nerve mechanosensitivity (NSNAP).

Methods: All patients completed the PD-Q before QST. QST was performed bilaterally in the maximal pain area and the affected dermatome in 23 patients with painful C6 or C7 radiculopathy and in 8 patients with NSNAP following a C6/7 dermatomal pain distribution.

Results: Patients with CxRAD demonstrated a significant loss of sensory function in mechanical (P≤0.021) and vibration sense (P≤0.003) on the symptomatic side compared with the asymptomatic side in both tested body regions and in the dermatome reduced cold detection (P=0.021) and pressure pain sensitivity (P=0.005), findings consistent with nerve root damage. These sensory alterations in the maximal pain area/symptomatic side are confirmative for the presence of NeP. In contrast to these QST data, only 30% of patients with CxRAD demonstrated a NeP component according to the PD-Q score. In patients with NSNAP, a significant side-to-side difference was demonstrated for warm detection threshold in the dermatome (P=0.030). The PD-Q score indicated that NeP components were unlikely in this group.

Discussion: QST data suggest that NeP is likely to be observed in patients with painful CxRAD, but not in patients with NSNAP.

*School of Physiotherapy, Curtin Health Innovation Research Institute, Curtin University

Departments of Physiotherapy

Neurosurgery, Sir Charles Gairdner Hospital, Perth

§Pain Medicine Unit, Fremantle Hospital and Health Service, Fremantle, WA, Australia

The authors declare no conflict of interest. Supported by the National Health and Medical Research Council (Grant 425560) Canberra, ACT, Australia, Arthritis Australia (Victorian Ladies’ Bowls Association Grant) Sydney, New South Wales, Australia, and the Physiotherapy Research Foundation (seeding grant) Melbourne, Victoria, Australia.

Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website, www.clinicalpain.com.

Reprints: Brigitte Tampin, PhD, School of Physiotherapy, Curtin Health Innovation Research Institute, Curtin University, G.P.O. Box U1987, Perth, WA 6845, Australia (e-mails: bvdh@iinet.net.au; brigitte.tampin@health.wa.gov.au).

Received December 17, 2011

Accepted October 11, 2012

© 2013 by Lippincott Williams & Wilkins