title: Back complaints in older adults: prevalence of neuropathic pain and its characteristics.
abstract: OBJECTIVE
  Neuropathic symptoms are reported in 16-55.6% of patients with back pain. Studies were performed in various populations; however, none focused on older adults. The aim of the study was to assess prevalence of neuropathic pain in older adults with back pain.
  
  
  METHODS
  Prevalence of neuropathic pain, measured with the Dolour Neuropathique en 4 questions (DN4), was assessed in the Back Complaints in the Elders study (Netherlands). Patients (>55 years) consulting their general practitioner with a new episode of back complaints were included. Two DN4-versions were used: one based on interview plus physical examination, the other based on interview alone. In the interview plus physical examination version, patients' and complaint characteristics were compared between groups with different scores (0, 1, 2, 3, and ≥4). The DN4 interview-version compared patients with negative and positive scores.
  
  
  RESULTS
  Of the 261 included patients available for analysis were 250 patients (95.8%) with the DN4 interview plus physical examination, and 259 patients (99.2%) with the DN4 interview. In DN4 interview plus physical examination (N = 250), five patients (2%) scored positive (score ≥4). Higher score was associated with pain radiating below the knee (P < 0.001) and use of paracetamol (P = 0.02). In DN4 interview (N = 259), 29 (11.2%) patients scored positive (score ≥3). Positive score was associated with higher body mass index (P = 0.01), pain radiating below the knee (P = 0.001), and use of paracetamol (P = 0.002).
  
  
  CONCLUSIONS
  In older adults with back pain presenting with a new episode in primary care, prevalence of neuropathic pain is low and seems to be associated with pain radiating below the knee, use of paracetamol, and higher body mass index.
authors.affiliation: Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
authors.forename: Wendy T M
authors.initials: WT
authors.lastname: Enthoven
authors.forename: Jantine
authors.initials: J
authors.lastname: Scheele
authors.forename: Sita M A
authors.initials: SM
authors.lastname: Bierma-Zeinstra
authors.forename: Herman J
authors.initials: HJ
authors.lastname: Bueving
authors.forename: Arthur M
authors.initials: AM
authors.lastname: Bohnen
authors.forename: Wilco C
authors.initials: WC
authors.lastname: Peul
authors.forename: Maurits W
authors.initials: MW
authors.lastname: van Tulder
authors.forename: Marjolein Y
authors.initials: MY
authors.lastname: Berger
authors.forename: Bart W
authors.initials: BW
authors.lastname: Koes
authors.forename: Pim A J
authors.initials: PA
authors.lastname: Luijsterburg
mesh_terms: D000368:Aged; D001416:Back Pain / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009437:Neuralgia / Q000453:epidemiology*; D015995:Prevalence; D011795:Surveys and Questionnaires
keywords: Back Pain; Neuropathic Pain; Older Adults