title: What is the evidence that neuropathic pain is present in chronic low back pain and soft tissue syndromes? An evidence-based structured review.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, Miller School of Medicine at the University of Miami, Coconut Grove, Florida, USA; Department of Neurological Surgery, Miller School of Medicine at the University of Miami, Coconut Grove, Florida, USA; Department of Anesthesiology, Miller School of Medicine at the University of Miami, Coconut Grove, Florida, USA; Department of Psychiatry, Miami VA Medical Center, Miami, Florida, USA; State Farm Insurance, Bloomington, Illinois, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Fishbain
authors.forename: Brandly
authors.initials: B
authors.lastname: Cole
authors.forename: John E
authors.initials: JE
authors.lastname: Lewis
authors.forename: Jinrun
authors.initials: J
authors.lastname: Gao
mesh_terms: D059350:Chronic Pain / Q000503:physiopathology*; D019317:Evidence-Based Medicine; D055111:Failed Back Surgery Syndrome / Q000503:physiopathology; D005356:Fibromyalgia / Q000503:physiopathology; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D009140:Musculoskeletal Diseases / Q000503:physiopathology; D009437:Neuralgia / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D010147:Pain Measurement; D015995:Prevalence; D011843:Radiculopathy / Q000503:physiopathology; D012585:Sciatica / Q000453:epidemiology / Q000209:etiology; D017695:Soft Tissue Injuries / Q000503:physiopathology*
keywords: Chronic Low Back Pain; Evidence-Based Structured Review; Leeds Assessment of Neuropathic Symptoms and Signs (LANSS); Neuropathic Pain Diagnostic Questionnaire (DN4); Pain Detect Questionnaire; Prevalence Neuropathic Pain; Soft tissue Syndromes