title: Classifying patients with lumbar spinal stenosis using painDETECT: a cross-sectional study.
abstract: The pathological mechanisms of lumbar spinal stenosis are unclear. Family doctors in the primary care setting may perform medical examinations of patients with lumbar spinal stenosis. Our aim was to use the painDETECT questionnaire to quantify the pathological mechanisms of low back pain and/or leg pain caused by lumbar spinal stenosis.
  
  
  
  We enrolled 102 patients (37 men, 65 women) who had been newly diagnosed with lumbar spinal stenosis at 2 facilities. The patients' conditions were evaluated using the painDETECT questionnaire, Numerical Rating Scale, Roland-Morris Disability Questionnaire, Japanese Orthopaedic Association Back Pain Evaluation Questionnaire, and 36-Item Short-Form Health Survey. The pathological mechanisms of low back pain and/or leg pain caused by lumbar spinal stenosis were classified based on results of the painDETECT questionnaire as nociceptive pain, neuropathic pain, or unclear type of pain (mixed pain). Statistical analyses were performed using the Kruskal-Wallis test. A value of p < 0.05 was considered to indicate statistical significance.
  
  
  
  The mean age of all patients in this study was 70.3 ± 2 years. The male:female distribution was 37:65 (36.3:63.7 %). In all, 72 (70.6 %) patients had chronic pain (duration of ≥3 months), and 30 (29.4 %) had subacute or acute pain (duration of <3 months). The pain was classified as nociceptive in 59 patients (57.9 %), neuropathic in 18 (17.6 %), and unclear in 25 (24.5 %). The neuropathic pain group had a significantly lower quality of life (p < 0.05) than did the other groups.
  
  
  
  Patients with neuropathic back and/or leg pain caused by lumbar spinal stenosis may have lower physical and/or psychological quality of life than patients with such pain caused by other mechanisms.
authors.affiliation: Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan. naotot211@aol.com.|Department of Pain Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan. naotot211@aol.com.|Department of Orthopaedic Surgery, Hoshi General Hospital, Koriyama, Japan. naotot211@aol.com.|Department of Orthopaedic and Spinal Surgery, Aizu Medical Center Fukushima Medical University, Aizuwakamatsu, Japan. naotot211@aol.com.|Department of Orthopaedic Surgery, Fukushima Prefectural Minami-Aizu Hospital, Minami Aizu, Japan. naotot211@aol.com.
authors.forename: Naoto
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Department of Orthopaedic and Spinal Surgery, Aizu Medical Center Fukushima Medical University, Aizuwakamatsu, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Shirado
authors.affiliation: Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.|Department of Orthopaedic Surgery, Fukushima Prefectural Minami-Aizu Hospital, Minami Aizu, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.|Department of Orthopaedic Surgery, Fukushima Prefectural Minami-Aizu Hospital, Minami Aizu, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Mashiko
authors.affiliation: Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, Japan.
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Konno
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007866:Leg; D017116:Low Back Pain / Q000145:classification* / Q000209:etiology* / Q000523:psychology; D008159:Lumbar Vertebrae; D008297:Male; D009437:Neuralgia / Q000209:etiology* / Q000523:psychology; D059226:Nociceptive Pain / Q000209:etiology* / Q000523:psychology; D011788:Quality of Life; D013130:Spinal Stenosis / Q000150:complications* / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: 36-Item Short-Form Health Survey; Cross-sectional study; Japanese Orthopaedic Association Back Pain Evaluation Questionnaire; Lumbar spinal stenosis; Neuropathic pain; Nociceptive pain; Numerical rating scale; Primary care; Roland–Morris Disability Questionnaire score; painDETECT questionnaire