Leeds Assessment of Neuropathic Symptoms and Signs (LANSS)

Original Editor - Melissa Coetsee

Top Contributors - Melissa Coetsee  

Objective[edit | edit source]

The LANSS was developed to provide a simple clinical tool that can be used to identify pain of predominantly neuropathic origin, thus distinguishing between neuropathic pain and nociceptive pain[1]. By identifying neuropathic pain mechanisms, more individualised treatment can follow. The LANSS was developed in 2001, and a self-report version, the S-LANSS was developed in 2005[2].

Intended Population[edit | edit source]

The LANSS can be used in any patient presenting with chronic pain. Conditions that often have a neuropathic component include:

  • Human Immune-deficiency virus (HIV)
  • Phantom limb pain
  • Cancer
  • Diabetic neuropathies
  • Peripheral neuropathies
  • Central nervous system lesions (stroke, multiple sclerosis, spinal cord injury)
  • Complex regional pain syndrome
  • Chronic low back pain

Method of Use[edit | edit source]

LANSS: Contains 5 symptoms items and 2 clinical examination items[1]. For the clinical examination, a cotton wool and 23 gauge needle is required. A score of 12 or above is indicative of predominantly neuropathic pain.

S-LANSS: A 7-item self-reported questionnaire without a clinical assessment component. It's accuracy is slightly improved when used in an interview format (rather than self-completed)[2].

Evidence[edit | edit source]

Although some studies report good psychometric properties for the LANSS, a systematic review concluded that only the specificity of the LANSS is satisfactory[3]. It is important to consider clinical judgement and clinical findings in combination with screening tools - screening tools fail to identify about 10-20% of patients with neuropathic pain[4].

LANSS[edit | edit source]

The LANSS has been tested and validated in several settings/conditions (including cancer pain and chronic low back pain)[4]

  • Sensitivity: Ranges from 82-91%[4]
  • Specificity: Ranges from 80-94%[4]

S-LANSS[edit | edit source]

  • Internal consistency and convergent validity was demonstrated with its development[2]
  • Sensitivity: Ranges from 52-78%[2][5]

Additional Languages[edit | edit source]

  • Turkish: The Turkish translation of the S-LANSS has been validated for use[6]
  • Greek, Portuguese, Spanish, Korean and Brazilian Portuguese versions have also been developed and tested in single studies - overall the psychometric properties of the translated versions were less than for the original versions[7].

Links[edit | edit source]

LANSS Pain Scale - English

S-LANSS Pain Score - English

References[edit | edit source]

  1. 1.0 1.1 Bennett M. The LANSS Pain Scale: the Leeds assessment of neuropathic symptoms and signs. Pain. 2001 May 1;92(1-2):147-57.
  2. 2.0 2.1 2.2 2.3 Bennett MI, Smith BH, Torrance N, Potter J. The S-LANSS score for identifying pain of predominantly neuropathic origin: validation for use in clinical and postal research. The Journal of Pain. 2005 Mar 1;6(3):149-58.
  3. Mathieson S, Maher CG, Terwee CB, De Campos TF, Lin CW. Neuropathic pain screening questionnaires have limited measurement properties. A systematic review. Journal of clinical epidemiology. 2015 Aug 1;68(8):957-66.
  4. 4.0 4.1 4.2 4.3 Bennett MI, Attal N, Backonja MM, Baron R, Bouhassira D, Freynhagen R, Scholz J, Tölle TR, Wittchen HU, Jensen TS. Using screening tools to identify neuropathic pain. Pain. 2007 Feb 1;127(3):199-203.
  5. Weingarten TN, Watson JC, Hooten WM, Wollan PC, Melton III LJ, Locketz AJ, Wong GY, Yawn BP. Validation of the S-LANSS in the community setting. Pain. 2007 Nov 1;132(1-2):189-94.
  6. Koc R, Erdemoglu AK. Validity and reliability of the Turkish Self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire. Pain Medicine. 2010 Jul 1;11(7):1107-14.
  7. Fagbohun TR. Systematic Review on the psychometric, reliability and validity properties of translated neuropathic pain screening tools (DN4, LANSS and PDQ) 1 January 2005 - 19 July 2019. International Journal of Medicine and Medical Research. 2021;7(1):51-67.