PainDETECT

Original Editor - Melissa Coetsee

Top Contributors - Melissa Coetsee and Bruno Serra  

Objective[edit | edit source]

PainDETECT was initially developed to be used as a screening tool to detect neuropathic pain components in persons with chronic low back pain[1]. It has however increasingly been applied to other pain conditions. By identifying neuropathic pain components, treatment choices can be directed at targeting more specific pain mechanisms.

Intended Population[edit | edit source]

PainDETECT was initially developed for use in patients with chronic low back pain. One study found that neuropathic pain is the predominant pain mechanism in up to 37% of people with chronic low back pain[1].

The use of the questionnaire has however expanded to other populations/conditions, including[2]:

Although it has not yet been validated for use for all conditions, it can theoretically be used to identify neuropathic pain components in any patient presenting with pain. In conditions for which use has not yet been validated, it is important to incorporate clinical examination and additional screening tools to ensure accurate diagnosis[3].

Method of Use[edit | edit source]

PainDETECT is a simple, easy to use screening questionnaire. The questionnaire consists of 9 items and is completed by the patient (no clinical examination is required)[1][3]. There are 7 weighted sensory descriptor items (never to very strongly) and 2 items relating to spatial and temporal pain characteristics[3]. A total score of 19 or more is indicative of likely neuropathic pain.

Languages: The PainDETECT has been translated and cross-culturally adapted to Dutch, English, Finnish, Japanese, Spanish and Swedish[4].

Evidence[edit | edit source]

Most studies recommend using neuropathic screening tools in conjunction with clinical assessment for accurate diagnosis - especially when the questionnaire is not being used in its original language/context[4]. The reliability and validity varies among different conditions:

  • Low Back Pain: Sensitivity of about 85% and Specificity of 80% in people with chronic low back pain[1].
  • Chronic Pain: PainDETECT has good consistency and test-retest reliability, but shows only moderate sensitivity and low specificity[5]. It may be useful as a screening tool to alert clinicians of the need for further investigation[6].
  • Fibromyalgia: Not as useful in this population group, possible explained by the involvement of altered central pain control. Should only be used in combination with other tools and clinical examination[7].
  • Paediatric pain: Moderate accuracy in identifying predominant neuropathic pain from predominant nociceptive pain[8].
  • Trigeminal Neuralgia: Has limited ability to detect neuropathic pain associated with trigeminal nerve injuries[9] and is only recommended to track treatment outcomes rather than being used as a screening tool for this population[10].

Links[edit | edit source]

English Version of PainDETECT

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 Freynhagen R, Baron R, Gockel U, Tölle TR. Pain DETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Current medical research and opinion. 2006 Oct 1;22(10):1911-20.
  2. ↑ Freynhagen R, Tölle TR, Gockel U, Baron R. The painDETECT project–far more than a screening tool on neuropathic pain. Current medical research and opinion. 2016 Jun 2;32(6):1033-57.
  3. ↑ 3.0 3.1 3.2 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.
  4. ↑ 4.0 4.1 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.
  5. ↑ Timmerman H, Wolff AP, Bronkhorst EM, Wilder-Smith OH, Schenkels MJ, van Dasselaar NT, Huygen FJ, Steegers MA, Vissers KC. Avoiding Catch-22: validating the Pain DETECT in a population of patients with chronic pain. BMC neurology. 2018 Dec;18:1-4.
  6. ↑ König SL, Prusak M, Pramhas S, Windpassinger M. Correlation between the Neuropathic PainDETECT Screening Questionnaire and Pain Intensity in Chronic Pain Patients. Medicina. 2021 Apr 7;57(4):353.
  7. ↑ Gauffin J, Hankama T, Kautiainen H, Hannonen P, Haanpää M. Neuropathic pain and use of Pain DETECT in patients with fibromyalgia: a cohort study. BMC neurology. 2013 Dec;13:1-6.
  8. ↑ Van Orden AR, Hess CW, Mesaroli G, Stinson J, Borsook D, Simons LE. Application of painDETECT in Pediatric Chronic Pain: How Well Does It Identify Neuropathic Pain and Its Characteristics?. The Journal of Pain. 2022 May 1;23(5):51.
  9. ↑ Elias LA, Yilmaz Z, Smith JG, Bouchiba M, van der Valk RA, Page L, Barker S, Renton T. PainDETECT: a suitable screening tool for neuropathic pain in patients with painful post-traumatic trigeminal nerve injuries?. International journal of oral and maxillofacial surgery. 2014 Jan 1;43(1):120-6.
  10. ↑ Klein J, Schackert G. Assessment of the painDETECT questionnaire as a tool for screening and treatment evaluation in trigeminal neuralgia. Principles and Practice of Clinical Research. 2022;8(4).
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