Question 6 asks about the pain course pattern, scored from −1 to 2, depending on which pain course pattern diagram is selected. BMS-777607 solubility dmso Question 7 asks about radiating pain, answered as yes or no, and scored as 2 or 0 respectively. The final score between −1 and 38, indicates the likelihood of a neuropathic pain component. A score of ≤ 12 indicates that pain is unlikely to have a neuropathic component (< 15%), while a score of ≥ 19 suggests that pain is likely to have a neuropathic component (> 90%). A score between these values indicates that the result is uncertain and a more detailed examination is required to ensure a proper diagnosis ( Freynhagen et al 2006). Since

its development, four additional questions have been added to the painDETECT but do not contribute to the scoring. They ask the patient to rate their pain now and over the last four weeks, and to mark on a body chart if there is pain radiating into other parts of the body. Reliability, validity LY2157299 in vitro and sensitivity to change: There are only a few studies investigating the clinimetric properties of the painDETECT questionnaire and they show it is a good screening tool to detect a neuropathic pain component in patients with low back pain. It has excellent test-retest reliability (ICC = 0.93) and good internal consistency (Cronbach’s alpha > 0.83) ( Freynhagen et al 2006, De Andres et al 2012). The

electronic and paper version of the questionnaire demonstrated high criterion validity, compared to the reference standard of an expert pain physician, indicated by high sensitivity, specificity, and positive predictive value (all > 80%) ( Freynhagen et al 2006). However, when the questionnaire was used in patients with fibromyalgia, criterion validity was not as good (sensitivity 79%, specificity 53% and positive predictive

value 46%, Gauffin et al 2013). This indicates that the questionnaire may not be suited for use in other musculoskeletal conditions. It has been used as an outcome measure but the responsiveness or sensitivity to change has not been assessed. Neuropathic pain is a common clinical presentation that is often under-diagnosed and under-treated. Neuropathic pain is produced by injuries or diseases affecting the somatosensory many system and can manifest in disease states affecting the central and peripheral nervous system (Haanpaa and Treede 2010). Patients with neuropathic pain usually have severe, chronic symptoms that affect their quality of life and are often difficult to manage. This may be due to poor diagnosis or the presence of mixed pain states, ie, neuropathic pain plus nociceptive pain (De Andres et al 2012). Correct identification of neuropathic pain enables a more direct and specialised management strategy for these patients, and screening tools aid in the diagnosis.