OBJECTIVE: To evaluate which Korean pain descriptors are frequently used in the patients with neuromusculoskeletal diseases and compare the frequency of Korean pain descriptor according to age, gender, pain pattern and intensity, and clinical diagnosis.METHOD: Two hundreds sixty nine patients with neuromusculoskeletal diseases were enrolled in this study. The patients were asked to fill out a pain questionnaire using Korean. The Korean pain descriptors were collected and classified according to neurophysiological mechanism. The frequency of Korean pain descriptor was analyzed by age, gender, pain pattern and intensity, and clinical diagnosis. They were divided into axial spine and peripheral joint pain group depending on the location of causal disease and shoulder pain descriptors were divided into intra-articular and bursa group.RESULTS: Among 24 Korean pain descriptors, ‘arida’ was the most common pain descriptor, followed by ‘ssusida’ and ‘jjireunda’. When the pain descriptors were classified according to neurophysiological mechanism, superficial somatic pain was the most common, followed by deep somatic pain. There was a significant difference in the frequency of the pain descriptor between axial spine and peripheral joint pain group (p=0.007). The pain descriptor ‘danggida’ was used significantly more in the patients with axial spine pain than peripheral joint pain (p=0.024). However, there was no significant difference in other factors.CONCLUSION: The patients with neuromusculoskeletal diseases expressed their pain using various Korean pain descriptors with stabbing nature and superficial somatic pain. Our results may be helpful to assess and develop a new Korean pain quality measure in the patients with neuromusculoskeletal diseases.
Arthralgia ; Diagnosis ; Humans ; Methods ; Musculoskeletal Pain ; Neuralgia ; Nociceptive Pain ; Sensation ; Shoulder Pain ; Spine ; Subject Headings

Chronic low back pain (CLBP) has become more prominent with globally increasing life expectancy. Its cause is more attributable to degenerative changes than to traumatic lesions. Although the diagnosis of CLBP is recently on higher demand, lack of clinical features and non-informative imaging findings in patients with CLBP are challenging to clinicians to establish the diagnosis. Therefore, understanding of the new concept of pathogenesis, elimination of prejudice, and evidence-based diagnostic steps are required to resolve the question of pain source. Analysis of pain distribution patterns and careful history taking can be utilized as an initial guide to divide CLBP into somatic and radicular pain. Zygapophyseal joint pain and sacroiliac joint pain representing somatic pain can be further investigated using medial branch and sacroiliac joint blocks. However, comparative blocks are essential to decreased false positive rate. Infiltration of a small volume of local anesthetics can increase the specificity of the procedures. Discogenic pain stemming from internal disk derangement can be confirmed by pressure-controlled discography. Automated discography is recommended to provide the constant rate of dye injection with obviating the fluctuation of intradiscal pressure. Evidencebased concept and diagnostic procedures can provide more accurate and efficient methods to establish the diagnosis of CLBP.
Anesthetics, Local ; Diagnosis ; Evidence-Based Medicine ; Humans ; Life Expectancy ; Low Back Pain* ; Nerve Block ; Nociceptive Pain ; Prejudice ; Sacroiliac Joint ; Sensitivity and Specificity ; Zygapophyseal Joint

BACKGROUND: Pain with neuropathic characteristics is generally more severe and associated with a lower quality of life compared to nociceptive pain (NcP). Short form of the Douleur Neuropathique en 4 Questions (S-DN4) is one of the most used and reliable screening questionnaires and is reported to have good diagnostic properties. This study was aimed to cross-culturally validate the Hindi version of the S-DN4 in patients with various chronic pain conditions. METHODS: The S-DN4 is already translated into the Hindi language by Mapi Research Trust. This study assessed the psychometric properties of the Hindi version of the S-DN4 including internal consistency and test-retest reliability after 3 days' post-baseline assessment. Diagnostic performance was also assessed. RESULTS: One hundred sixty patients with chronic pain, 80 each in the neuropathic pain (NeP) present and NeP absent groups, were recruited. Patients with NeP present reported significantly higher S-DN4 scores in comparison to patients in the NeP absent group (mean (SD), 4.7 (1.7) vs. 1.8 (1.6), P < 0.01). The S-DN4 was found to have an AUC of 0.88 with adequate internal consistency (Cronbach's α = 0.80) and a test-retest reliability (ICC = 0.92) with an optimal cut-off value of 3 (Youden's index = 0.66, sensitivity and specificity of 88.7% and 77.5%). The diagnostic concordance rate between clinician diagnosis and the S-DN4 questionnaire was 83.1% (kappa = 0.66). CONCLUSIONS: Overall, the Hindi version of the S-DN4 has good internal consistency and test-retest reliability along with good diagnostic accuracy.
Area Under Curve ; Chronic Pain ; Diagnosis ; Humans ; Mass Screening ; Neuralgia* ; Nociceptive Pain ; Psychometrics ; Quality of Life ; Reproducibility of Results ; Sensitivity and Specificity ; Surveys and Questionnaires

Distinction between neuropathic pain and nociceptive pain helps facilitate appropriate management of pain; however, diagnosis of neuropathic pain remains a challenge. The aim of this study was to develop a Korean version of the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) pain scale and assess its reliability and validity. The translation and cross-cultural adaptation of the original LANSS pain scale into Korean was established according to the published guidelines. The Korean version of the LANSS pain scale was applied to a total of 213 patients who were expertly diagnosed with neuropathic (n = 113) or nociceptive pain (n = 100). The Korean version of the scale had good reliability (Cronbach's alpha coefficient = 0.815, Guttman split-half coefficient = 0.800). The area under the receiver operating characteristic curve was 0.928 with a 95% confidence interval of 0.885-0.959 (P < 0.001), suggesting good discriminate value. With a cut-off score > or = 12, sensitivity was 72.6%, specificity was 98.0%, and the positive and negative predictive values were 98% and 76%, respectively. The Korean version of the LANSS pain scale is a useful, reliable, and valid instrument for screening neuropathic pain from nociceptive pain.
*Cross-Cultural Comparison ; Diagnosis, Differential ; *Diagnostic Techniques, Neurological ; England ; Female ; Humans ; Male ; Middle Aged ; Neuralgia/classification/*diagnosis ; Nociceptive Pain/*diagnosis ; Observer Variation ; Pain Measurement/*methods ; Reproducibility of Results ; Republic of Korea ; Sensitivity and Specificity ; Surveys and Questionnaires ; Symptom Assessment/methods ; *Translating